current evidence evaluated
February 2008 ISSN 1832-6013
Prevention of harm
from alcohol consumption
in rural and remote
Prevention Research Quarterly: Current evidence evaluated
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Prevention of harm from
alcohol consumption in rural
and remote communities
Issues Paper no. 4 1
Reading and Resource List no. 22 15
No. 4 • February 2008
Prevention of harm from
alcohol consumption in rural
and remote communities
Mr Ged Dibley, PDF Management Services
Alcohol consumption is part of daily life in rural and
remote Australia: celebrating with friends; drinking
with a meal; or just relaxing at the end of a hard day’s
work. Many people use alcohol responsibly and for
them drinking alcohol is a pleasurable and arguably
safe activity that does not lead to harm.
However, the short-term harms that can result
from alcohol consumption are well documented.
For individuals there are acute health risks, such as
alcohol poisoning, motor vehicle accidents, falls and
other injuries and the risk of physical or sexual assault.
Chronic health consequences include liver cirrhosis,
cancer, mental health and acquired brain injury,
irreversible nerve damage and premature death.
Major social consequences may also include
family breakdown, domestic violence, crime and
public violence, property damage and decreased
workplace productivity through absenteeism and
Research tells us that:
◗◗ the extent of alcohol consumption, particularly
at risky levels, is disproportionately higher in rural
and remote regions of Australia (Strong et al.
◗◗ services and systems that might otherwise prevent
or reduce harm from alcohol consumption are less
readily available in rural and remote communities
◗◗ in recent times, in particular, rural communities are
feeling the social and economic pressures of the
drought (Stehlik, Gray & Lawrence 1999).
The purpose of this paper is to:
◗◗ provide a description of some of the issues facing
rural and remote communities around Victoria in
relation to alcohol-related harms; and
◗◗ explore the range of practical prevention and early
intervention strategies available to them to prevent
and reduce such harms.
The paper draws on recent literature on the subject
and is also informed by input and advice from people
actively working to reduce alcohol and other drugrelated
harm in rural and remote areas across Victoria.
For simplicity, the term “rural” is used in this paper to
refer to non-metropolitan areas of Victoria, that is,
population centres of less than 100 000 people, and
includes remote areas.
The diversity between rural areas in terms of
demographic, socioeconomic, aspirational and many
other factors means that general statements should
be treated with caution and any local action should
be underpinned with local analysis and consultation.
Alcohol consumption and
harm in rural Victoria
As stated above, the extent of alcohol consumption,
particularly at risky levels, is disproportionately higher in
rural and remote regions of Australia, including Victoria.
In rural and remote regions, the consumption of high
levels of alcohol by men is inversely proportional to
the size of the population, ranging from 5% of men
in a large rural centre to 8% in remote areas with less
than 5000 people. The consumption of high levels of
alcohol by women does not follow the same linear
pattern seen for men, with increased levels of high
alcohol consumption by women seen only for small
rural centres and in remote areas with less than 5000
Issues Paper | No. 4 | February 2008
people. These areas show a doubling of the proportion
of women consuming high levels of alcohol (2.4%
and 2.1% respectively) compared to capital cities
(1.2%; Strong et al. 1998).
The incidence of alcohol-related harm is frequently higher
across a range of indicators such as: alcohol-related
assaults, family violence incidents and serious road
injuries. In Table 1 the regional rates are generally higher
than the figure for Victoria for these indicators and two
regions stand out as significantly higher in relation to
“deaths”. The figures for these indicators also vary for
local government areas within regions, and vary again at
the township or small area level within municipalities, so
that there are some small towns with rates far in excess
of the figure for Victoria or for their region.
Some population groups in rural areas also emerge
as being at greater risk of harm from alcohol
consumption. Young people, in particular (including
underage drinkers), living in regional Victoria
routinely drink at levels that put them at a high risk
of harm compared with those in metropolitan areas.
For example, 43% of young people living in nonmetropolitan
Melbourne consumed 20 plus drinks in
one day at least once in the past 12 months, compared
to 37% of those from metropolitan areas. Figure 1
shows the higher prevalence among young men.
Seventeen per cent of young people living in nonmetropolitan
areas of Melbourne (compared to 13% of
young people living in metropolitan areas) consumed
20 plus drinks in one day, monthly or more frequently
(Victorian Premier’s Drug Prevention Council 2005).
Table 1: Incidence of alcohol-related harm from 2002/03–2003/04
Health region Assaults* Family
Barwon South West 10.29 17.96 2.84 22.70 1.84
Grampians 12.83 20.91 3.89 18.95 1.27
Loddon Mallee 11.16 22.12 3.31 19.97 1.28
Hume 10.94 22.96 3.67 19.21 1.35
Gippsland 15.59 24.22 3.78 22.06 1.93
Victoria 9.65 15.80 3.42 26.92 1.49
*Rates are annual per 10 000 population. Source: Laslett, Dietze & Matthews 2005.
Figure 1: Consumption of 20+ standard drinks in one day during last 12 months
Source: Victorian Premier’s Drug Prevention Council 2005.
2 Prevention of harm from alcohol consumption in rural and remote communities
Figure 2: Major contributors to harm from alcohol consumption
• High numbers of outlets:
– licensed premises
– bottle shops and other liquor stores
• Ready availability in outlets
– longer opening hours
– irresponsible serving
– underage access
• Drinking in public places condoned
• Inappropriate advertising
• Low prices
• High strength
risky and high
• Wide acceptance of alcohol:
– to celebrate
– to commiserate
– to relax
• Social pressure
– to join in
• People from rural and regional areas
• Young people
• People with mental health problems
• Homeless people
• Public violence
• Accident victims
• Property damage
• Family violence and breakdown
• Decreased workplace productivity
• Costs to the community of acute and chronic
• Costs to the community of related crime and
other social impacts
Individual harms to users
• Acute health risks, such as alcohol poisoning
• Motor vehicle accidents
• Falls and other injuries
• Physical or sexual assault risk
• Disrupted education and training
• Chronic health risks, such as liver cirrhosis,
cancer and irreversible brain damage
• Premature death
*Current Australian Alcohol Guidelines that define alcohol consumption risk are available
from www.alcoholguidelines.gov.au. These are periodically revised and updated.
Adapted from Dibley 2007.
Based on these statistics, it would be easy to focus
solely on young people or some other specific
population groups. However, it is important to
recognise the risks of harm from alcohol consumption
across the entire population and respond with broad
based strategies as well.
Factors influencing harm
from alcohol consumption
The factors that contribute to harm from alcohol
consumption are very complex. One way of thinking
about it is to consider the “supply side” (the factors
that result in alcohol being readily available to
consumers) and the “demand side” (the factors
that are more likely to draw people into patterns of
harmful drinking). Figure 2 illustrates these broad
factors and the harms that can result.
Geographical location can clearly influence these
factors. This influence will vary between locations and
will potentially differ depending on the prevailing
culture regarding alcohol consumption.
Supply side factors in rural communities
There are major strategies designed to control or
manage the supply of alcohol at a national and/or
statewide level. This includes measures such as:
◗◗ border controls, which limit what alcohol gets into
◗◗ high level policies, laws and regulations regarding
availability, strength and advertising
◗◗ taxes and excise, which impact on price (Loxley et
◗◗ social marketing and media campaigns aimed at
promoting responsible use.
