Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697631980033.pdf (Australia)
ADF Submission House of Representatives Inquiry into family, domestic and sexual violence That the Standing Committee on Social Policy and Legal Affairs inquire into and report on family, domestic and sexual violence, including with a view to informing the next National Plan to Reduce Violence against Women and their Children, the following: a) Immediate and long-term measures to prevent violence against women and their children and improve gender equality.
Alcohol misuse is strongly linked to Family, domestic and sexual violence Preventing and minimising alcohol and other drug harms is a key component in reducing family, domestic and sexual violence.

Based on the strong relationship between alcohol and violence against women and children, there are significant opportunities to implement intermediate and long-term measures to prevent violence against women and children (DFV).
The World Health Organization (WHO) notes that harmful use of alcohol and drugs is a commonly cited risk factor for experiencing and perpetrating intimate partner violence and sexual violence.i In Australia, alcohol is involved in 34% of intimate partner violence incidents and 29% of family violence incidents.ii In the 2012 Personal Safety Survey, an estimated 53 per cent of women who had been physically assaulted by a male reported that alcohol or drugs had been involved in their most recent incident.iii Australian Institute of Health and Welfare data shows that more than half of all homicide perpetrators who killed an intimate partner were under the influence of alcohol.iv Alcohol can directly affect cognitive and physical function, impair judgement and problem solving, reducing self-control and emotional regulation.
v. Alcohol is one of the multiple contributing factors to an increase risk of family violence.

Other factors, including social norms, masculinity, price, promotion, availability, and alcohol cultures all intersect to increase risk of harm to the individual and to others.

vi vii viii While there is no direct causal relationship between alcohol and DFV, the evidence demonstrates that alcohol increases the incidence and severity of harms from DFV.
Individual and societal beliefs that alcohol causes violence can lead to alcohol intoxication being used as an excuse for violent behaviour and impact on prevention efforts.

ix xxi A range of policy levers need to be employed that address all of these areas including preventing targeting marketing toward young adults that align “sexual success” with drinking and who are at greatest risk of drinking at risky levels.
Drinking is part of Australia’s culture and adolescents have Level 12 607 Bourke Street Melbourne VIC 3000 PO Box 818 North Melbourne VIC 3051 - T 03 9611 6100 F 03 8672 5983 adf@adf.org.au adf.org.au ABN 66 057 731 192 Inquiry into family, domestic and sexual violenceSubmission 91 PG.2 traditionally sought access to alcohol as a badge of adulthood.
Yet while adolescence may be a seemingly natural time to start drinking, it is a particularly risky time to do so because of the substantial development occurring in the brain.

Current evidence indicates that many of the regions of the brain undergoing development during adolescence are “particularly sensitive to even fairly low doses of alcohol”.

Exposure to alcohol during this period can mean a young person never reaches their full intellectual potential.
Drinking alcohol during adolescence increases the risk of problematic drinking in the future.xii Primary prevention can help prevent the uptake of the use of alcohol and other drugs, particularly at young ages, delay or reduce the use of alcohol and other drugs and thus prevent and reduce the harms associated with alcohol and other drugs (AOD).
This is achieved through either influencing individuals’ attitudes and behaviours towards AOD or changing environmental conditions to reduce the potential for certain behaviours to develop.xiii The local community plays a significant role in facilitating or contributing to effective prevention strategies.

National and international evidence highlights the effectiveness and importance of community engagement in preventing harms from alcohol and other drugs.
This is especially the case in high-risk populations such as young people, Aboriginal and Torres Strait Islander communities, migrant communities, and low socioeconomic communities.xiv xv xvi xvii Children who witness family violence appear to be more likely to develop substance use disorders and harmful drinking patterns later in life which may then become a risk factor for further violence.
xviii The National Alcohol Strategy 2019-28, endorsed by Australian governments in December 2019, states: “Greater attention should be paid to the relationship between access to alcohol and family violence in light of the evidence showing that alcohol misuse increases the severity and frequency of family violence.” The National Alcohol Strategy includes the following policy options which will impact positively on harms related to alcohol: 1.
Licensing procedures that consider known factors for risks and harms (outlet density, trading hours, impact on amenity).

Increased access to alcohol is a significant risk factor for domestic and family violence.

