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The 50-or-so papers in this collection have been divided into thirteen thematic sub-categories to make it easier to find the relevant information. To view the documents in each sub-category, as well as a description of the sub-category itself, please click on the links below.
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1. Overviews of Alcohol Harm Reduction
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2. Alcohol Consumption - Recorded and Unrecorded
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3. National and International Policies
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4. Local Policies and Strategies
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5. Managing Public Space
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6. Interventions for High-Risk Groups
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7. Drinking and Driving
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8. Changing Drinking Environments
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9. Glassware in Bars
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10. Server Training
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11. Harm Reduction Treatments
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12. Alcohol and HIV
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13. The Alcohol Industry: Partnership, Codes and Conduct
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1. Overviews of Alcohol Harm Reduction
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The papers in this section have been included in order to provide an introduction to the broad topic of alcohol harm reduction. The papers may not go into much detail about specific interventions, but overview the harm reduction policy approaches and where they might fit with traditional responses to alcohol use, misuse and harms. In particular, the report by Professor Gerry Stimson (IHRA’s Executive Director) outlines how alcohol policies should account for different drinking patterns within a population, by using targeted interventions that are aimed towards specific high-risk groups, drinking behaviours and drinking contexts.
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2. Alcohol Consumption - Recorded and Unrecorded
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Alcohol is a complex commodity – used around the world in its many guises and forms. The production, supply and consumption of regulated alcohol can be controlled through population-level responses such as taxation and licensing restrictions, and is reviewed in this section by a global report from the World Health Organization (WHO). However, in order to provide an insight into the complexity of global alcohol consumption, this section also explores unrecorded, illicit or unregulated alcohol - such as ‘moonshine’ (home-brewed drinks) and surrogate alcohol products (such as aftershaves and cleaning products) – and the specific harms that are associated with these.
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3. National and International Policies
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Around the world, there are good examples of alcohol policy documents that have embraced the harm reduction approach to alcohol to some extent. This section aims to provide a sample of these – with examples from Europe, Australia and Canada. The section also includes a global assessment of alcohol policies by the World Health Organization, and a global policy guide from the International Centre for Alcohol Policies – the “Blue Book”.
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4. Local Policies and Strategies
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One of the benefits of harm reduction as a complementary approach to traditional, population-level alcohol approaches is that it can be easily developed and implemented at the local level in a way that targets specific local problems or contexts. This section provides examples of successful local strategies from Australia, Sweden, the United Kingdom and the USA – as well as a number of guides to support the development of new local strategies around the world.
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5. Managing Public Space
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In many parts of the world, alcohol is associated with late night consumption, ‘binge’ drinking and the night-time economy. Through the harm reduction approach, with its focus on targeting drinking behaviours and contexts, alcohol policies and responses have become closely linked to the management of public spaces (such as city centres) in the evenings and weekends. This section includes a number of reports on best practice in the management of public spaces in order to prevent, reduce or manage alcohol-related harms – including guides for police, policy-makers and those responsible for town planning.
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6. Interventions for High-Risk Groups
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Alcohol harm reduction approaches can be targeted towards specific high-risk groups of alcohol consumers. This section provides some examples of this targeted approach and covers interventions for homeless or street drinkers, intoxicated Aboriginal drinkers, students and young people, drug service clients, and seniors.
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7. Drinking and Driving
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Perhaps some of the best known and most established alcohol harm reduction approaches are those that aim to prevent drunk driving. These interventions target a specific high-risk behaviour (driving when intoxicated) by deterring the use of cars – through blood alcohol limits, the enforcement of legislation, awareness campaigns, improving or extending public transport services, and designated driver schemes (where one member of a group of drinkers is encouraged to remain sober and transport the others). This section includes an international manual on the topic from the Global Road Safety Partnership, as well as evidence reviews and guidelines for developing new schemes.
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8. Changing Drinking Environments
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Around the world, alcohol is consumed in a range of different environments and settings – some associated with higher levels of harm than others. This section overviews some of the interventions that have been targeted to reduce harm in drinking settings – especially bars and clubs. Harms such as violence, injury and drunkenness can be reduced through the safer design of drinking venues, the provision of food, the use of strengthened glass or non-glass receptacles (see section 9), and the training of staff on responsible service (see section 10). This section includes a number of guidelines and reviews – including a randomised controlled trial of the groundbreaking ‘Safer Bars’ programme in the USA.
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9. Glassware in Bars
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One of the most specific risk factors in most drinking contexts is the serving of alcoholic beverages in glassware (and, therefore, this section should be read in conjunction with section 8). Glasses and glass bottles can be used as weapons in violent situations and can also cause accidental injuries to both servers and consumers. Despite this, however, their use is widespread and few safety regulations exist to promote or regulate ‘toughened’ glass.
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10. Server Training
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One of the most common interventions at the drinking venue level is server training – the education of key staff on responsible service techniques to avoid heavy intoxication, underage sales and violent incidents. Server training schemes have been established around the world – by NGOs, charities, alcohol manufacturers and the hospitality trade – but have typically been poorly evaluated or reported. This section includes a systematic Cochrane Review on the topic, as well as international guidelines for establishing new, evidence-based projects.
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11: Harm Reduction Treatments
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The concept of harm reduction has also been applied to the field of alcohol treatment, with drinking in moderation seen as a valuable intervention in addition to traditional abstinence-orientated approaches for many problem drinkers. This section overviews the concept of ‘Moderation Management’ and the controversy that it has created in the field. This section also includes papers on ‘Brief Interventions’ – short and targeted discussions from respected authority figures (such as Doctors) to advise against problematic drinking patterns and reduce alcohol-related harms.
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12: Alcohol and HIV/AIDS
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In the field of illicit drugs, harm reduction has historically developed as a result of global concerns to prevent HIV transmission. Until recently, however, very little attention has been paid to the links between alcohol use and HIV transmission – and most of this recent focus has been aimed at developing countries. This link is associated with sexual risk-taking and unsafe sexual behaviours when intoxicated. This section showcases some of the (few) studies that have explored this topic, with the intention of putting this link higher on the international agenda for both alcohol and HIV organisations.
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13: The Alcohol Industry: Partnership, Codes and Conduct
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The engagement of alcohol manufacturers and vendors (collectively referred to as “the alcohol industry”) in alcohol policies and interventions is a fiercely debated issue in many academic and advocacy fora. Traditionally, however, the harm reduction approach has always aimed to include all relevant stakeholders – of which the alcohol industry is undoubtedly one. This section explores the composition and dynamics of the alcohol industry and provides some examples and assessments of industry self-regulation.
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