Alcohol

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The National Health and Medical Research Council (NHMRC) publishes guidelines for reducing health risks associated with drinking alcohol. New Australian guidelines to reduce health risks from drinking alcohol were released in December 2020. Data for alcohol risk in this report are measured against the guidelines in place at the time of data collection. For example the 2019 National Drug Strategy Household Survey (NDSHS) and 2017-2018 National Health Survey (NHS) data are collected against the 2009 guidelines, while 2020 NHS data are collected against the 2020 guidelines. NDSHS data relating to the updated guidelines are available in the Measuring risky drinking according to the Australian alcohol guidelines report.

The consumption of alcohol is widespread within Australia and associated with many social and cultural activities. Provided compliance with certain conditions, consuming and selling alcohol is legal in Australia and it is widely accepted. When consumed, alcohol produces a number of central nervous system depressant effects.

Alcohol concentration varies considerably with the type of drink. In Australia, beer contains 0.9–6% alcohol, wine contains 12–14%, fortified wines such as sherry and port contain around 18–20%, and spirits such as scotch, rum, bourbon and vodka contain 40–50% (NSW Ministry of Health 2017).

Availability

For related content on alcohol availability by region, see also:

Data by region: International comparisons

Data about the volume of alcohol available for consumption in Australia are collated by the Australian Institute of Health and Welfare using data on import clearance, excise and domestic alcohol sales (AIHW 2023c). There were 208.8 million litres of pure alcohol available for consumption in Australia in 2019–20, a slight decrease from 210.3 million litres in 2018–19 (Figure ALCOHOL1). This represents around 10 litres per capita , which has remained stable over the past decade (per capita consumption refers to the Australian population aged 15 and over). 

In 2019–20, wine accounted for the largest proportion of apparent alcohol consumption (42% of all available alcohol), followed by beer (35%) and spirits (21%)  (AIHW 2023c). Trends in apparent alcohol consumption vary by beverage type:

  • Wine consumption decreased from 90.4 to 87.0 million litres of pure alcohol between 2018–19 and 2019–20 (or 4.4 to 4.2 litres per capita). This represents the first decline since 2012–13, following an overall rise since the 1960s.
  • Beer consumption has steadily fallen since peak in the 1970s, declining from 92.2 to 72.4 million litres of pure alcohol between 1974–75 and 2019–20 (or 9.2 to 3.5 litres per capita).
  • Apparent consumption of spirits has fluctuated over time, rising from 35.4 to 44.2 million litres of pure alcohol between 2016–17 and 2019–20 (or 1.8 to 2.1 litres of pure alcohol). This is the highest level since 2007–08 (38.8 million litres, or 2.3 litres per capita).
  • Cider consumption has remained low and stable over time, representing 5.2 million litres of pure alcohol in 2019–20 (0.25 litres per capita) (Figure ALCOHOL1).

In 2021, Australia was above the OECD average for litres per capita of alcohol available for consumption by people aged 15 and over (10.1 compared with 8.4 litres per capita) (OECD 2022). It should be noted the OECD report has yet to be updated with the latest available Australian data.

 In terms of Australian household spending on alcohol, on average households spent $32 on alcoholic beverages per week and this has remained stable between 2009–10 and 2015–16 (ABS 2017, Table 1.1).

Figure ALCOHOL1: Apparent consumption of alcohol by beverage type, 1944–45 to 2019–20 (litres per capita or total volume)

This figure shows a decrease in the per capita consumption of pure alcohol in litres from 1968 to 2018. In 2018, there were 9.51 litres of pure alcohol available for consumption per person aged 15 years and over, a trend that has remained stable since 2017 (9.48 litres) and a decrease from 10.78 litres in 1968. The per capita consumption of wine and spirits/ready to drinks consumed in litres has increased from 1968 to 2018, while the per capita consumption of beer has decreased.