Outlet density has been significantly associated with rates of domestic violence, even controlling for socio-demographic factors.
The density of hotels (pubs) has been positively associated with domestic violence rates and the density of restaurants and bars negatively associated with domestic violence.
.xix During the Victorian Royal Commission into Family Violence, which reported in 2016, the Victorian Government announced a “major review of the Liquor Control Reform Act to assess the current balance between culture and the need to reduce alcohol-related harm, particularly street violence and family violence.” In its submission, VicHealth highlighted the role of packaged liquor and its contribution to health and social harms in Victoria – specifically family violence – and the need to better regulate the availability of alcohol through packaged liquor outlets.
The Royal Commission adf.org.au ABN 66 057 731 192 Inquiry into family, domestic and sexual violenceSubmission 91 PG.3 recommended: “The Victorian Government ensure that the terms of reference of the current review of the Liquor Control Reform Act 1998 (Vic) consider family violence and alcohol-related harms.”xx The second phase of the review is underway.
The increased growth of alcohol delivery, including the sharp increase in rapid delivery services and the ability of online alcohol retail to allow purchases of alcohol from anywhere and delivery of alcohol directly to people’s homes, has dramatically increased the accessibility and availability of alcohol and challenges traditional regulatory approaches.

Greater availability of alcohol from online sales and home delivery will cause increased harm in Australian communities.
A strong body of Australian and international research shows that increases in the availability of alcohol through increases in the number of liquor outlets in a community leads to increases in violence, family violence, injury and chronic disease.xxi Alcohol-related assaults increase substantially between 6pm and 3am (peaking between midnight and 3am), with 37 per cent of alcohol-related assaults occurring in the home, and more than half (57 per cent) of those being domestic violence.xxii In Australia, suicides and sudden or unnatural deaths involving alcohol predominantly happen at night, in the home environment.xxiii Research linking alcohol and family violence is highly relevant to the online sale and delivery of alcohol, given the relative ease of access to online sale and delivery of alcohol and its rapid availability.
In May 2020, the Foundation for Alcohol Research and Education and Women’s Safety NSW released the report “Family violence and alcohol” which found almost half of specialists had seen an increase in their caseload during Covid-19.xxiv 2.
Improve capacity of communities to identify, prevent and minimise alcohol related harm through evidence-based activities Primary prevention initiatives seek to change attitudes and behaviours to achieve healthier outcomes for individuals over time thus preventing social health issues such as substance use problems, mental health conditions and domestic and family violence (DFV).

While prevention programs tend to offer a strong return on investment, they are not well suited to traditional funding models.
As they are typically funded for periods of three or four years which is usually too short to enable initiatives to be fully developed, tested and evaluated in a robust manner that would contribute to a solid evidence base.

Consequently, primary prevention faces the charge that it lacks proof of success.
An exception is the Alcohol and Drug Foundation’s evidence-based Good Sports which have been able to refine its approach so that it could match the precise need of sporting clubs to reduce harmful alcohol consumption.

Further, to promote healthier attitudes and behaviours related to alcohol, making clubs more female and child friendly.

The Good Sports program is Australia’s largest and longest-running health initiative in community sport.
Adopted in more than 9,000 clubs nationwide and reaching more than 2 million Australians, Good Sports has transformed the behavioural environment of community sports clubs through an evidence based approach aimed at shifting attitudes, behaviours and strategies in the clubs to reduce the risk of alcohol related harms.
Key to its success is its ability to shift club culture around alcohol making Good Sports Clubs more family friendly, resulting in increased participation from adf.org.au ABN 66 057 731 192 Inquiry into family, domestic and sexual violenceSubmission 91 PG.4 women and children in club activities.

Community programs that aim to shift the culture surrounding alcohol, while not explicitly targeting domestic violence, are an important tool for reducing risk factors for all alcohol related harms.
The outcome of Good Sports has been a transference of healthier attitudes and behaviours towards alcohol, leading to lower alcohol availability and consumption, creating a healthier and safe culture toward alcohol in club and thus the home environment.

3.
3.