Issues Paper | No. 4 | February 2008
Broadly speaking, the reach of these is reasonably
uniform regardless of geographical location.
Shortcomings in communication systems, however,
might limit coverage for some media campaigns,
particularly television and more recently the Internet.
There are nonetheless, local supply side factors
that will vary between locations. Primarily these are
concerned with licensing (including distribution) and
For example, research indicates that the level of outlet
density is highly predictive of alcohol-related harm
(Loxley et al. 2004). Rural Victoria has significantly
more licensed premises per head of population than
Victoria as a whole (Table 2).
Again, these figures are calculated across a region,
which means that for some municipalities and some
townships, the outlet density is higher still. In some
areas this increased outlet density may be connected
to tourism and hospitality operations. Nonetheless,
the increased availability is likely to impact adversely
on visitors and local residents.
Enforcement at a local level falls predominantly to
local policing and to an extent the social support and
cooperation of the community.
Demand side factors in rural communities
As with supply side factors, there are many national
and statewide policies and strategies aimed directly
at reducing demand for alcohol, for example through
education, and health promotion.
Factors influencing demand in rural communities are
numerous and might include:
◗◗ diverse impacts of social isolation, such as
loneliness and boredom
◗◗ infrastructure limitations, such as access to
facilities and transport
◗◗ individual, family and community stresses, such as
drought or bushfires.
The potential for social isolation will vary enormously
between townships and will also reflect diverse
individual needs. However, individuals in rural
communities are at greater risk of social isolation
given the barriers involved in getting together with
others—distance, transport, time and cost.
Small, sparsely distributed populations and a smaller
pool of people can mean more pressure to “fit in”.
The consequences of this social isolation are complex
and broad. For some, it might lead to the solitary
consumption of alcohol for company or solace.
For others, it might mean that getting together, on
whatever basis, is ample cause for celebration. This
can be accompanied by a view that opportunities
should not be squandered and events should
be memorable—buoyed by sometimes excessive
consumption of alcohol. This may be reinforced by
the seasonal nature of some rural activities or the
influxes of visitors in the holiday season in some areas.
Table 2: Number of licensed premises per head of population
Health region Outlet density* Variation †
Barwon South West 39.29 +5.48
Grampians 48.68 +14.87
Loddon Mallee 47.83 +14.02
Hume 59.72 +25.91
Gippsland 44.63 +10.82
*Number of licensed premises per 10 000 population.
†Variation in comparison to Victorian figure.
Source: Laslett, Dietze & Matthews 2005.
4 Prevention of harm from alcohol consumption in rural and remote communities
Examples include annual events like harvest or
bachelor and spinster balls, but also include more
regular interaction around local sporting clubs.
Research suggests alcohol has been a major part of
country sports clubs. Football clubs and, to a lesser
extent, cricket clubs and bowls clubs have been
associated with a culture of excessive and unsafe
drinking (Snow & Munro 2000).
Higher consumption of alcohol in rural areas and
even binge drinking can often be associated with
values of “self-reliance”, “hardiness” and “mateship”
(Dunn 1998). It can be regarded as a reward for hard
work or consolation for hard times.
There is often limited access to suitable
entertainment, recreation and sporting facilities in
many rural areas—with local pubs becoming the
major social hub.
This lack of facilities is felt particularly strongly by
young people. The view that “there’s nothing to do”
for young people, it is often associated with boredom
which may lead to a greater propensity (traditionally
among young men) to drink large quantities of
alcohol, resulting in feelings of alienation and
marginalisation making them more vulnerable to
depression and suicide (Patterson & Pegg 1999).
The lack of leisure facilities for rural people and
young people in particular is often compounded by
a lack of transport options and lower road quality.
For example, transport availability and ease of travel
would enable young people in small country towns
to access more entertainment facilities in the nearest
Individual, family and community stresses
It is well documented that people who live in rural
and remote Australia experience many health
disadvantages when compared to their urban
counterparts. This is demonstrated by higher
morbidity and mortality rates, with health worsening
the further one travels away from urban areas
In addition, access to employment and education is
limited compared with urban areas (Strong et al. 1998).
In recent years, drought conditions in many parts of
Victoria have disrupted rural enterprises, sometimes to
the point of collapse. This has resulted in pressure on
family finances and subsequently on local economies.
In addition, calamities such as bushfires and floods
have cut deep into personal and community resilience.
Cases of mental illness and suicide have consequently
been on the increase in rural areas. Alcohol
consumption has been identified as a major risk factor
for suicide, particularly when it occurs in association
with other risk factors (De Leo et al. 1999).
The challenge of reducing harm
from alcohol consumption
The capacity of rural communities to respond to
the challenges presented by the harms from alcohol
consumption varies considerably. In general, rural
areas are socioeconomically disadvantaged compared
to metropolitan areas (see population-weighted
socioeconomic indexes for areas in Laslett, Matthews
& Dietze 2006).
This means lower revenue bases for local councils to
draw on and less disposable income for residents to
contribute to community initiatives or meet the costs
associated with accessing services themselves.
Of course, many programs and services tackling
prevention and early intervention of alcohol-related
harm in rural and remote areas are provided by way
of federal or state funding. However, geographical
location has a significant impact on the capacity for
delivery. Services can be restricted by:
◗◗ Difficulties recruiting and retaining suitable
There is a recognised global shortage of health
professionals. The shortage of nurses for example
is being felt around Australia and is most
pronounced in rural and remote areas.
Funding uncertainty, inadequate information
and management systems, lack of professional
supervision, limited access to further training and
professional development are commonly reported
and lead to stress and burnout among rural and
remote alcohol and other drug practitioners.
In the absence of specialised practitioners,
considerable pressure is placed on law enforcement
officers, welfare workers, youth workers and
teachers who frequently deal with alcohol and
other drug related problems in their daily work.
Issues Paper | No. 4 | February 2008
◗◗ The need to travel considerable distances to
For service providers, this translates as higher
costs per client contact and less client contact
time. Conversely the need for clients to travel
considerable distances to access services brings
with it ongoing transport pressures for clients and
is a barrier to seeking assistance.
◗◗ Client concerns regarding confidentiality and
Concerns regarding confidentiality and anonymity
often occur in small “close-knit” communities
in which most people know or recognise each
other. This means attending health services may
not go unnoticed. This is exacerbated by the lack
of transport options to visit larger regional or
◗◗ The lack of early intervention, treatment and
There is a lack of detoxification and rehabilitation
services for young people in some rural areas,
which means that services based in larger regional
or metropolitan centres are the only option—
isolating clients from their families and existing
◗◗ Responding to clients with dual diagnosis
There are strong links between alcohol and other
drug use and some forms of mental illness,
particularly depression and anxiety. In areas where
specialist services are limited, “bouncing around
the service system” on the basis of diagnosis fit
can be a serious risk.
Taking up the challenge
Research tells us that prevention strategies at the
community level are a key ingredient to enabling
change to occur (Loxley et al. 2004). This is because
many of the factors influencing harm from alcohol
can be affected by locally driven regulation and
enforcement, social marketing, service provision,
advocacy and planning.