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Consumption

For related content on alcohol consumption by region, see also:
Data by region: Alcohol consumption

The majority of Australians aged 14 and older have consumed alcohol in their lifetime. The 2019 National Drug Strategy Household Survey (NDSHS) found that:

  • of the population aged 14 and over, around three-quarters (77%) had consumed a full serve of alcohol in the previous 12 months, and 23% had not consumed alcohol (Figure ALCOHOL2; AIHW 2020, Table 3.1)
  • the proportion of the population aged 14 and over who consumed alcohol daily declined significantly between 2016 (6.0%) and 2019 (5.4%) (AIHW 2020, Table 3.1)
  • the proportion of ex‑drinkers increased significantly from 7.6% in 2016 to 8.9% in 2019 (AIHW 2020, Table 3.1)
  • alcohol was the only drug where approval of regular use by an adult (45%) was higher than disapproval (21%) (AIHW 2020).

Figure ALCOHOL2: Alcohol drinking status, people aged 14 and over, 2001 to 2019 (percent)

The figure shows a long-term decline in the proportion of people aged 14 and over who drink weekly or daily, and an increase in people who have never consumed a full glass of alcohol or drink less than monthly. From 2004 to 2019, the graph shows a steady decline in the proportion of people who drink alcohol weekly (from 41.7% to 34.9%) or daily (from 9.1% to 5.4%). Conversely, over the same period, there has been a rise in the number of ex-drinkers (from 6.3% in 2004 to 8.9% in 2019) and people who have never consumed a full glass of alcohol (from 9.3% to 14.4%, respectively). In 2019, people were more likely to drink weekly (both 34.9%).

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These findings are consistent with the National Health Survey (NHS) which found that in 2017–18 among Australians aged 18 and over, 79% had consumed alcohol in the past year (ABS 2018b). A further 8.5% had consumed alcohol 12 or more months ago, and 11.6% had never consumed alcohol (ABS 2018b, Table 10.3).

Lifetime risk

Many drinkers consume alcohol responsibly; however, a substantial proportion of drinkers consume alcohol at a level that exceeds that recommended by the NHMRC and in doing so, increase their risk of alcohol-related harm (see Box ALCOHOL1).

Box ALCOHOL1: Summary of the Australian guidelines to reduce health risks from drinking alcohol

The National Health and Medical Research Council (NHMRC) publishes guidelines for reducing health risks of drinking alcohol. The NHMRC released new Australian guidelines to reduce health risks from drinking alcohol in December 2020. Data for alcohol risk in this report are measured against the guidelines in place at the time of data collection. For example NDSHS and 2017-2018 NHS data are collected against the 2009 guidelines, while 2020 NHS data are collected against the 2020 guidelines. NDSHS data relating to the updated guidelines are available in the Measuring risky drinking according to the Australian alcohol guidelines report.

The 2009 Guidelines state:

  1. Guideline 1: To reduce the risk of alcohol-related harm over a lifetime (such as chronic disease or injury); a healthy adult should drink no more than 2 standard drinks a day.
  2. Guideline 2: To reduce the risks of injury on a single occasion of drinking, a healthy adult should drink no more than 4 standard drinks on any one occasion.
  3. Guideline 3: For children and young people under 18, not drinking is the safest option. For young people aged 15–17 years, delaying the start of alcohol consumption for as long as possible is the safest option.
  4. Guideline 4: Women who are pregnant, planning a pregnancy or breast-feeding should not drink at all. The greatest harm to the foetus or breastfeeding infant occurs when drinking is at high and frequent levels, but no level of drinking is considered safe (NHMRC 2009).

The 2020 Guidelines state:

  1. Guideline 1: To reduce the risk of harm from alcohol-related disease or injury, healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day.
  2. Guideline 2: To reduce the risk of injury and other harms to health, children and people under 18 years of age should not drink alcohol.
  3. Guideline 3:
    1. To prevent harm from alcohol to their unborn child, women who are pregnant or planning a pregnancy should not drink alcohol.
    2. For women who are breastfeeding, not drinking alcohol is safest for their baby (NHMRC 2020).

There has been a decline in the proportion of Australians exceeding the 2009 guidelines for lifetime risk by consuming more than 2 standard drinks per day, on average (Figure ALCOHOL3). The 2019 NDSHS found that:

  • The proportion of people aged 14 and older exceeding lifetime risk guidelines declined from 21% in 2001 to 16.8% in 2019. However, there has been little change since 2016 (17.2%) (AIHW 2020, Table 3.13).
  • Of people aged 14 and over, males are far more likely than females to drink at risky levels – about 1 in 4 (24%) males and 1 in 10 (9.4%) females exceeded the lifetime risk guidelines (AIHW 2020).

