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Fact from the front line: youth and excessive alcohol a risky combination

By Paul Middleton - posted Tuesday, 6 November 2012

In a small hospital room, blandly furnished with barely comfortable armchairs and anonymous watercolours prints, I watched Michelle’s parents sink into a black hole of disbelief and grief. Since being woken out of their sleep in the darkest hours of the morning, they had furiously hoped. Now that hope was gone.

Michelle was 19, and out for her first day at the horse races with her friends. They had saved up, dressed up, and drank all the champagne they could afford. The party went on into the night, with the group giggling and staggering in their high heels through the city streets. The fun stopped when Michelle overbalanced on a corner, stumbled into the road and was hit by a truck coming round the bend. She survived for almost two hours before blood loss and brain damage took her life.

I remembered Michelle when I read commentator Miranda Devine argue that young people’s drinking is being unfairly demonized in The Daily Telegraph last week. Like Devine, I think it is unrealistic and over-simplistic to tell young people they shouldn't drink. But I also believe it is deeply irresponsible and even nihilistic not to warn them of the very real dangers of excessive alcohol consumption, especially as we head into summer and the ‘silly season’.


The tragedies and traumas I see in the emergency department are not caused by drinking per se. They are caused by drinking to absolute excess. It’s not Australians’ collective love of a drink that is the problem, but our love of getting blind drunk.

But the public debate about alcohol—now littered with phrases like ‘wowser’ and ‘nanny’— has become so mired in hyperbole that the true messages young Australians need to hear have become confused and blurred.

Civil libertarians argue that young people should not be demonised for having a ‘sip of wine’. But this line of argument consciously distorts the vitally important message that drinking a lot of booze when you are young makes you far more likely to be assaulted, have accidents and die.

Alcohol is undoubtedly the drug associated with more harm than any other in every emergency department I have ever worked.

According to the National Health and Medical Research Council, alcohol is to blame for one in six deaths among 14–17-year-old Australians. They estimate that one Australian teenager dies each week because of alcohol, and more than 60 are hospitalised.

Risky drinking isn’t something kids grow out of when they come of age either. The Australian Medical Association says that people in their twenties are one and half times more likely to binge drink than teenagers. A recent Australian study found that a quarter of female university students reported four or more heavy drinking sessions per month.


This is not a puritanical crusade against alcohol; I love the sociable Australian lifestyle. I love a few cold beers on a hot day, and great wine with food. I spent my 20’s as a medical student and rugby player, and learned first-hand that alcohol has social benefits as well as potential negative consequences.

Australians’ relationship with alcohol is complex, but our public debate about it is frustratingly simple.

I get angry when I remember Michelle, and remember her parents’ grief. I get angry when I think of all the other young men and women that arrived in the emergency ward in an ambulance but never got to go home. And I get angry when I see the real harm caused by alcohol obscured by the myopic politics of left versus right, or glossed over to make a cheap point about civil liberties and the ‘nanny state.’

Standing next to a mother and father as their desperate façade of bravery crumples, as the terrible reality of losing their child invades them, is the most awful time to be a doctor. The harm from alcohol is real and can destroy lives and families.

To those who believe my arguments are part of a leftist, anti-libertarian, political agenda, please feel free to spend an evening or two in the emergency department with me. See for yourself the blood, bruises and tears which are the reality behind young people’s excessive alcohol consumption every day and night across Australia.

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About the Author

Associate Professor Paul Middleton is a specialist in emergency medicine. He is Chair of the NSW branch of the Australian Resuscitation Council and works as a Visiting Medical Officer in Emergency Departments of major hospitals in NSW and ACT.

He is Director of the Australian Institute for Clinical Education which teaches doctors and nurses how to treat serious illness and injury. He is the author of What To Do When Your Child Gets Sick, published by Allen and Unwin.

Other articles by this Author

All articles by Paul Middleton

Creative Commons LicenseThis work is licensed under a Creative Commons License.

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