Cost of hidden harm: alcohol’s harm to others

Like us, you may have been verbally abused by a person drinking on public transport or at a bus station, or been woken up in the middle of night because your neighbours were drinking and having a party. You may have cut your foot on a broken bottle. In worse cases, some people may have been physically abused by an intoxicated partner or been assaulted by a stranger who was under the influence of alcohol.

Harms from others’ drinking include not only these kinds of harms, but being emotionally hurt, experiencing a lower quality of life because you are worried about the drinking of the person you live with, and having to do more work because they are not able to do what they would normally do because they are drinking. These various types of alcohol’s harm to others (AHTO) are commonplace but often hidden.

Although harms from others’ drinking have been reported upon more recently, the economic costs of these harms have rarely been discussed. The costs of alcohol use were USD $249 billion in the US in 2010 and CAD $16.6 billion in Canada in 2017. The social cost of alcohol use was $AUD 15.3 billion in 2004-05 and $14.4 billion in 2010 in Australia.

However, most of the costs measured were costs or harms to the person drinking, or for services they needed. The harms of alcohol use we refer to often extend to people other than the person drinking, such as to bystanders, non-drinkers and other people drinking but not affecting others.

Our study used a general population survey of over 2,600 adults and routinely collected social response agency data to quantify various costs of alcohol’s harm to others, such as for health care; social services; crimes; productivity loss; quality of life-year loss and other expenses.

What do we find?

Our study reveals that over two-thirds of Australian adults have been adversely affected by someone else’s drinking, costing the country an estimated $20 billion a year in healthcare and social services, informal caregiving, lost quality of life and diminished productivity.

While the costs for the agencies that address the needs of those affected by others’ drinking, for instance hospitals, the criminal justice system, police and alcohol and other drug treatment and counselling services, are large, the individual costs to those affected by others’ drinking are much greater. The majority of the costs of alcohol’s harm to others stem from the loss of quality of life, damage to property and personal belongings and other related expenses and time spent on informal caregiving. The system costs of providing child protection services linked to parents’ drinking are also substantial (See Table 1).

Table 1 Cost of alcohol harm to others in 2016 in Australia

Costing of harm items	Cost (million AUD)
Quality of life	$7,990.00m
Property and belongings damage and other expenses	$5133.29m
Informal care giving	$2,930.00m
Child protection	$1,610.00m
Time seeking health and social services	$573.55m
Violence and crime	$560.12m
Co-workers’ duty	$414.98m
Premature death	$373.59m
Public spending on services	$130.62m
Hospitalisations and other medical treatment	$84.39m
Government spending on counselling services	$2.10m
Total	$19.8 billion

We found that the total intangible cost (the quality-of-life loss and premature death) was slightly lower than the total tangible cost (system and individual financial expenses) estimated to be due to others’ drinking.

We found that the burden to others from drinking was of the same general magnitude as the burden that people drinking impose on themselves and on the response agencies addressing their needs.

Our study findings doubled the total societal costs of alcohol use (costs of alcohol use to drinkers and people around the drinkers) in Australia. This means that it is likely that these costs could be doubled in many countries. This distinguishes alcohol from tobacco, where the burden of health harm to the smoker is much greater than the burden of second-hand smoke.

What can we do?

Our study provides evidence that governments should take an active role in reducing the burden of harm that drinking causes for non-drinkers, bystanders and other people drinking in ways that do not cause harm. Active intervention in alcohol markets will reduce these externalities. Even politically conservative small-government advocates concede that governments have a role in remedying the market imperfections that create these externalities.

Alcohol control policies, such as raising taxes and prices or introducing a minimum unit price, controlling liquor outlet density, and brief interventions that reduce heavy drinking, will not only reduce harms and costs to drinkers themselves, but also reduce costs and the burden of alcohol harm caused to people around drinkers.

Written by Dr Heng (Jason) Jiang and Dr Anne-Marie Laslett, Senior Research Fellows at the Centre for Alcohol Policy Research (CAPR), School of Psychology and Public Health, La Trobe University.