Similarly, after adjusting for age, the NHS reported that in 2017–18, 16.0% of adults aged 18 and over exceeded the lifetime risk guideline, a decrease from 17.3% in 2014–15 and 19.4% in 2011–12 (Table S2.2). A higher proportion of males than females exceeded the lifetime risk guidelines (23.7% compared with 8.8%) (Table S2.27).

The National Health Survey 2020-21 was collected online during the COVID-19 pandemic and is a break in time series. Data should be used for point-in-time analysis only and can’t be compared to previous years. Data for this release were collected against the 2020 Australian guidelines to reduce health risks from drinking alcohol. Estimates using self-reported data show that in 2020-21:

  • 1 in 4 (25.8%) Australians aged 18 years and over exceeded the 2020 Australian Alcohol Guidelines. This includes people who consumed more than 10 drinks in the last week and/or consumed 5 or more drinks in any day at least monthly in the last 12 months.
  • Men were more likely than women to exceed the guideline (33.6% compared to 18.5%).
  • People born in Australia were almost twice as likely as those born overseas to exceed the guideline (30.0% compared to 17.3%) (ABS 2022).

Single occasion risk

There are a considerable number of Australians who report consuming alcohol in excess of the single occasion risk guidelines – that is, more than 4 standard drinks on any one occasion (this is the case for the 2009 and 2020 guidelines). Specifically, 2019 NDSHS findings showed that:

  • 1 in 4 (25%) people aged 14 and over drank at a risky level on a single occasion at least monthly, a similar proportion to 2016 (26%) (AIHW 2020, Table 3.13).
  • As with lifetime risk, a higher proportion of males (33%) than females (16.6%) exceeded the single occasion risk guideline (AIHW 2020).
  • While people aged 18–24 (41%) and 25–29 (36%) were most likely to exceed the single occasion risk guideline in 2019, there were significant increases in the proportions for people aged 50–59 (27%, up from 25% in 2016) and 70 and over (8.8%, up from 7.2% in 2016). Conversely, there was a significant decrease in the proportion of people aged 30–39 who exceeded the single occasion risk guideline in 2019 (28%, compared with 31% in 2016) (AIHW 2020, Table 3.17).

The 2017–18 NHS results reported about 2 in 5 (42.1%) adults aged 18 and older consumed more than 4 standard drinks on a single occasion at least once in the past year, exceeding the single occasion risk guidelines (ABS 2018b). Adult males (54.2%) were more likely than females (30.5%) to exceed the single occasion risk guideline in the last 12 months (ABS 2018b, Table 11.3).

Figure ALCOHOL3: Abstainers, lifetime risk or single occasion risk (at least monthly), people aged 14 and over, by age and sex, 2007 to 2019 (percent)

The figure shows a long-term increase in the proportion of people aged 14 and over who exceeded single occasion risky drinking guidelines between 2007 and 2019. People aged 18–24 and 14–17 who exceeded single occasion risky drinking guidelines experienced the largest decrease between 2007 and 2019 (from 53.8% to 40.9% and from 24.7% to 8.9%, respectively). Over the same period there were increases in the proportion of people aged 50–59 and 60–69 who exceeded single occasion risky drinking guidelines (from 23% to 27.4% and 14.9% to 17.4%, respectively). In 2019, people aged 18–24 were most likely to exceed single occasion risky drinking guidelines (40.9%).

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Geographic trends

As with the national trends for the 2019 NDSHS, there were no significant differences in the proportion of people exceeding the lifetime and single occasion risk guidelines across jurisdictions between 2016 and 2019. However, the proportions reported across jurisdictions in 2019 were lower than those reported in 2007 (AIHW 2020). The proportion of ex‑drinkers increased significantly between 2016 and 2019 in New South Wales (from 7.2% to 9.3%), Victoria (from 7.0% to 8.8%) and South Australia (from 6.6% to 8.5%) (AIHW 2020).

In general, people living in Regional and Remote areas of Australia are more likely than people in Major cities to exceed risk guidelines.