Despite the challenges, there are many features of
rural areas that lend themselves to tackling issues of
this kind. For example, a small “close-knit” community
may raise concerns for confidentiality and anonymity
but it might also mean strong partnerships can be
developed based on interpersonal relationships,
good will and a shared vision. A willingness to
respond with flexibility (and sometimes outside
the strict parameters of what might be regarded
as core business) is often required in less well
Many active community members are also likely
to have multiple roles, sitting on professional and
community organisations, for example, being a
member of the community health agency and a
member of the football and netball club. This can
fast-track communication and consultation; speed up
decision-making and action; and mobilise strategies
that span different settings.
A “close knit” community can also mean behaviours
that might otherwise escalate unobserved are
picked-up early enough for timely and effective
intervention. For example, the preservation of close
family relationships in rural areas can offer timely
or early motivational intervention and support for
a family member engaging in risky levels of alcohol
There are many people and organisations in any rural
community whose work or other roles means that
they might be interested in preventing harm from
alcohol consumption. Examples include:
◗◗ Local councils
◗◗ Government and non-government community
◗◗ General practitioners
◗◗ Primary care partnerships
◗◗ Residents groups
◗◗ Traders and business associations
◗◗ Community development and health promotion
◗◗ Alcohol and other drug workers
◗◗ Youth workers
◗◗ Primary health care practitioners
◗◗ School health nurses
◗◗ Indigenous workers
◗◗ Cultural and Linguistic Diversity workers
◗◗ Sporting clubs
◗◗ Social groups of various kinds.
6 Prevention of harm from alcohol consumption in rural and remote communities
Many are already actively involved with the health
and wellbeing of the community, which means
they have many areas of interest that overlap with
prevention of harm from alcohol consumption.
Some of these people may be in a position to take
on a leadership or coordination role, others may be
able to assist with information and training, while
others may simply support local initiatives through
advocacy within their specific local interest group.
Local councils already significantly influence the
impact of alcohol consumption on their communities
(King & Richards 2003). This includes measures
that impact on the entire population, for example,
public space strategies and regulations and targeted
strategies intended for those groups within the
community who may be more vulnerable to harm
from alcohol consumption, such as maternal and
child health programs or youth services.
Prevention and early
The Monograph, Prevention of substance use, risk
and harm in Australia: A review of the evidence
(Loxley et al. 2004), provides a valuable resource in
examining numerous types of prevention strategies
for their effectiveness.
This research suggests that some strategies designed
to reduce harm from alcohol consumption are
demonstrably more effective than others. This includes
effective and timely early intervention responses. Of
particular interest for rural areas are also prevention
strategies designed to regulate the physical availability
of alcohol, modify the drinking context and work with
communities, homes, schools and workplaces.
Some ways in which rural communities in Victoria have
responded to the challenge of reducing harm from
alcohol consumption are set out in Table 3. Importantly,
the evidence strongly indicates that integrated
and collaborative responses that span regulation,
enforcement, social marketing, service provision and
advocacy are generally more effective in achieving
sustainable change than isolated and one-off activities.
Table 3: Some ways in which rural communities in Victoria are attempting to reduce harm from
Regulatory and enforcement
Limiting the number of local
“No drinking” areas or
Enforcement of liquor
Enforcement of drink driving
Members of the community may object to the granting of a liquor licence if they believe that the
amenity of the area will be adversely affected.
For more information see the Objections to Liquor Licensing Applications fact sheet (PDF,
Alcohol free zones may be prescribed under local laws or may be instigated by event organisers.
This can result in more family-friendly social events.
For example, the City of Shepparton maintains an alcohol ban zone for the annual Springcar
Nationals auto show which attracts tens of thousands to the regional centre. Shortly after that
event, the nearby Numurkah community also runs the popular Showusyarwheels as a “strictly
no alcohol” event.
Enforcement is not just responding to breaches. Liquor licensing forums and accords in local
communities bring together police, licensees, local government and community representatives
to proactively improve compliance with regulations (for example, ensuring easy access to
responsible serving of alcohol training) and also improve community safety (see case study
on page 12).
Random breath testing at particular times of the year (for example, holiday periods) or during
particular events and locations provides an important means to influence driver behaviour.
Designated driver programs, including where water and soft drink are provided free by the
licensee, provide strong support to reducing drink driving.
Issues Paper | No. 4 | February 2008
Regulatory and enforcement
for minor alcohol-related
Implementation of a banned
An example of this kind of strategy is Your Choice, a program developed by Victoria Police aimed
at tackling underage drinking. When apprehended by a police officer or a council local laws
officer, offenders can either formally commit to attending a responsible drinking seminar with a
parent or be issued with an infringement notice.
A lockout at hotels and clubs can be used to curb antisocial late night behaviour. It might be
informally agreed through an accord or forum or enforced through the Director of Liquor
Licensing. Under a lockout, patrons are not able to enter premises after a specified time
(for example, 3 am) They can leave at any point before closing time but will not be readmitted.
Identification of individuals with a history of antisocial behaviour occurs at times through alcohol
accords or forums.
Developing a united approach among members, a banned persons list means that a consistent
message is conveyed to both the individual and to others in the community.
Advocacy and community programs
Local plans to reduce harm
from alcohol consumption
Local networks or
Community renewal and
social connection programs
Local area drug and alcohol plans are effective in bringing together key stakeholders, such
as local council, alcohol and other drug services, police, and community representatives
to address local alcohol issues. A formal planning process enables integrated action to be
agreed at a “whole of community” and population group level.
Plans can be developed between agencies and across council boundaries. See, for example,
the Glenelg and Grampians Drug Action Plan (www.sthgrampians.vic.gov.au/Page/Download.
In some instances other formal plans may deal with alcohol. For example, local council Municipal
Public Health Plans or Community Safety Plans often deal with alcohol issues as health and
wellbeing matters or because of the safety risks experienced by both those drinking and those
in the vicinity.
Local networks or partnerships may emerge from formal planning approaches as described
above and meet to monitor the plan. Some may form in response to a pressing issue or to
coordinate a specific activity; others may form to pool resources, collaborate on programs or
address the ongoing needs of a given population group.
An example is the Barwon South West Youth Alliance which is a collaboration of nine services
committed to reducing drug related harm among young people across the Barwon South West
Region of Victoria (see case study on page 13).
Another example is the SSMART (Surviving Substance Misuse & Alcohol Risk Taking) Network,
a collaboration of local government with health, welfare, community, education and justice
organisations and young people, brought together to tackle the issues of binge drinking
and unsafe party behaviour. One of its projects, the ASSK (Alcohol and Substance Survival
Knowledge) Program—is a harm minimisation program for year 9 students, delivered in a
nightclub environment. Young people learn how to do a risk audit, understand the amount of
alcohol in drinks, risks of drink spiking, risks of binge drinking and substance use and what to do
in an emergency.
SSMART is part of Strengthening Generations, a City of Ballarat and local community services
program that originally focussed on community renewal in the areas of Sebastopol, Delacombe
and Wendouree. Since its evaluation in 2005, Strengthening Generations moved from a model
focusing on specific small communities to a model focusing on specific risk factors such as
alcohol and other drug use (www.ballarat.vic.gov.au/Community_and_Culture/index.aspx).