Development of public health campaigns promoting the risks and harms associated with alcohol consumption The Foundation for Alcohol and Drug Education has argued that there are no public awareness campaigns or school-based education programs in Australia that adequately integrate the relationship between alcohol and family violence.
xxv The 2017-26 National Drug Strategy states: “Approaches and policy responses aimed at reducing alcohol, tobacco and other drug harms in priority populations should be informed by evidence as it develops and should be reviewed regularly.
It is also important that any responses do not inadvertently or unintentionally further marginalise or stigmatise people who are at higher risk of experiencing alcohol, tobacco and other drug related harm.” Most people who consume alcohol or other drugs do not commit acts of domestic, sexual or family violence.
In 2015, alcohol was responsible for 22.4% of the burden due to road traffic injuries, 28.0% of the burden due to chronic liver disease, 40.2% of the burden due to liver cancer, 14.3% of the burden due to suicide and self-inflicted injuries, 14.1% of the burden due to homicide and violence, and 11.0% of the burden due to drowning (Australian Institute of Health and Welfare 2019).
A general campaign that highlights alcohol harms offers potential in reducing the excessive alcohol consumption linked to domestic violence, regardless of why an individual changes their relationship with alcohol.

An evaluation of the VicHealth Alcohol Culture Change campaign, “No Excuse Needed” found the campaign was widely recognised, with 46% of the target audience reporting they had seen the campaign.
One third of those who recognised the campaign reported drinking less alcohol, and one third took an action around their own alcohol consumption behaviour as a result of seeing the campaign.xxvi 4.

Introduction of a minimum floor price for alcohol.

The Northern Territory introduced a Minimum Unit Price of $1.30 per standard drink on October 1 2018.
An independent report has found MUP, as one of several alcohol reforms, is associated with significant declines in alcohol-related offences, child protection notifications and protective custody episodes.

Business reported that implementation of the legislation was straightforward and that turnover, including tourism, has improved or remained stable.

It was one the third of four major changes made in liquor policy in the NT.
xxvii adf.org.au ABN 66 057 731 192 Inquiry into family, domestic and sexual violenceSubmission 91 PG.5 Recommendation: That the Inquiry recommend that implementation of policy options contained in the National Alcohol Strategy offer significant potential for reducing family, sexual and domestic violence.
Recommendation: That the Inquiry recommend that the Commonwealth work with the States and Territories to better regulate alcohol online and delivery services, with a view to deliveries being proscribed between 10pm and 10am.
Recommendation: That in relation to alcohol and other drug harms and domestic violence, the Inquiry recognise the social and economic value of broad-based community prevention programs and recommend that support for such programs be included in the 2020-21 Budget and National Preventative Health Strategy.

Recommendation: That family, domestic and sexual violence campaigns acknowledge the role of alcohol in creating an unhealthy home environment.
Recommendation: That the Inquiry recommend a broad-based alcohol campaign, linked with the release of the next NHMRC Australian guidelines to reduce health risks from drinking alcohol.

Recommendation: While a minimum floor price is an issue for state and territory governments, the federal government should take a leadership role.

b) Best practice and lessons learnt from international experience, ranging from prevention to early intervention and response, that could be considered in an Australian context.
The evidence highlights the efficacy of alcohol supply reduction initiatives in reducing the incidence of domestic and family violence including in Australia, United States and Greenland, as well as reduction of violence after perpetrators of DFV have been treated for alcohol dependence.
xxviii In Greenland, a program that implemented a coupon-based system to limit alcohol purchases to adults, to the equivalent of 72 beers per month, achieved a 58% reduction in the number of police calls for incidents related to domestic violence.xxix Alcohol outlet density has been consistently linked to higher rates of IPV in the US.

For example, one study found an increase of 10 alcohol outlets per 10,000 persons was associated with a 34% increase in male-to-female partner violence.
“Policies that work to reduce a community’s alcohol outlet density are one example of an approach that might help reduce community rates of IPV.”xxx There is also evidence that certain programs seeking to reducing substance use can be effective in reducing harms from DFV.
As an example, a couples-based Therapy program (BCT) from the United States, is a substance use treatment program for substance using individuals and their adf.org.au ABN 66 057 731 192 Inquiry into family, domestic and sexual violenceSubmission 91 PG.6 partners.

The program works with the couple on conflict management and other relationship skills as part of the substance use treatment.
An evidence review of 23 studies found that BCT is associated with significant reductions in perpetration of intimate partner violence (IPV) among couples participating in treatment groups.

c) The level and impact of coordination, accountability for, and access to services and policy responses across the Commonwealth, state and territory governments, local governments, non- government and community organisations, and business.
A more coordinated approach to AOD treatment Acknowledging the strong relationship between domestic violence and alcohol and other drug use should encourage greater investment in AOD treatment, as a strategy to reduce DFV.