  • The 2019 NDSHS findings showed that people aged 14 or over living in Remote and very remote areas of Australia are about 1.5 times as likely as people living in Major cities to exceed lifetime risk guidelines (26% compared with 15.6%) and the single occasion risk guidelines (at least monthly) (38% compared with 24%) (Figure ALCOHOL4; AIHW 2020, Table 7.15). These findings were still apparent after adjusting for differences in age (AIHW 2020).
  • The 2017–18 NHS results showed that adults (aged 18 or older) in Outer regional and Remote areas were 1.7 times as likely to exceed lifetime risk guidelines as those in Major cities (24.4% and 14.7%, respectively) (Table S2.2; age-standardised proportions).

Figure ALCOHOL4: Exceeded lifetime risk or single occasion risk (at least monthly) guidelines, by remoteness area or socioeconomic area, people aged 14 and over, 2010 to 2019 (percent)

The figure shows the proportion of people aged 14 and over who exceeded lifetime risk guidelines by remoteness area for 2010, 2013, 2016 and 2019. The proportion of people exceeding lifetime risk guidelines has declined across all 5 remoteness areas between 2010 and 2019. In 2019, the proportion of people exceeding lifetime risk guidelines were most likely to be located in Remote and very remote areas (26%) and the proportion of people least likely to exceed these guidelines were located in Major cities (16%).

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The National Wastewater Drug Monitoring Program (NWDMP) measures the presence of substances in sewerage treatment plants across Australia. Alcohol is typically one of the most commonly detected substances monitored by the program. Since the beginning of the Program in 2016, the estimated population-weighted average consumption of alcohol has remained relatively steady, averaging out short-term fluctuations (ACIC 2022).

Data from Report 20 of the NWDMP showed that between December 2022 and April 2023, population-weighted average regional alcohol consumption exceeded consumption in capital cities. Additionally:

  • Consumption levels rose slightly for regional areas and capital cities in April 2023, but have remained at the lower levels recorded since the beginning of the program in 2016.
  • Since 2021, population-weighted national average consumption of alcohol has declined in regional areas, with little change in capital cities.
  • In many parts of the country, differences in consumption were recorded between days of the week, in most cases due to higher consumption of alcohol on weekends (ACIC 2023). 

For state and territory data, see the National Wastewater Drug Monitoring Program reports.

Figure ALCOHOL5: Estimated consumption of alcohol in Australia based on detections in wastewater, December 2022 to April 2023

Alcohol is one of the most consumed drugs measured in wastewater

Alcohol consumption was slightly higher in regional areas than capital cities

Between December 2022 and April 2023, average consumptionᵃ of alcohol increased in both Capital cities and in Regional sites

a 'Average consumption' refers to estimated population-weighted average consumption.
Note: April and June 2023 data are from 55 wastewater treatment sites, covering approximately 55% of the Australian population.
Source: AIHW, adapted from ACIC 2023.

Poly drug use

Poly drug use is defined as the use of mixing or taking another illicit or licit drug whilst under the influence of another drug. In 2019, the NDSHS showed more than 1 in 4 recent risky drinkers reported recent use of cannabis (27% for lifetime risky drinkers and 28% for single occasion risky drinkers). Around 1 in 5 reported that they were also daily smokers (21% for lifetime risky drinkers and 18.7% for single occasion risky drinkers) (AIHW 2020, Table 1.3).

Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System (NASS). Monthly data for 2021and 2022 are currently available for New South Wales, Victoria, Queensland, Tasmania, and the Australian Capital Territory. It should be noted that some data for Tasmania and the Australian Capital Territory have been suppressed due to low numbers. For more information, please see the data quality statement.

In 2022, the proportion of alcohol intoxication-related ambulance attendances where multiple drugs were involved was low relative to other drug-related attendances, ranging from 15% of attendances in New South Wales to 20% of attendances in Australian Capital Territory (Table S1.11).

For related content on multiple drug involvement see Impacts: Ambulance attendances.

Harms

Alcohol is absorbed rapidly in the bloodstream and affects the brain within about 5 minutes, though this may vary from person to person depending on body mass and general state of health (NSW Ministry of Health 2017). Short-term effects of alcohol such as a sense of relaxation and reduced inhibitions, may add to the appeal of its consumption. However, when consumed in excess, alcohol can also produce unpleasant effects such as nausea and vomiting and may influence people to engage in harmful behaviour (Table ALCOHOL1).