Programs and activities aimed at increasing the social cohesion and resilience of communities
provide a strong opportunity to tackle how alcohol is regarded within the community.
For example, Neighbourhood Renewal communities commonly confront the issues of alcohol as
a community safety or social issue (www.neighbourhoodrenewal.vic.gov.au/).
8 Prevention of harm from alcohol consumption in rural and remote communities
Advocacy and community programs
Safe transport options
Alcohol-free activities for
Good Sports program
Community sponsorship and
Safer parties and events
Getting home safely has been a focus for many alcohol accords and community safety initiatives.
In addition to designated driver programs, these have resulted in:
• the provision of additional community bus services, in some instances funded by licensees
and the local council
• the establishment of reliable taxi services
• the creation of safe taxi ranks monitored by security and in some instances paid for by
Creating opportunities for young people to take part in interesting and engaging activities
provides an important alternative to “drinking because there’s nothing better to do”.
Alcohol-free events reduce the peer pressure to drink that often accompanies events
where alcohol is present.
The FReeZA program is a Victorian Office for Youth initiative that supports young people to
organise drug, alcohol and smoke-free music and cultural events for other young people in
their local community. In rural communities many businesses and organisations support
the FReeZA events, ranging from traders, local schools, councils and health services
The Blue Light initiative provides alcohol-free entertainment for many young people in
country Victoria. Originally providing discos supervised by off duty police officers and other
community members, activities have expanded to include camps and forums for young
people; self defence classes; clinics for basketball, abseiling, canoeing, skate-boarding,
tennis and cricket; and educational excursions and trips to sporting events
The Good Sports program is an Australian Drug Foundation (ADF) initiative that helps sporting
clubs manage alcohol responsibly and reduce alcohol related problems such as binge and
underage drinking. Many clubs have turned around club cultures that previously encouraged
high risk alcohol consumption and have created much safer environments for players, members,
families and supporters. In many instances this has improved their financial viability as well.
For more information and examples visit www.goodsports.com.au.
Alcohol is often a key component in community fundraising and sponsorship. The local hotel
might sponsor the local sports team; a brewing company might sponsor a local community
event—sometimes with cash, sometimes with alcohol. Community clubs and groups themselves
often rely on alcohol sales, bar takings and alcohol as prizes, to maintain their viability.
The experience of Good Sports and of many alcohol-free events, is that less alcohol can create
a more family-friendly environment, which in turn can attract greater attendance and a greater
mix of sponsors. For some alternative fundraising ideas visit the Good Sports website
Private parties and community events with alcohol available can be made safer.
For example, PartySafe is a Victoria Police program that “provides information to help minimise
the risk of having intoxicated guests or gatecrashers ruin a private party”. Party organisers
can register their party and local police will assist in ensuring it is safe (www.police.vic.gov.au/
Local communities in popular “schoolies week” destinations, such as Torquay and Lorne,
Phillip Island, Sorrento and Portsea have all invested in strategies to limit harm from alcohol
consumption for the young people arriving to celebrate the end of school. These include
mobile support services, safe transport options and activities for those aged over 18 years and
for younger people. One example is Surf Coast Shire Council which has developed a dedicated
website that is focused on having fun in safety (www.schooliesdownsouth.com.au).
Issues Paper | No. 4 | February 2008
Drug Action Week activities
School based education
Community information campaigns are often centrally funded and coordinated.
To be effective in rural areas media campaigns need to be backed up with locally available
material, internet based information or other innovations, such as SMS promotions via
Consideration should be given to using images and depictions familiar to rural people and
focussing on issues and solutions relevant to rural communities, for example, designated
Drug Action Week is an initiative of the Alcohol and other Drugs Council of Australia, to raise
awareness about alcohol and other drug issues.
Information is able to be shaped and driven by local groups working on Drug Action Week
activities and is often presented in engaging and novel ways. For example, the Drug Action Week
website (www.drugactionweek.org.au) describes:
“A play titled ‘Toxic’ was performed at schools in the Mitchell Community Health Services
District, Victoria, to entertain students and share some important messages”.
‘‘‘Within Reach’ was an art exhibition in which young people involved with alcohol and other
drug services in Victoria created art works in a variety of media on the theme of drug use and
other social issues” .
Schools provide a convenient and effective setting in which to provide information and
create a sense of social connectedness and resilience that can help to reduce the likelihood of
consumption of alcohol at risky levels among young people.
Available evidence suggests that school based drug education is more likely to be effective when
a broad multilayered approach is used.
The Victorian Department of Education has useful resources and information on its website including
information and case studies on School Community Approaches to Drug Education (SCADE) projects
The Australian Government Department of Education, Science and Training developed
Principles for School Drug Education (Meyer & Cahill 2004) which contains 12 principles that
are recommended to underpin drug education programs in schools. This document and other
resources are available at www.redi.gov.au.
Parent education can often go hand in hand with school based education programs so
that messages are reinforced and consistent. Separate parent forums can help to clarify
Resources available at www.redi.gov.au include parent focused materials. More information can
also be accessed at the Victorian Department of Education website (www.education.vic.gov.au/
Workplace education and
The use of alcohol can have a significant impact on workplaces in terms of accidents, lost
productivity and absenteeism. Work related factors such as stress may influence the way people
use alcohol. Workplaces therefore are a key setting for tackling alcohol.
Taking an occupational health and safety perspective provides a practical motivation for
employers and employees to embrace workplace education concerning alcohol harms.
Examples of workplace strategies include training programs to raise awareness of alcohol issues
developed by industry bodies and health agencies (see the case study on page 14) and Employee
Assistance Programs provided within particular businesses or organisations that provide services,
including alcohol and drug counselling.
10 Prevention of harm from alcohol consumption in rural and remote communities
Recruitment and retention
Screening initiatives at health
care contact points
Increased training for health
professionals, working in
alcohol related areas
Recruitment to rural health services has been addressed with varying degrees of success.
Increasing the pool from which to recruit by:
• increasing undergraduate rural-health curricula
• preferential university admission of rural students
• rural attachments and international recruitment.
Providing incentives including:
• community involvement in welcoming newcomers
• financial incentives
• appropriate accommodation
• mentoring and accessible professional development
• assistance finding employment for spouses and partners
• provision of good equipment.
Alternatives to resident health professionals including:
• visiting or sessional services
• electronic and telecommunication-based service options.
Screening provides an effective early intervention strategy for identifying those who may be at
risk of harm from high levels of alcohol consumption.
For example, Northeast Health Wangaratta and Wodonga Regional Health staff routinely
administer a simple screening test to those attending hospital accident and emergency
departments or other wards. This provides an opportunity to identify people at risk and provide
a brief intervention or a referral if required.
Many qualifications, including those dealing with alcohol, such as the Certificate IV in Alcohol
and Other Drugs Work, are supported with high quality, text-based material and software
featuring scenarios, images and interactive activities that simulate real life.
Online learning of this kind helps to cut the distance between student and the learning centre.
