Minimum unit pricing in the Northern Territory. What we know, and where to next
Alcohol is a significant risk factor for injury and death in Australia. This substantial level of harm has risen in recent years, with the alcohol-induced death rate rising in 2021 to its highest point in 10 years. The burden of alcohol-related harm is experienced most intensely in the Northern Territory (NT), and those harms are further heightened for Indigenous Territorians, 80 per cent of whom live in remote areas with high levels of socioeconomic disadvantage. Alcohol attributable death rates for Indigenous Territorians are about 10 times greater than the national average, while non-indigenous Territorians experience an alcohol-attributable death rate about twice the national average. In 2019, the annual social and economic costs of alcohol in the Territory were estimated to be AU$1.4 billion. Alcohol-related harm, particularly violence, in the NT has also come into the national spotlight recently as rates of assault have reportedly increased in Alice Springs, which has widely been attributed to expiry of the Stronger Futures policy that had banned alcohol on large swathes of Indigenous land.
The Minimum Unit Price
The NT has a long history of attempting to curb its substantial alcohol problem through a variety of policy measures, many of which have been criticised as taking a discriminatory approach to the issue (including Stronger Futures). In October 2018 a non-discriminatory pricing policy, known as the Minimum Unit Price (MUP), was introduced across the Territory.
The MUP set a floor price of AU$1.30 per standard drink (10 grams of pure alcohol) below which alcohol could not be sold. This price is set to increase in line with inflation in 2023; it is likely to increase to about AU$1.50, depending on final inflation figures.
The MUP was introduced in close proximity to two other notable interventions aimed at reducing alcohol-related harm. The first was Police Auxiliary Liquor Inspectors in all bottle shops outside Darwin, meaning any alcohol purchased outside Darwin would be done under the supervision of a police officer. The second, a Banned Drinkers Register that prevented specific individuals from purchasing alcohol, was enforced by mandatory identification scanners in all bottle shops across the NT.
The proximity of each of these interventions has made deciphering the unique impact of any one intervention difficult for researchers. Further, both of these additional interventions have been criticised as contributing to discrimination against Indigenous Territorians.
What does the evidence show?
I recently published a commentary summarising the evidence obtained in the first three years of the MUP being implemented in the NT. In summary, there has been a mostly positive impact from the MUP, with significant decreases in cask wine consumption, alcohol-related assaults, emergency department presentations, hospitalisations, and ambulance attendances. The evidence also suggested the alcohol industry was not negatively financially impacted by the introduction of the policy. Two subsequent articles have also been published, one showing that police-escorted emergency department attendances in Darwin have decreased, and the other finding that alcohol-related assaults had decreased by 14 per cent in Darwin following the introduction of the MUP. Again, the introduction of other policies and interruption caused by the pandemic meant much of this evidence was limited in scope.
Where to next?
Little is known about how much the MUP influenced purchasing behaviour of heavy or moderate drinkers, beyond that cask wine consumption halved. A substantial concern surrounding the MUP is that heavy drinkers may go without other necessities, rather than consuming less alcohol; to date, this is yet to be examined in the NT. Further, our understanding of the extent to which the MUP influences alcohol-related harm is still in its early stages. We do not know about the long-term impacts of the MUP on alcohol-related deaths, and long-term alcohol-related diseases such as liver cirrhosis. The price increase set to take place in the middle of this year will also provide researchers with an opportunity to examine the impact of an increase in the MUP, free from the introduction of other interventions.
It is clear the NT MUP has had a positive impact on alcohol consumption and related harms, with no cost to the government or alcohol industry. It is still early days in terms of quantifying the full impact of the NT’s MUP on alcohol-related harms, and on the lives and behaviours of heavy and moderate consumers alike. Further research into the MUP is essential, particularly to inform any potential introduction of the policy in other jurisdictions.