Table ALCOHOL1: Effects of alcohol consumption
Short-term effectsLong-term effects
  • Reduced inhibitions
  • A sense of relaxation
  • Loss of alertness or coordination, and slower reaction times
  • Impaired memory and judgement
  • Nausea, shakiness, and vomiting
  • Blurred or double vision
  • Disturbed sleep patterns
  • Disturbed sexual functioning
  • Oral, throat, and breast cancers
  • Liver cirrhosis
  • Brain damage and dementia
  • Some forms of heart disease and stroke

Source: NSW Ministry of Health (2017).

Burden of disease and injury

The Australian Burden of Disease Study 2018 found that alcohol use was the fifth highest risk factor contributing to the burden of disease in Australia and was responsible for 4.5% of the total burden of disease and injury (AIHW 2021 (Table S2.3). The age-standardised rate of total attributable burden due to alcohol use decreased from 9.5 DALY per 1,000 population to 8.5 in 2018 (a 10.5 % decline from 2003 to 2018).

Alcohol use contributed to a number of diseases and injuries including:

  • 100% of the burden due to alcohol use disorders
  • 40% of the burden due to liver cancer
  • 25% of the burden due to road traffic injuries involving motor vehicle occupants
  • 19.2% of the burden due to chronic liver disease
  • 14.2% of the burden due to suicide and self-inflicted injuries (AIHW 2021b) (Table S2.4).

The 2019 NDSHS reported that 1.2% of recent drinkers were injured while under the influence of alcohol and required medical attention while less than 1% (0.4%) required admission to hospital for their injuries. Less than 1.0% of recent drinkers required medical attention (0.3%) or hospitalisation (0.2%) because they were intoxicated (AIHW 2020).

This risk increased for people who consumed alcohol at risky quantities. Specifically, 3.0% of people that exceeded lifetime risk guidelines required medical attention due to injuries sustained while drinking or due to intoxication, compared with less than 1% (0.5%) for low-risk drinkers. Further, 4.9% of people who consumed 11 or more standard drinks at least monthly, required medical attention for their injuries (AIHW 2020, Table 3.44; Figure ALCOHOL6).

Alcohol consumption in pregnancy

Alcohol consumption during pregnancy can lead to poorer perinatal outcomes including low birthweight, pre-term birth and fetal alcohol spectrum disorder (FASD). The National Health and Medical Research Council (NHMRC) advises that women who are planning a pregnancy, or are pregnant, should not drink alcohol.  Support to address alcohol consumption is available through antenatal clinics (AIHW 2023d).

In 2021, the AIHW’s National Perinatal Data Collection included data from 7 jurisdictions (data was not available for New South Wales). This data indicates that mothers consumption of alcohol in the first 20 weeks of pregnancy, mothers were more likely to consume alcohol if they:

  • lived in Very remote (7.1%) or Remote (4.6%) areas
  • were Indigenous (7.5%)
  • aged under 20 (4.6%) (AIHW 2023d).

Figure ALCOHOL6: People who have been injured or intoxicated and required medical attention while under the influence of alcohol, recent drinkers aged 14 and over, by alcohol risk, 2019 (percent)

This figure shows that, in 2019, 3% of people aged 14 and over that exceeded lifetime risk guidelines required medical attention due to injuries sustained while intoxicated, compared with 0.5% for low risk drinkers. Additionally, 4.9% of people who consumed 11 or more drinks on a single occasion at least monthly required medical attention, compared to 3.1% who consumed 11 or more drinks on a single occasion at least yearly.

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Ambulance attendances

Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System (NASS). 

The highest number and rate of ambulance attendances continues to be alcohol intoxication-related (Supplementary data Table 12 and & S2.10). Monthly data are presented from 2021 for people aged 15 years and over for New South Wales, Victoria, Queensland, Tasmania, and the Australian Capital Territory. Monthly data for Northern Territory are presented from 2022.

In 2022, for alcohol intoxication-related ambulance attendances in these jurisdictions:

  • Rates of attendances ranged from 444.3 per 100,000 population (29,641 attendances) in New South Wales to 2,598 (5,136 attendances) in the Northern Territory (Table S1.10).