Flexible service delivery and
Overcoming the distance
Alcohol and other drug and mental health sectors have long highlighted the plight of people
with dual diagnosis and recognised that working more closely together would achieve the
most effective outcomes. The structural and organisational barriers to making this happen can
Health agencies in the Central Hume Primary Care Partnership catchment area set out to do
this by developing the “Integrated Protocol 2006: paving the way to a ‘No Wrong Door’ service
The intent of the protocol is to establish:
• common intake and assessment processes used by all services
• referral pathways within and across services and sectors
• jointly developed care plans (involving the client) and joint case management
• collection and reporting on a common set of dual diagnosis data.
Overcoming the distance to services for the client can make the difference in terms of service
access. Options include:
• taking the service to the client through outreach services, including family home visiting
• low cost statewide telephone services, for example, the 24 hour DirectLine operated by
• locally based telephone or videoconference support services, for example, to support family
• videoconference specialist support services
• online service and support , for example, Counselling Online (www.counsellingonline.org.au)
also operated by Turning Point
Issues Paper | No. 4 | February 2008
There is no one solution for all communities and each will
need to find what is needed and what will work locally.
Whether communities choose to advocate for change,
deliver information and services themselves, or support
others to do so, it is critical to understand the issues
and identify the strategies that are most likely to achieve
results. Planning a response in an integrated way will
mean available resources are used to greatest benefit.
De Leo D, Hickey PA, Neulinger K & Cantor CH 1999 Ageing and
suicide: A report to the Commonwealth Department of Health
and Aged Care, Canberra: Australian Institute for Suicide Research
Dibley G 2007 Local Government reducing harm from alcohol
consumption, Melbourne: Australian Drug Foundation
Dunn P 1998 “Rural health and drug and alcohol dependence:
double jeopardy” in S Griffiths, P Dunn & S Ramanathan (eds)
Drug and alcohol services in rural and remote Australia, Wagga
Wagga: The Gilmore Centre, pp. 1–6
Humphreys J 1998 Rural health and the health of rural
communities, Bendigo: La Trobe University
King T, Richards J 2003 Australian Local Government: Alcohol
Harm Minimisation Projects—A good practice guide, Melbourne:
Turning Point Alcohol and Drug Centre
Laslett A-M, Dietze P & Matthews SM 2005 The Victorian alcohol
statistics handbook Volume 7: a summary of alcohol-related harm
for Victorian local government areas 2005, Melbourne: Turning
Point Alcohol and Drug Centre
Laslett A-M, Matthews SM & Dietze P 2006 The Victorian Alcohol
Statistics Handbook Volume 8: Alcohol use and related harm
among young people across Victorian Local Government Areas
2006, Melbourne: Turning Point Alcohol and Drug Centre
Loxley W, Toumbourou JW, Stockwell T, Haines B, Scott K et al.
2004 The prevention of substance use, risk and harm in Australia:
a review of the evidence, Canberra: Commonwealth of Australia
Loxley W, Gray D, Wilkinson C, Chikritzhs T, Midford R & Moore D
2005 “Alcohol policy and harm reduction in Australia”, Drug and
Alcohol Review, 24:6
Meyer L & Cahill H 2004 Principles for School Drug Education,
Canberra: Department of Education, Science and Training
Patterson I & Pegg S 1999 “Nothing to do: The relationship
between ‘leisure boredom’ and alcohol and drug addiction: is
there a link to youth suicide in rural Australia?”, Youth Studies
Australia, 18:2, pp. 24–9
Snow P & Munro G. 2000 “Alcohol consumption in amateur
Australian rules football clubs: evidence from a rural region”,
Health Promotion Journal of Australia, 10:237–243
Stehlik D, Gray I & Lawrence G 1999 Drought in the 1990s:
Australian farm families’ experiences. Canberra: Rural Industries
Research and Development Corporation
Strong K, Trickett P, Titulaer I & Bhatia K 1998 Health in Rural and
Remote Australia. Canberra: Australian Institute of Health and
Welfare, AIHW Cat No PHE 6
Victorian Premier’s Drug Prevention Council 2005 The Victorian
Youth Alcohol and Drug Survey 2004—Alcohol findings,
Melbourne: Victorian Government Publishing Service
A sample of rural liquor
There are dozens of accords and forums in
place across rural Victoria. Below are just a
few of them; some newly formed; some in
place and updated over many years. Meetings
are generally four to six times per year.
The Winchelsea, Moriac and District accord was
formed in March 2007 and jointly launched in
The licensees of this accord are enthusiastic to comply
with best practice in order to achieve the objectives of
the accord, which are to:
◗◗ work cooperatively to protect the welfare of
◗◗ discuss and resolve relevant issues that impact on
the local community
◗◗ discuss antisocial behaviour both in and near
◗◗ eliminate illegal underage patronage at licensed
◗◗ set a good example and promote the community
as a safe place to be
◗◗ acknowledge those who achieve good results.
The Colac Otway and District accord was officially
formalised in October 2006. The accord has been
able to initiate a number of incentives including a
Responsible Serving of Alcohol course for hospitality
workers and arranging guest speakers to attend
meetings. Members have agreed on the standards
they will tolerate in their premises and put steps in
place to deal with patrons who display unacceptable
behaviour. The accord has also made alcohol
management and anger management counselling
available to patrons who require it.
The Far East Gippsland accord has been running
since December 2004. The aim of this accord is
to create safer licensed venues for patrons. This in
turn, will create a safer environment for the Far East
Gippsland community. One particular outcome of the
accord is the improvement of the local taxi service.
12 Prevention of harm from alcohol consumption in rural and remote communities
When the accord commenced the taxi service was
sub standard and unreliable. Through the accord,
licensees were able to collectively write to the Taxi
Licensing Authority which responded promptly and
addressed all the issues. The service has improved
beyond licensees expectations.
Members of the accord believe the cooperation with
police and Liquor Licensing to assist with day to day
operations of businesses has been invaluable.
The Swan Hill accord was established in 2001.
Guest speakers at meetings inform members on a
range of issues. These include drink spiking/drug
issues, insurance, fire safety and security cameras.
Through the accord, members have also been able
to access Responsible Serving of Alcohol courses and
club seminars. It is a great opportunity for licensees
to share ideas and initiatives. Recently the Oasis Hotel
in Swan Hill developed its own in-house poster about
drink spiking. This was then made available to other
licensed premises in the area.
Source: Consumer Affairs Victoria (www.consumer.vic.
gov.au). Each of these accords along with many more can
be found at this website follow the Liquor link and scroll to
Forums and Accords
The Barwon South West
From a membership of three organisations seven
years ago, the Barwon South West Youth Alliance
(BSWYA) has grown to a membership of nine:
◗◗ Barwon Youth (BASYA Ltd)
◗◗ Western Region Alcohol and Drug Centre (WRAD)
◗◗ Glenelg Southern Grampians Drug
◗◗ Colac Area Health
◗◗ Brophy Family and Youth Services
◗◗ Kikkabush Aboriginal Advancement
◗◗ Odyssey House Victoria
◗◗ Salvation Army Geelong Withdrawal Unit Geelong
◗◗ Winda Mara Aboriginal Corporation.
