rp21 situational analysis - Pacific Health Voices

Situational analysis of drug and alcohol issues and responses in the Pacific
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9.4 Licit drug trends
Alcohol
In contrast to other PICTs, Palau’s drinking
culture is reported to be shaped by a cash
economy and imported alcohol, and not
dominated by ‘toddy’ or homebrew to the
same extent as elsewhere. 526 However, Palau
is similar to many other PICTs in that it involves
bars, house parties and car parties, at
which both men and women participate. In
contrast to daily life, alcohol consumption is
an opportunity for egalitarianism, with participants
referring to one another as sechelik
(my friend) rather than usual ranks in the
hierarchy. 527
The 2009 Epidemiological Profile of Use/
Substance Abuse Patterns in the Republic of
Palau noted 2006 household expenditure in
the range of 3.1 per cent and 5.6 per cent
on alcohol, tobacco and betel nut depending
on region (highest in Kayangel/Angaur and
lowest in Koror). This represents an overall
household expenditure slightly more than
half what is spent on health, personal care,
education and personal services combined.
For some regions, more was spent on alcohol,
tobacco and betel nut than the above
services. 528 The same data also show tobacco
in dollar terms is by far the most significant
proportion of this category of expenditure
followed by betel then alcohol, with Koror 529
providing the exception where expenditure
on alcohol almost equals that on tobacco.
Alcohol is identified as a key substance of
concern in Palau with alcohol-related death
from accident, injury, motor vehicle accidents,
suicide and chronic disease all identified as a
concern in the 2009 epidemiological profile
of substance use. 530 The highest of these
was 28 per 100 000 deaths from chronic
alcohol-related disease which has been the
main reported contributor every year since
2001. 531 However, the epidemiological profile
rightly notes limitations of the data in
that the figures do not reflect alcohol- and
other substance use-related morbidity and
other social consequences of use. By way of
example, arrests were one of the few identified
indicators for drink-driving in Palau but
the accuracy of data is limited in a small
island population where police are known to
exercise significant discretion. The Council on
Substance Abuse Prevention reports that at
times police will intervene to prevent intoxicated
people driving home, often impounding
cars and driving them home themselves. 532
This is a pragmatic and laudable approach,
but this intervention masks the true extent
of the problem.
526 P.W. Black (1998), Music and Ingested Substances: music and alcohol on Palau and Tobi. In
The Garland Encyclopedia of World Music, vol.9: Australia and the Pacific Islands. New York:
Routledge; this term needs an explanation.
527 Ibid.
528 Above, fn.509.
529 70 per cent of the population of Palau is reported to live on the island of Koror.
530 Above, fn.509.
531 Ibid.
532 Above, fn.517.