For the 5 jurisdictions where alcohol and other drug-related ambulance attendance data are available for age and sex disaggregation (New South Wales, Victoria, Queensland, Tasmania and the Australian Capital Territory):

  • 3 in 5 (59%) of total attendances were for males.
  • The highest rates of attendances were in people aged:
    • 45–54 in Queensland (828.7 per 100,000 population) and Tasmania (819.0 per 100,000 population)
    • 15–24 in Tasmania (941.0 per 100,000 population) and Queensland (851.0 per 100,000 population) (Table S1.9).

For the 5 jurisdictions where monthly data from 2021 is available, between 2021 and 2022:

  • Rates of alcohol intoxication-related ambulance attendances have decreased across all jurisdictions, with the exception of Tasmania.
  • In Tasmania, rates of alcohol intoxication-related ambulance attendances have increased from 561.9 per 100,000 population in 2021 to 627.0 in 2022 (Table S1.10).

Figure ALCOHOL7: Ambulance attendances for alcohol, by age, sex and selected states and territories, 2021 to 2022

This figure shows alcohol-related ambulance attendances in NSW. The highest number of attendances were for males aged 55+. There is a filter to select year, state/territory, drug and measure (number of attendances or rate per 100,000 population).

Hospitalisations

Drug-related hospitalisations are defined as hospitalisations with a principal diagnosis relating to a substance use disorder or direct harm relating to use of selected substances (AIHW 2018).

AIHW analysis of the National Hospital Morbidity Database showed that alcohol accounted for more than half of drug-related hospitalisations in 2021–22 (59% or 80,300 hospitalisations). This represents a rate of 311.4 alcohol-related hospitalisations per 100,000 population (Table S1.15). Alcohol has remained the most common drug recorded in drug-related hospitalisations over the 7 years to 2021–22.

In 2021–22:

  •  Around 1 in 2 alcohol-related hospitalisations involved an overnight stay (52% or 41,300 hospitalisations), while the remainder ended with a same-day discharge.
  • Males were more likely than females to be hospitalised; almost 3 in 5 alcohol-related hospitalisations (58% or 46,300 hospitalisations).
  • 1 in 3 alcohol-related hospitalisations were people aged 55 years and over (31% or 24,700 hospitalisations) (Table S1.14). 
  • Almost 3 in 4 alcohol-related hospitalisations occurred in Major cities (73% or 58,300 hospitalisations) (Table S1.16). 
  • Alcohol-related hospitalisations were twice as likely in Remote and Very remote areas than in Major cities (Remote and Very remote areas 627.3 hospitalisations per 100,000 population, compared with 316.5 in Major cities). 

In the 7 years to 2021–22:

  • The number alcohol-related hospitalisations increased between 2015–16 and 2020-21 (from 68,200 to 86,400 hospitalisations), before falling to 80,300 in 2021–22.
  • Accounting for population growth, the rate of alcohol-related hospitalisations increased between 2015–16 and 2020-21 (from 284.3 to 337.1 per 100,000 population), then decreased in 2021–22 (311.4 per 100,000). 
  • The rate of alcohol-related hospitalisations in Remote and Very remote areas reflected the rates seen nationally, with a peak in 2020–21 (775.4 per 100,000), declining in 2021–22 (627.3 per 100,000). 

Population estimates used to calculate rates for 2020–21 may have been impacted by public health measures introduced during the COVID-19 pandemic. For more information, see the Technical notes.

Alcohol-related injuries

The definitions of alcohol-related conditions in the following injury statistics are different to those reported elsewhere in this report; for methodology and definitions please see Alcohol-related injury: hospitalisations and deaths, 2019-20.

In 2019–20, alcohol-related injury hospitalisations accounted for 5.7% of all injury hospitalisations and 14% of all injury deaths.

Polydrug use was common in alcohol-related injuries, with 55% (16,400) of cases recording the presence of other drugs in addition to alcohol (AIHW 2023b).

Alcohol-related injury hospitalisations

In 2019–20 alcohol-related injuries resulted in 30,000 hospitalisations (118 per 100,000 population). The most common causes of alcohol-related injury hospitalisations were falls (39%), intentional self-harm (24%), assault (15%) and transport (7.2%) (AIHW 2023b).