Initially responsible for youth residential services, the
BSWYA now brings together complementary skills,
knowledge and expertise from a wider range of drug
and alcohol and youth specific services. Together,
the alliance is able to provide an integrated service
response to young people affected by or at risk of
harm from alcohol and other drug use across the
entire Barwon South West Region. Services include:
◗◗ youth residential and home based withdrawal
◗◗ community development
◗◗ alcohol and other drugs counselling
◗◗ youth alcohol and drug day program
◗◗ general practice
◗◗ drug education
◗◗ youth outreach.
The Youth Access Program (YAP) is one example of
a regional program operating through the alliance
which provides a level of prevention and early
intervention in relation to alcohol and other drugs
issues associated with young people. The program
works with local services and schools, including those
in more remote areas, to get in touch with young
people and identify those at risk.
Outpost arrangements and protocols have been
established with schools, which are visited once a
week or fortnightly. Frequent visits help to build
relationships with the school community and mean
that alcohol and other drug workers become more
familiar to students and more approachable to them.
The program’s three outreach workers routinely
travel up to 3000 kilometres a week to reach up to
500 young people in rural and remote communities
such as Apollo Bay, Colac, Warrnambool, Hamilton,
Heywood and Portland.
While drug education is not strictly core business
for YAP, demand means that workers deliver drug
education sessions in some identified schools that
are more rural and remote. For example, although
the Corangamite area has a WRAD alcohol and other
drugs clinician visiting the health service weekly, it
does not have an alcohol and other drugs mainstream
service. This means the local capacity to deliver drug
education to schools is limited.
Issues Paper | No. 4 | February 2008
In 2006, YAP received an award for excellence
in services for young people from the Australian
National Council on Drugs. Attracting resources to
support the work of YAP has been a challenge since
its earliest days; however funding of $750 000 over
the next three years under a Commonwealth Proceeds
of Crime Grant will see the program continue to
respond to this vital need.
The BSWYA is actively involved in finding ways
to assist other existing services and programs on
the ground to access or make the most use of the
resources available. For example, writing submissions
for grants to focus on health promotion or drug
education or establishing working groups for projects
that pool resources and expertise.
The BSWYA is governed by an Executive Committee
made up of the Executive Directors/Managers of the
services operating under a joint Memorandum of
Understanding. The BSWYA is also supported by a
Regional Reference Group that meets quarterly and
allows input from a broad range of professionals
working with young people across the region. It
also provides a great opportunity for workers and
community members to get together to build and
strengthen relationships that make the alliance and
the services it supports work.
Contact: Shannon Luttrell, Senior Project Officer,
Barwon Youth, Ph: (03) 5244 7306;
Drugs or alcohol? The Victorian
building and construction
industry says “Not at work”
Incolink is a joint enterprise of unions and employer
associations in the building and construction industry
and provides a range of services to its members,
including a drug and alcohol program. Drug and
alcohol use has been identified as one of the
pressures likely to be faced by young workers and
apprentices who are commencing their careers.
Under the slogan “Drugs or Alcohol? Not at Work!”
the Incolink drug and alcohol program aims to make
sure that young workers and apprentices are aware
of the risks in using drugs and/or alcohol and are
aware of the supports available to them. With over
1000 apprentices per year participating in the Incolink
Drug and Alcohol Awareness Program run in TAFE
and industry training centres, this slogan and its key
message are well and truly “front of mind” for young
workers and apprentices entering the building and
construction industry across Victoria.
The building industry has long had a drugs and
alcohol policy and Incolink provides information and
assistance for industry members, family members
and employers on the harm caused by the misuse of
alcohol and other drugs. This includes free counselling
and confidential drug and alcohol treatment and
referral services where required.
More recently Incolink has been in discussion
with TAFE colleges and other Registered Training
Organisations in rural Victoria to extend the drugs
and alcohol module to these areas on a regular basis.
The idea is to provide modules dealing with alcohol
and drugs to apprentices who are participating in
Incolink’s Life Care Skills Program, funded through
the Federal Government Department of Health and
Ageing and supported by CBUS.
The success of Incolink’s Life Care Skills Program, a
suicide prevention program based in Bendigo, has
provided a great deal of momentum for responding
to the issue of alcohol in rural areas. The program
supports young people facing the many changes
and transitions that occur as they move into the
construction industry. Alcohol and other drug use is
an issue that many apprentices and young workers
may confront and the program will ensure this
important issue is kept at the forefront.
TAFEs in Mildura, Geelong, Bendigo and Ballarat
are already expressing interest and it is anticipated
many more will follow. Incolink also hopes to link
in with local alcohol and other drug services to
ensure material is accurate and locally relevant, and
that appropriate support and referral pathways
Contacts: David Clark, Support for Apprentices,
Ph: (03) 9639 3000
Troy Matisons, Life Care Worker—Life Care Skills Program,
Ph: 0438 059 859
Contact INCOLINK on (03) 9639 3000 or toll free on
1800 337 789 or visit www.incolink.org.au
14 Prevention of harm from alcohol consumption in rural and remote communities
Reading and Resource List
No. 22 • February 2008
Prevention of harm from
alcohol consumption in rural
and remote communities
This list is intended as a guide and a starting point for the researcher. It does not aim to be
comprehensive of the subject. For further information please search the library online public
access catalogue, or contact DrugInfo for assistance. The list is sorted chronologically and by
author within each time period. All of the following resources are available in the
DrugInfo Clearinghouse Library.
Books and reports
Drugs and Crime Prevention Committee
2006 “An overlooked problem: harmful alcohol
consumption in rural and regional Victoria” in
Inquiry into strategies to reduce harmful alcohol
consumption: final report, volume two, Melbourne:
Drugs and Crime Prevention Committee,
This chapter discusses the particular problems related
to alcohol misuse in the rural and regional areas of
Victoria, with significant comment from Dr Rodger
Brough. Nine specific recommendations for the
management of alcohol use in rural areas are made,
and a discussion of the importance of Local Alcohol
and Drug Action Plans is included.
Laslett A–M, Matthews S & Dietze P 2006
The Victorian alcohol statistics handbook, volume 8.
Alcohol use and related harm among young people
across Victorian Local Government Areas 2006,
Fitzroy: Turning Point Alcohol and Drug Centre
This handbook, the eighth in a series providing
information on alcohol consumption and related harms
in Victorian statewide, regional and local government
areas, focuses on young people aged 15–24 years.
DrugInfo Clearinghouse no. STATS
Mission Australia 2006 Rural and regional
Australia: change, challenge and capacity,
Sydney: Mission Australia
Using a capitals framework—economic, human,
institutional, social and natural capital—the report
considers the various resources required to develop
functional, resilient communities and the impact of
resources or “capital” deficits on the wellbeing of
individuals and communities. (Mission Australia)
DrugInfo Clearinghouse no. JF246 MIS
Fortney J & Booth BM 2001 “Access to substance
abuse services in rural areas” in M Galanter (ed.)