The 2019-29 National Framework for Alcohol, Tobacco and other Drug Treatment notes: “Responsibility for planning and coordinating the availability and accessibility of alcohol and other drug treatment resides with both levels of government.
Siloed planning, purchasing, and resourcing can result in treatment gaps and planning duplication.

Coordination and collaboration in planning, purchasing and resourcing is a key principle for effective, accessible and equitable alcohol and other drug treatment services in Australia.”xxxi Even before COVID-19, every year up to 500,000 Australians were unable to access alcohol and other drugs treatment because not enough funding for treatment is available to meet demand.
The Alcohol and Drug Foundation is part of a formal coalition that supports improved coordination across all levels of government to enhance the integration and delivery of alcohol and other drugs treatment services in Australia.

Coordination between AOD and mental health treatment The evidence demonstrates the significant overlap and association between individuals who experience mentally ill health, domestic violence and AOD problems and that these individuals typically experience poorer outcomes.
xxxii xxxiii these matters requires considerations of all of them, similar to the approach by outlined by the Australian Government Productivity Commission Draft report on Mental Health.

As such any approach, treatment or management of It found “substance use comorbidity has been a focus area for about 20 years” (p.325); “increasing interest and investment in co-located services” by Federal and State governments; and the strong support for co-located services and community hubs from inquiry participants.
Headspace is a prominent example.

xxxiv adf.org.au ABN 66 057 731 192 Inquiry into family, domestic and sexual violenceSubmission 91 PG.7 Recommendation: That the Inquiry recommend greater investment in AOD services; support for AOD services in community mental health investment; review of available data sources to provide a better picture of need and trends; increased investment in workforce capability; and special focus on regional Australia.
Recommendation: That the Inquiry ask the Australian government to consider whether National Cabinet serves as a useful model for governments to quickly respond to national challenges such as those posed by alcohol and other drugs.

Recommendation: That the inquiry recommend that the next national plan to reduce domestic violence elevate the importance of preventing alcohol and other drug harms.
f) The adequacy of the qualitative and quantitative evidence base around the prevalence of domestic and family violence and how to overcome limitations in the collection of nationally consistent and timely qualitative and quantitative data including, but not limited to, court, police, hospitalisation and housing.
According to the AIHW, there are many national data collections on services that assist populations at increased risk of family, domestic and sexual violence, such as the Alcohol and Other Drug Treatment Services National Minimum Data Set.

“Often, though, there are no means to identify these clients in national data collections.” The AIHW has highlighted there is currently no consistent method for police to identify family and domestic violence incidents across states and territories.
xxxv The ability to monitor and respond to changes to alcohol and drug use to prevent and minimise the associated harms including access to treatment because of the COVID-19 pandemic on was hampered by poor data.

Currently, while there are numerous sources of data about alcohol and other drugs, there is often a significant time delay between collection and reporting of data making the ability to implement real time policy change difficult.
In a such as we are currently in, this time lag may be contributing to increased harm among a vulnerable population as the ability to respond swiftly and accurately to avert harm is hampered.

Access to high quality data that monitored alcohol sales, consumption, and harms to support timely responses to the pandemic and reduce alcohol and other drug harms also proved problematic.
Multiple surveys using different methodologies and different target audiences resulted in conflicting information compounding the problem.

There does not appear to be definitive guidance for recording whether a family, domestic or sexual assault is alcohol related.
The New South Wales Bureau of Crime Statistics and Research has adf.org.au ABN 66 057 731 192 Inquiry into family, domestic and sexual violenceSubmission 91 PG.8 noted “we are not entirely confident that all alcohol-related assaults would be coded as alcohol- related’.xxxvi Recommendation: That the Inquiry recommend that alcohol delivery services be required to retain sales data and delivery data that indicates the volume of sales per business, the postcode location of deliveries and the amount of alcohol delivered in all deliveries.
Recommendation: That the Inquiry recommend better data collection in relation to alcohol- related family, domestic and sexual violence., particularly by Police.

h) The experiences of all women, including Aboriginal and Torres Strait Islander women, rural women, culturally and linguistically diverse women, LGBTQI women, women with a disability, and women on temporary visas.
The Australian Institute of Health and Welfare reports that alcohol consumption is significantly higher in regional and remote areas of Australia when compared to major cities and that the use of alcohol and some drugs, as well as harms related to use and access to treatment, is very different for people living in non-urban areas.xxxvii.