Alcohol-related injury deaths

In 2019–20, there were 1,900 alcohol-related injury deaths (7.7 per 100,000 population. The most common causes of alcohol-related deaths were suicide (47%), accidental poisoning (26%) and transport (11%).

Among those who died due to alcohol-related injuries:

  • 77% of deaths occurred among those aged 25–64 years of age
  • males aged 45–64 had the highest number and rate of deaths (590 deaths and 19.5 per 100,000) (AIHW 2023b).

Deaths

Alcohol-induced deaths are defined as those that can be directly attributable to alcohol use (that is, where an alcohol-related condition is recorded as the underlying cause of death), as determined by toxicology and pathology reports (for example, alcoholic liver cirrhosis or alcohol poisoning). Alcohol-related deaths include deaths directly attributable to alcohol use and deaths where alcohol was listed as an associated cause of death (for example a motor vehicle accident where a person recorded a high blood alcohol concentration) (ABS 2018a). See also Health impacts: Deaths due to harmful alcohol consumption.

In 2022, ABS Causes of Death reported 1,742 alcohol-induced deaths registered (1,245 males and 497 females) (ABS 2023, Table 13.11), additionally:

  • The alcohol-induced death rate for males was higher than females (8.7 per 100,000 population for males, compared with 3.4 deaths per 100,000 population for females) (ABS 2023, Table 13.11).
  • The highest age-specific rates were for 55–64 (17.5 per 100,000 population) and the lowest rates were for those aged 15–34 (0.8 per 100,000 population) (ABS 2023, Table 13.12).

Around 9 in 10 (1,588 or 91%) alcohol-induced deaths were related to chronic conditions (including alcoholic liver cirrhosis). Acute alcohol-induced deaths (including alcohol poisoning) accounted for 154 deaths. Additionally:

  • 72% of chronic alcohol-induced deaths were for males and 63% were in people aged 55 and over.
  • 71% of acute alcohol-induced deaths were for males and 53% were in those aged between 45–64 years (ABS 2023, Table 13.16).

Australian Institute of Health and Welfare (AIHW) analysis of the AIHW National Mortality Database showed that of the 1,559 alcohol-induced deaths registered in 2021:

  • the highest age-specific rates were for older people, 15.5 per 100,000 population for those aged 55–64; 11.8 for those aged 45–54 and 11.2 for those aged over 65 (Supplementary Table S1.4b). 
  • the majority (74%, or 1,156 deaths) were recorded for males (Supplementary Table S1.4a).

The most common cause of alcohol-induced death in 2021 was liver disease, followed by mental and behavioural disorders due to psychoactive substance use. Mental and behavioural conditions due to psychoactive substance use was also the most common contributor to alcohol-related deaths (Table S1.6).

See also:

Treatment

The 2021–22 Alcohol and Other Drug Treatment Services in Australia annual report shows that for people receiving treatment for their own drug use, alcohol was the most common principal drug of concern (42% of episodes) (AIHW 2023a).

This was an increase from 37% in 2020–21 (AIHW 2023a).

Data collected for the AODTS NMDS are released twice each year – an Early Insights report in April and a detailed report mid-year.

The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) provides information on treatment provided to clients by publicly funded AOD treatment services, including government and non-government organisations. Data from the AODTS NMDS show that alcohol is the most common principal drug of concern among clients seeking treatment for their own drug use (AIHW 2023a). 

In 2021–22, where alcohol was the principal drug of concern:

  • 3 in 5 (61%) of clients were male and over 1 in 6 (17%) were Indigenous Australians (AIHW 2023a, tables SC.9 and SC.11; Figure ALCOHOL8)
  • 26% of clients were aged 30–39 and 25% of clients were aged 40–49 and 26% were aged 30–39 (AIHW 2023a, Table SC.10) 
  • The most common source of referral was self/family (41% of treatment episodes), followed by health services (39%) (AIHW 2023a, Table Drg.13)
  • The most common main treatment type was counselling (35% of treatment episodes), followed by assessment only (22%) and withdrawal management (14%). These 3 main treatment types have remained the most common over the 10-year period to 2021–22 (AIHW 2023a, Table Drg.18; Figure ALCOHOL8)
  • The median treatment duration for alcohol was just over 4 weeks (29 days) (AIHW 2023a, Table Drg.21).