Recent developments in alcoholism, 15, New York:
Kluwer Academic, pp. 177–208
Access to effective treatments for substance use
disorders is a critical public health issue, especially in
rural areas. Difficulties in access to care may account
for the large proportion of individuals with alcohol
and/or drug use disorders who do not receive any
care for their disorder and the small proportion that
engage in, or achieve sustained involvement with,
treatment. (Kluwer Academic)
DrugInfo Clearinghouse no. ref GC58 REC
Reading and Resource List | No. 22 | February 2008
Australian Drug Foundation 1999 1998 Regional
youth alcohol campaign. Project report, West
Melbourne: Australian Drug Foundation
This campaign was, in essence, a partnership between
the Department of Human Services and the Australian
Drug Foundation, regional working groups and local
young people. Emphasis was placed on developing
creative strategies to reduce associated harm from
excessive alcohol use and to ensure that the strategies
developed were positive reflections of young people
rather than feeding off stereotypical or negative
images. (Australian Drug Foundation)
DrugInfo Clearinghouse no. adf JP14 ADF
Diamantopoulou K, Mullan N, Dyte D &
Gantzer S 1997 Evaluation of the country random
breath testing publicity program in Victoria,
1993–1994, Clayton: Monash University Accident
This evaluation, carried out by Monash University
Accident Research Centre on behalf of the Transport
Accident Commission, evaluated the program in
terms of its implementation characteristics and
effects on road trauma, and provided information to
optimise the mix and levels of the major components
of random breath testing programs in the future.
DrugInfo Clearinghouse no. MO6 CAM
Salter A & Boots K 1996 “Rural alcohol harm
reduction strategies for young people—the COMPARI
experience in Geraldton” in Reshaping the future:
drugs and young people: a conference examining
how schools and communities address young
people’s use of alcohol and other drugs,
29 September–1 October, 1996, the Holme Building
University of Sydney, New South Wales: conference
proceedings, pp. 301–320, South Melbourne:
Australian Drug Foundation
This paper describes some of the work undertaken
by a rural health promotion project called COMPARI
in Geraldton, Western Australia, which undertook a
range of strategies to reduce alcohol-related harm,
including addressing fraudulent use of proof of age
cards, community development relating to relocation
of a licensed premises, an art exhibition relating to
underage drinking and health marketing to promote
DrugInfo Clearinghouse no. JF36 RES
Sheehan M, Schonfeld C & Davey J 1995
A community based prevention/rehabilitation
programme for drink drivers in a rural region:
“Under the limit”, Canberra: Australian Government
This report describes the development and
implementation of a trial drink driving prevention and
rehabilitation model in a rural region of Queensland. The
program, called “Under the limit”, used an intersectoral
framework for change which involved coordination and
collaboration between all the major agencies who play a
role in the management of the issue.
DrugInfo Clearinghouse no. AN66 SHE
Sturmey R 1994 “Rural/remote women: drugs and
alcohol” in J Copeland & W Swift (eds) 1994 National
Women and Drugs Conference: challenge, consensus
and change issues papers, Sydney: National Drug and
Alcohol Research Centre, pp. 99–151
This paper brings together available statistics on
women’s drug and alcohol usage in rural and remote
areas. It also outlines a service delivery oriented
rural and remote area classification for Australia,
the key types of communities that exist in rural and
remote areas, the differences in the way smaller rural
communities function, and a summary of models and
principles considered important in servicing such areas.
DrugInfo Clearinghouse no. GC101 COP
Hamdan-Mansour AM 2007 “Perceived social
support, coping strategies and alcohol use among
rural adolescents/USA sample”, International Journal
of Mental Health and Addiction, 5:1, pp. 53–64
Rural adolescents are under-researched in substance
use studies. The purpose of this study was to
determine whether perceived social support and
coping strategies predict rural adolescents’ alcohol
use. Avoidance coping strategies and perception of
social support from family are strong predictors of
alcohol use among rural adolescents. (Springer)
DrugInfo Clearinghouse no. HAMDAN-MANSOUR 07
Spence R 2007 “Treatment seeking in populations in
urban and rural settings on the border”, Alcoholism:
Clinical and Experimental Research, 31:6, June, pp.
16 Prevention of harm from alcohol consumption in rural and remote communities
This framework for understanding treatment seeking
in border communities suggests that pathways to
treatment seeking vary by locality in ways that may
reflect variations in local environments and service
systems. Design of outreach efforts should be tailored
to the unique social and service system challenges of
each local community. (Blackwell)
Graham ML 2006 “Rural parents, teenagers and
alcohol: what are parents thinking?”, Rural and
Remote Health, 383, Feb., pp. 1–13
Rural parents are unsure how to respond to teenagers’
alcohol use and drunkenness. While some parental
strategies for harm reduction (such as supplying
adolescents with a small amount of alcohol) may have
good face validity in reducing alcohol consumption
among adolescents, these strategies are not supported
by previous research findings.
DrugInfo Clearinghouse no. vf GRAHAM 06
Kenny A, Kidd S, Tuena J, Jarvis M &
Robertson A 2006 “Falling through the cracks.
Supporting young people with dual diagnosis in rural
and regional Victoria”, Australian Journal of Primary
Health, 12:3, Dec., pp. 12–19
For young people with a dual diagnosis, particularly in
rural and regional areas, there are significant barriers
to the provision of optimal care. Currently, a lack of
communication between mental health, drug and
alcohol services and consumers results in the inadequate
provision of treatment for young people, with a
resultant significant service gap.(La Trobe University)
DrugInfo Clearinghouse no. vf KIDD 06
Miller AS 2005 “Adolescent alcohol and substance
abuse in rural areas: how Telehealth can provide
treatment solutions”, Journal of Addictions Nursing,
16:3, pp. 107–115
In the past decade, adolescent alcohol and
substance abuse has grown significantly as a
problem for rural areas. Deficits in adolescent
alcohol and substance abuse treatment have
predictably contributed to this phenomenon.
As a solution to these deficits, videoteleconferencing
(VTC) creates an opportunity for rural communities to
increase the accessibility and quality of alcohol and
substance abuse treatment. (Ingenta)
DrugInfo Clearinghouse no. vf MILLER 05
Booth BM, Curran GM & Xiaotong H 2004
“Predictors of short-term course of drinking in
untreated rural and urban at-risk drinkers: effects of
gender, illegal drug use and psychiatric comorbidity”,
Journal of Studies on Alcohol, 65:1, pp. 63–73
The purpose of this study was to examine predictors
of changes in drinking and drinking consequences
in untreated at-risk drinkers in a community sample.
