APRIL 28 — Four weeks ago, I lost a friend suddenly to an alcohol-induced heart attack.

I've never really focused on alcohol policy but the sudden tragic loss made me decide to look at an innovative alcohol policy -- one that does not prohibit, but rather one that supports the concept of harm reduction, ie. a policy that seeks to reduce harm related to heavy alcohol use.

What is clear is that "excessive alcohol consumption is related to many life-threatening diseases" (Baal et al. 2010) and that "controlling alcohol affordability and availability are amongst the most effective policy options available to governments." (Babor et al. 2010)

What is also clear is that there simply has not been a vocal and comprehensive approach to excessive drinking. The reasons for this are unclear -- although it may well be that alcohol consumption is generally discouraged completely in Malaysia, and so persons who ignore abstinence-based rhetoric are left to fend for themselves.

Alcohol consumption will not stop, and what policymakers must concentrate on is changing the environment so persons who consume alcohol do not drink excessively, and that they are protected from alcohol-related harm.

There are a number of legal and policy reforms that can be considered; the following are a few of them:

1.     Water is provided free of charge.
2.     Requiring that all establishments serving alcohol provide affordable food (drinking on an empty stomach speeds up intoxication).
3.     Intoxicated persons are not to be offered alcohol.
4.     Training alcohol servers to call cabs for intoxicated persons.
5.     Ensuring non-alcoholic drinks are cheaper than alcoholic drinks.
6.     Preventing intoxicated persons from entering premises where alcohol is served. (Kingsland et al. 2011).
7.     Better alcohol labelling.
8.     Increasing alcohol prices.

Point number 3 is especially important. If my friend had been prevented access to the amount of alcohol he'd been served that night, the chances of him surviving the night would've likely been much higher. An alcohol server could simply say, "I can’t give you that beer, mate. You’re already drunk."

This is known as the concept of "alcohol server liability" as discussed in the NSW case of Cole v South Tweed Heads Rugby League Football Club Limited [2004] HCA 29. The concept basically asks whether a supplier of alcohol has a duty to monitor and moderate the amount of alcohol served to customers and to ensure that an intoxicated customer leaves the premises safely. We can ask several key questions about alcohol server liability, the most pertinent being: Is it practical to impose such a duty on alcohol servers? And can public health interests be an overriding factor to allow the existence of such a duty? It should be noted that there may also be difficulties in determining whether the person is actually intoxicated.

He may generally just have a ruddy complexion, or have a speech debilitation that makes his words seem slurred. Would it be unfair to impose a duty upon alcohol servers where there were no outward signs that the person was intoxicated prior to the alcohol-related harm?

In the interests of public health I would argue that it is better to be safe than sorry. But these would be the possible legal challenges to requiring such a duty from alcohol servers.

With regards to point number 7, the picture shows a beer label from New South Wales, Australia. On the bottom right corner of the label, it is stated that that the bottle of beer amounts to 1.3 standard drinks, a reminder to the consumers in New South Wales that only persons who have consumed one standard drink are allowed to operate a vehicle.

Data on alcohol-related deaths in Malaysia don’t seem to be readily available, but it would be extremely useful to see just how bad/good the situation is, and to discuss the possibility of a national taskforce on evidence-based innovative alcohol policy to reduce harm caused by alcohol use.

RIP Gunasegaran Suppiah (June 9, 1970-March 22, 2012)