Statistics show that Aboriginal and Torres Strait Islander peoples are less likely to drink alcohol than other Australians.
But those that do drink are more likely to drink at dangerous levels.

xxxviii Aboriginal and Torres Strait Islander women are five times more likely to experience physical violence than other Australian women in the previous year and Aboriginal and Torres Strait Islander women are 35 times more likely to be hospitalised due to family violence related assaults than other Australian women.
According to the Australian Productivity Commission, Aboriginal and Torres Strait Islander women are twice as likely to die as an outcome of family violence compared to other Australian women.xxxix The National Community Attitudes towards Violence Against Women Survey reported that, compared with respondents from English speaking backgrounds, people from countries where English was not the main language were more than two times as likely to agree that a woman was partly to blame for a sexual assault if affected by alcohol or drugs at the time and more than 3 times as likely to agree that domestic violence could be excused if the victim was heavily affected by alcohol.xl i) The impact of natural disasters and other significant events such as COVID-19, including health requirements such as staying at home, on the prevalence of domestic violence and provision of support services.
In the wake of other experiences of mass trauma, such as terrorism, mass shootings, natural disasters like hurricanes, and economic events such as the 2008 global financial crisis an overall increase in alcohol use was recorded.
In addition to massive events that can affect whole adf.org.au ABN 66 057 731 192 Inquiry into family, domestic and sexual violenceSubmission 91 PG.9 populations, individual stressors such as job loss, financial strain, the death of a loved one, and relationship breakdown can also lead to an increase in a person’s alcohol consumption.
xli People who currently experience issues with alcohol, or have in the past, might be more vulnerable to using alcohol as a coping mechanism to deal with stress.xlii The UN Inter-Agency statement on violence against women and girls in the context of COVID-19 has urged governments to make prevention and redress of violence against women and girls a key part of their national response plans for COVID-19.
It mentions “curtailing alcohol sales” as a preventative measure.xliii There is emerging data that has highlighted that the role the COVID-19 pandemic is having in increasing alcohol consumption patterns in Australia.

An ABS Household Impacts of COVID-19 Survey found 14 per cent reported drinking more.
xlivAn ANU study found almost one-in-four women who drank at all (22.8 per cent) reported an increase in drinking during May 2020; and almost one-in-five men (17.9 per cent).xlv An ADF commissioned YouGov poll found 14 29% of parents in Australia have increased their alcohol consumption during the COVID-19 lockdown, 14% drinking alcohol on a daily basis during the COVID-19 lockdown and 20% drinking every day or every other day in front of their children.xlvi This is in addition to the increase in the risks factors for increased AOD use (such as unemployment) that contributes and is changing the alcohol consumption patterns of Australians (i.e.
drinking more at home) which is of strong concern for the ADF.

Noting the strong relationship between alcohol use and DFV, and the increase in time families are spending together in the home, these raises some concerns and strategies to reduce the risks should be considered.

A Monash University survey of 166 Victorian family violence victim support practitioners, during Covid-19, found almost 60 per cent of practitioners said the COVID-19 pandemic had increased the frequency of violence against women.
Half of respondents said the severity of violence had increased.xlvii An ADF survey found 29% of parents in Australia have increased their alcohol consumption during the COVID-19 lockdown and 14% reporting drinking alcohol on a daily basis during the COVID-19 lockdown.

xlviii The ADF welcomes the Australian Government’s announcement on the 29th March 2020, of $.1.1 billion to support more Medicare, mental health and domestic violence services.
The ADF is particularly pleased the Australian government announced on April 24th, 2020 that it would commit an additional $6 million to support online access to drug and alcohol services during Covid-19.

This includes $2 million for the ADF to deliver information and awareness campaigns to make Australians aware of the help that is available, as well as develop resources specific to the isolation context.
Relationships that were already strained can deteriorate further under new pressures such as everyone being in the home all day.

For people who are already living in a volatile relationship, this can be a significant problem.
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