Figure ALCOHOL8: Treatment provided for own use of alcohol, 2021–22

Alcohol was the most common principal drug of concern (42% of treatment episodes)

1 in 6 clients were Indigenous Australians

Counselling was the most common main treatment type (over 1 in 3 episodes)

Source: AIHW 2023, tables Drg.1, SC.11 and Drg.18.

Where the principal drug of concern was alcohol, the proportion of clients who travelled one hour or longer to treatment services in 2016–17 was higher in Regional and remote areas than in Major cities (29% compared with 7%) (AIHW 2019).

Alcohol cessation medicines

Data from the Pharmaceutical Benefits Scheme (PBS) provide information on the number of prescriptions dispensed and the number of patients dispensed a script under supply of the PBS within a given financial year. The PBS database includes information on medicines that are used to help people stop alcohol consumption or maintain abstinence from alcohol (alcohol cessation medicines). For more information, refer to the Technical notes and Box PHARMS2.

Pharmacotherapy is recommended for all people experiencing moderate to severe alcohol use disorder in Australia and is best used in conjunction with psychosocial support (Haber & Riordan 2021). Data from the PBS indicate that approximately 101,000 scripts for alcohol cessation medicines were dispensed to 37,000 patients in 2021–22 (a rate of 390 scripts dispensed and 140 patients per 100,000 population) (tables PBS77–80). In 2021–22:

  • Rates of alcohol cessation medicine dispensing were higher for males than females, and males aged 40–49 had the highest rates of scripts dispensed and patients of any group (around 965 scripts and 380 patients per 100,000 population) (tables PBS82 and PBS84).
  • People aged 40–49 and 50–59 had the highest rates of dispensing of any age group (tables PBS82 and PBS84). Rates of dispensing were highest in Inner regional areas and dispensing varied between states and territories (tables PBS85–92). See Older people: Treatment for more information.
  • Rates of dispensing were highest in Inner regional areas and dispensing varied between states and territories (tables PBS85–92). Refer to Data by region for more information.

Between 2012–13 and 2020–21, rates of dispensing rose from 245 scripts and 90 patients to 390 scripts and 145 patients per 100,000 population (Supplementary tables PBS78 and PBS80).

At-risk groups

While alcohol is widely consumed in Australia, some population groups are at a greater risk of problematic consumption.

  • The proportion of First Nations people exceeding lifetime and single occasion risk guidelines is slightly higher than that of non-Indigenous Australians. There has been an increase in the proportion of First Nations people Australians who exceeded single occasion risk guidelines for drinking between 2002 and 2018–19.
  • People aged 70 and over are the most likely to drink alcohol daily and those aged 50–59 were one of the age groups most likely to exceed the lifetime risk guideline. 
  • People aged 18–24 were the most likely to exceed the single occasion risk guideline, at least monthly.
  • A higher proportion of people with a mental health condition reported drinking at risky levels (for both lifetime and single occasion risk) compared with people who had not been diagnosed or treated for a mental health condition.

Policy context

National Alcohol Strategy 2019–2028

The National Alcohol Strategy aims to provide a national framework to prevent and minimise alcohol-related harms among individuals, families and communities by:

  • Identifying agreed national priority areas of focus and policy options;
  • Promoting and facilitating collaboration, partnership and commitment from the government and non-government sectors
  • Targeting a 10% reduction in harmful alcohol consumption
    • Alcohol consumption at levels that puts individuals at risk of injury from a single occasion of drinking, at least monthly.
    • Alcohol consumption at levels that puts individuals at risk of disease or injury over a lifetime (DoH 2019).

For more information, see the National Alcohol Strategy 2019–2028

Policy support for measures to reduce problems associated with alcohol

The NDSHS includes questions aimed at measuring the level of public support for policies to reduce problems associated with alcohol. In 2019, public support declined for the majority of measures to reduce the harms from alcohol. The policies with the most support to reduce alcohol related harm were:

  • more severe penalties for drunk driving (85%)
  • the stricter enforcement of the law against supplying alcohol to minors (79%).

The least supported policy measure was to increase the price of alcohol (26%) (AIHW 2020).