Fact check: only drugs and alcohol together cause violence

On ABC TV’s Four Corners program last night, Paul Nicolaou, chief executive officer of Australia Hotels Association New South Wales, dismissed claims that alcohol is fuelling late-night violence, arguing instead that it’s a mixture of drugs and alcohol that’s causing the problem.

The argument that illicit drugs rather than alcohol consumption are the key contributors to night-time violence is commonly made. There is research evidence against this claim at several levels.

When expert pharmacologists are asked to compare the inherent dangerousness of drugs, alcohol ranks very high. In one study published in The Lancet in 2010, the consensus was that alcohol was the most dangerous of drugs. This was partly due to the amount of harm experienced by those other than the drinker (the rankings are reproduced here).

Concerning violence in particular, a review of the role of different drugs in inducing violence noted that alcohol was “by far the drug most likely to be associated with heightened likelihood of interpersonal violence”.

Summarising the relationships found in population studies, a World Health Organization report concludes that “studies increasingly highlight the role of alcohol consumption in people becoming victims of violence and perpetrators of violence”.

In Australian studies, alcohol is considerably more likely than other drugs to be involved in violence.

First of all, alcohol intoxication is simply more common than illicit drug use. A recent large-scale study interviewed nearly 4,000 people visiting licensed venues in Geelong and Newcastle. This study found that 7% reported any illicit drug use (most commonly cannabis), while two-thirds reported drinking alcohol even before arriving at a licensed venue.

More importantly, specific studies of violence and injury typically find alcohol involvement more than twice as often as drug involvement.

Data from the Drug Use Monitoring in Australia program shows that alcohol is responsible for around three times as much violent offending as all illicit drugs combined (33.6% vs 12.4%).

Similarly, the National Homicide Monitoring Program shows high levels of alcohol involvement in violent deaths. Homicide offenders were over twice as likely to have been drinking prior to their offence than to have been using drugs.

These findings are further supported by surveys of crime victims. In the National Drug Strategy Household Survey, 8.1% of Australian adults reported being the victim of an alcohol-related assault. The corresponding figure for illicit drugs was just 2.2%.

And unpublished data from the Personal Safety Survey found that 85% of assaults attributed to substance use were alcohol-related (with the other 15% linked to illicits).

Alcohol plays the leading role in violence among drugs in Australia both because of its pharmacological properties and because it is so available and commonly used. Attempts to get alcohol off the hook by pointing elsewhere are not supported by the science.

Michael Livingston supported by the National Health and Medical Research Council Early Career Fellowship. He also receives funding from the Foundation for Alcohol Research and Education (FARE), an independent, charitable organisation working to prevent the harmful use of alcohol in Australia (www.fare.org.au).

Robin Room does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.