Rural residents maintained higher drinking quantity
and were less likely to be safe drinkers than urban
residents were. These data distinguish which drinkers
might benefit from short interventions, and which
should receive more intensive treatment. (Rutgers)
Nietert PJ, French MT, Kirchener J, Han X &
Booth BM 2004 “Health services utilizations
and cost for at-risk drinkers: rural and urban
comparisons”, Journal of Studies on Alcohol, 65:3,
May, pp. 353–362
The purpose of the study was to examine differences
between healthcare use and associated costs in rural
and urban at-risk drinkers. While overall healthcare
costs were not significantly different between
rural and urban residents in this sample of at-risk
drinkers, there are some notable differences in the
costs associated with inpatient and emergency room
services. (National Institute on Alcohol Abuse
SAMHSA, Office of Applied Studies 2004
“Underage drinking in rural areas”, The NSDUH
Report, Aug., at www.oas.samhsa.gov/2k4/
ruralYouthAlc/ruralYouthAlc.htm (accessed 2/11/07)
This report presents comparisons from the 2002
NSDUH on the prevalence of any past month and
binge alcohol use among persons below the legal
drinking age (aged 12 to 20) who lived in rural and
DrugInfo Clearinghouse no. SAMHSA 04
Reading and Resource List | No. 22 | February 2008
Williams P 2001 “Alcohol-related social disorder
and rural youth”, Youth Studies Australia, 20:3,
Sept., pp. 11–19
The consumption of alcohol is embedded in the
cultural psyche of rural Australia. By their early teens,
most rural young people have tried alcohol, and some
consume alcohol regularly. When they drink, the
young often do so at hazardous and harmful rates,
increasing their likelihood of being involved in social
disorder as victims or perpetrators, or both. Paul
Williams analyses the available data, and suggests
strategies to lower the rates of alcohol-related social
disorder in rural regions.(Australian Clearinghouse for
Booth BM & McLaughlin YS 2000 “Barriers to
and need for alcohol services for women in rural
populations”, Alcoholism: Clinical and Experimental
Research, 24:8, pp. 1267–1275
We discuss the prevalence of alcohol problems, helpseeking
behavior and barriers to help-seeking for rural
women and suggest directions for future research for
rural women with alcohol problems. We also address
key methodological issues in measuring rurality that
must be considered when designing research on rural
women. (Blackwell Synergy)
d’Abbs P & Togni S 2000 “Liquor licensing and
community action in regional and remote Australia:
a review on recent initiatives”, Australian and New
Zealand Journal of Public Health, 24:1, pp. 45–53
The objective of this research was to review the
effectiveness of community-based initiatives involving
restrictions on alcohol availability in remote and
regional locations in Australia, and to assess their
implications for other communities or towns
contemplating similar measures. (Public Health
Association of Australia.)
Snow P & Munro G 2000 “Alcohol consumption in
amateur Australian rules football clubs. Evidence from
a rural region”, Health Promotion Journal of Australia,
10:3, pp. 237–243
This paper examines the extent to which amateur
rural sporting clubs are settings in which harmful and
hazardous levels of alcohol are consumed by players,
and suggests that rural sporting clubs should be
targeted as health promotion settings so that policies
and practices which promote the responsible service
and consumption of alcohol can be developed,
implemented and evaluated. (Australian Health
DrugInfo Clearinghouse no. vf SNOW 00
Stewart L & Conway K 2000 “Community action to
reduce rural drink and drive crashes in New Zealand:
adapting approaches in dynamic environments”,
Substance Use and Misuse, 35:1&2, pp. 141–155
This paper discusses the evolution of a two-and-ahalf
year pilot community action project aimed at
developing strategies to reduce alcohol-use-related
crashes in a rural police district in New Zealand.
(Marcel Dekker Inc.)
Patterson I & Pegg S 1999 “Nothing to do: the
relationship between ‘leisure boredom’ and alcohol and
drug addiction: is there a link to youth suicide in rural
Australia?”, Youth Studies Australia, 18:2, pp. 24–29
This review of research in regard to young adults
and adolescents suggests that there may be a causal
link between leisure boredom and high-risk health
behaviours such as substance abuse as well as various
forms of mental distress. The findings support the
hypothesis that adolescents and young adults who
perceive their leisure to be unsatisfying, or in some
way incomplete, may be at greater risk of engaging
in patterns of leisure behaviour that are detrimental
to their physical and/or psychological well-being.
(Australian Clearinghouse for Youth Studies)
Peach HG, Bath NE & Farish SJ 1998 “Comparison
of unsafe drinking between a rural and metropolitan
area”, Drug and Alcohol Review, 17:1, pp. 117–120
Factors associated with unsafe drinking in a rural
area were identified and the prevalence of unsafe
drinking and alcohol related mortality compared with
a metropolitan area. Alcohol consumption data were
collected from a random sample of adults in Greater
Ballarat. (Australian Professional Society on Alcohol
and Other Drugs)
Pozzi R, James R, Kirby G, Cassells J &
Wylie I 1996 “Using media to increase community
discussion: the rural alcohol campaign in Western
Australia”, Health Promotion Journal of Australia,
6:3, pp. 50–51
18 Prevention of harm from alcohol consumption in rural and remote communities
A media-based alcohol education campaign was
developed to address the high alcohol-consumption
levels and associated harm occurring in the North
West and Goldfield regions of Western Australia. The
aim of the campaign was to encourage community
discussion of the personal and social effects of unsafe
alcohol consumption. (Australian Association of
Health Promotion Professionals)
Sitharthan T, Kavanah DJ & Sayer G 1996
“Moderating drinking by correspondence: an
evaluation of a new method of intervention”,
Addiction, 91:3, pp. 345–355
Recognising the need to offer alternative methods of
brief interventions, this Australian study developed
correspondence treatments for low-dependent
problem drinkers and evaluated their impact. High
levels of consumer satisfaction, a high representation
of women and a substantial participation from
isolated rural areas attested to the feasibility of
the correspondence programme as an alternative
treatment. (Society for the Study of Addiction to
Alcohol and Other Drugs)
Major C 1995 “More feet on the … ground”,
Connexions, 15:5, pp. 22–25
This Australian article investigates a change in the
Murrumbidgee and Hume Districts in South Western
New South Wales where a shared alcohol and drug
coordinator position was replaced by two worker
positions. This was seen as not only increasing
services but redirecting responsibility through the
local community health centre. This trial may be seen
as a model for future structural changes in country
NSW. It does however depend on commitment to
alcohol and drug issues from local health authorities
to make it a success.
Helliwell D, Reilly D & Rippingale C 1992
“Establishing a drug and alcohol service in an
Australian rural area”, Drug and Alcohol Review, 11:4,
This paper describes the development of a drug
and alcohol service from the perspective of a local
general practitioner. Reference is made to problems
of community resistance, hospital issues and the
steps taken to acquire knowledge and skills in the
management of patients presenting to the practice.
(Australian Medical and Professional Society on
Alcohol and Other Drugs)
Rural Health Education Foundation 2006
The “Can Do” initiative. Managing mental health and
substance abuse in general practice, ACT: Rural Health
This DVD, presented in a panel discussion style, aims
to equip general practitioners in rural and remote
areas, to identify, treat and support people with
mental health and substance abuse issues. Support
information is available at www.rhef.com.au
DrugInfo Clearinghouse no. av GC42 RUR
Lillie S & Parkin J 2003 Club Eyerus, Windsor, NSW:
Hawkesbury Film Project
This is the second video production of the
Hawkesbury Film Project, an initiative of Hawkesbury
District Health Service and Hawkesbury Police
Command. This prevention project was aimed at
involving young people, from the region, in the
creation of drug education videos that were relevant
to their environment and experiences.
DrugInfo Clearinghouse no. VID JF24 HAW
All material listed is available from the Australian Drug Foundation library.
Membership to the library is open to professionals in Victoria who work in the areas of health, welfare, and education.
Members are able to borrow from the collection as well as access other services provided by the library. Membership is free
to these groups.
For more information about membership or how to access material:
Tel. (03) 9278 8121 (Monday to Friday, 9am to 5pm)
Fax. (03) 9328 3008
Or visit our website at www.druginfo.adf.org.au/library
Reading and Resource List | No. 22 | February 2008
409 King Street West Melbourne VIC 3003