Alcohol law enforcement the answer to dangers, says expert

Government’s alcohol ban during lockdown, which aimed to reduce the heavy burden on the healthcare system, not only reduced levels of trauma patient intakes at hospitals, but also helped “dramatically drop” injury-induced mortality and violent crime.

Public health expert Prof Sue Goldstein from the University of Witwatersrand said although the ban helped improve crime statistics, it was important to note that over a longer period of time, it increased illegal alcohol sales and also affected those who made a living from the sales.

Goldstein said South Africa did not have to implement new laws or change the laws it already had, but rather needed to be firm on its policies in order to change the country’s drinking habits and decrease harmful drinking.

The “Alcohol, violence and injury-induced mortality: evidence from a modern-day prohibition study”, which evaluated the impact of the unexpected nationwide alcohol ban, found the policy causally reduced injury-induced mortality by at least 14%, and 21.99 deaths per day.

“Our main result is that the alcohol ban reduced the number of people dying from unnatural causes in South Africa by at least 120 per week,” the study noted.

“This reflects the lowest estimate of the effect size that we obtain across a range of different empirical specifications.”

The analysis also showed the reduction in mortality was almost entirely confined to men. “Approximately 78% of the over 150 000 deaths from unnatural causes recorded in our dataset between 2017 and 2019 were males,” the study read.

“This pattern is not unique to SA, for example, Gawryszewski and Rodrigues [2006] describe the gender distribution of injury-related mortality in Brazil in 2003 and show that 84.3% of the people that died from injury-related causes were men.”

The impact of the alcohol ban on the subpopulation of people between the ages of 15 and 34 years showed young adults were “typically more likely to engage in risky behaviour such as risky drinking”.

However, Goldstein said if South Africans stopped glorifying alcohol with adverts and promotions, then people could change the culture of drinking.

“We need to monitor and enforce the laws that already exist. We know the law currently is that you’re not supposed to drink if you’re under 18, you’re not even supposed to be in a place that sells alcohol if you’re under 18.

“There isn’t an enforcement process and communities aren’t able to go to a government alcohol policy website to report an illegal outlet which could help stop underage drinking as well.”

The study by substance abuse epidemiologist and policy analyst Prof Charles Parry showed a tight link between alcohol and aggressive behaviour, the harm alcohol could cause and pointed towards a role for policy measures which targeted the heaviest drinkers in society.

Dr Erica Munnik, clinical psychologist from the department of psychology at the University of the Western Cape, said alcohol increased agitation and violent behaviour as it often affected the way people thought.

Many were passive-aggressive when intoxicated because they had difficulty concentrating, processing before reacting and logical reasoning was also affected.

“Alcohol use is top of what we call comorbid, so you get alcohol use and then you get either depression or impulsive behaviour and even anxiety,” she said.

“So alcohol helps the individual [from their perspective] to view more effectively whatever they are facing. But in reality, it affects judgment and affects insight.”

Meanwhile, following the Enyobeni Tavern tragedy, the Southern African Alcohol Policy Alliance called on President Cyril Ramaphosa to commit to a number of alcohol-related regulatory changes.

The president has said increasing the age limit, reducing hours of trade, raising the tax on alcohol and limiting advertising should all be considered as possible interventions to reduce the negative impact of harmful drinking.

The civil society group said the temporary restrictions put in place to manage Covid demonstrated that strengthened legislation was effective in reducing harmful drinking, calling for a permanent legislative change and “not reactive temporary measures that don’t deal with social challenges effectively and consistently”.

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