As my daughter's friends lifted her up the stairs, she vomited and turned blue.
Thankfully, her airway was able to be cleared. They called for assistance, but no ambulance was available.
The fire service turned up but refused to transport her to the emergency department due to the vomit.
This young woman was transported to safety in the back of a young man's car with anxiety about her breathing.
These scary, preventable and far-too-prevalent alcohol-related stories impact many of us. I was in Wellington to learn more about how to limit them.
Our conference this year was about fairer, healthier alcohol policy and asked the question: if not now - when?
The underestimated harms of alcohol, especially on the brain, were highlighted.
A common theme is that these effects can be mitigated by best-practice alcohol policy, and in our present health system there are few resources to assist those who have suffered these harms.
Valerie McGinn, a well-known neuropsychologist who specialises in fetal alcohol spectrum disorder (FASD), demonstrated how disabling brain damage from prenatal alcohol exposure can be.
Toxic brain injuries can result in impacting the ability of persons living with FASD to learn, modify their behaviour, and regulate their emotions.
Without early intervention, huge potential is lost.
However, disability support for FASD is often denied because the problems due to brain damage are classified as "behavioural".
This leaves families, schools and other support services stranded and under-resourced.
Senior scientist Jurgen Rhem, a keynote speaker from Toronto, painted the scenario of early onset dementia relating to heavy drinking.
Alcohol is associated with about 40 per cent of dementia occurring before age 65, and 18 per cent of people with early dementia have or have had an alcohol use disorder.
Because 20 per cent of our population drink hazardously, this has major implications for our health services.
There is a management challenge for these patients, because most dementia services are for over-65s.
The evidence for a public health approach was brought up to date prior to the book launch of the third edition of Alcohol: No Ordinary Commodity.
This is the bible of evidence-based alcohol harm reduction.
There is now stronger evidence that increasing excise tax reduces alcohol harm, and minimum unit pricing - which states the lowest price at which a unit of alcohol or standard drink can be sold - helps limit harm from ultra-cheap alcohol as an adjunct.
Dismantling advertising remains so important but presents a great challenge, because even non-alcoholic products displaying alcohol brands cause harm.
Social media is the wild west for brazen youth-oriented alcohol marketing, almost impossible to monitor and scrutinise.
Michael Livingston, an associate professor from the National Drug Institute in Melbourne, presented studies demonstrating that even small reductions in the accessibility for alcohol-reduced opening hours can have large impacts on reducing alcohol-related assaults.
The focus then turned to equity, as our advocacy not only encompasses the institution of evidence-based alcohol policy, but endeavours to ensure all citizens are protected by the policy in a proportionate manner.
In New Zealand, Māori and Pasifika suffer disproportionately high levels of alcohol-related harm.
The Sale and Supply of Alcohol Act does not include clauses that ensure the Treaty of Waitangi is given effect when it comes to alcohol policy. Without this, it is very difficult for Māori to have appropriate processes and representation in alcohol-related decision-making.
Consultant Kristen Maynard presented her mahi, funded by Te Hiringa Hauora (Health Promotion Agency), which recommended that New Zealand's alcohol laws include specific mention of Te Tiriti and that legislation ensures Māori can meaningfully and effectively participate in alcohol policy decisions.
She emphasised alcohol policy should require the elimination (not reduction) of inequities between Māori and non-Māori.
Ongoing monitoring and mandatory reporting of inequities are important in this regard.
The Labour government previously signalled an intent to review our liquor laws and more recently, an alcohol harm reduction bill has been announced.
These present another generational opportunity for leadership on this issue, which the National government overlooked a decade ago.
The social and health burdens relating to alcohol are onerous and we all pay the price of inaction.
We need more governance over our harmful and inequitable alcohol environment, especially for our unborn children, and tangata whenua.
This can be done without prohibition, incorporating the work of many great minds in the alcohol harm reduction field.
Tony Farrell has been a general practitioner for 30 years. He is a Mount Medical Centre director and a Fellow ofthe Royal New Zealand College of General Practitioners. Tony has a special interest in mental health and addiction and is a trustee of Hanmer Clinic and medical spokesperson for Alcohol Action NZ.
