76 Alcohol in our lives AcciDenTs AnD injury While preventable deaths are one important measure of alcohol harm,   the incidence of non-fatal alcohol- related injuries in this country is of even greater significance. Acute injury is one of our most significant health issues in relation to alcohol as each year thousands of New Zealanders are injured as a result of their own or somebody else’s drinking. Injury accounts for over a third of alcohol’s total contribution to the global burden of disease and disability³⁴ and, because the young are overwhelmingly represented in both the alcohol-related injury and death statistics, about   72 per cent of the years of life lost   due to alcohol in New Zealand.³⁵ A recent analysis of national hospital admission data for 15 to 24 year-olds showed the broad spread of alcohol’s involvement in illness and injury.³⁶   A total of 5,413 young people were hospitalised with alcohol-related admissions between 2002 and 2006. Admissions were considered alcohol- related if alcohol was listed in the national database as being one of the first 15 diagnoses, or one of the first 10 external causes of the admission. This approach is likely to significantly underestimate the total number of admissions. This figure also does not include patients that were only seen   in an emergency department. Of the 5,413 admissions, 34.7 per cent presented with injuries, 28 per cent with mental health problems and 11 per cent intoxication.³⁷ Of the injury cases, about 20 per cent were as a result of self- harm, 20 per cent as the result of an assault, and the remaining 60 per cent roughly equally divided between falls, motor car accidents and glass injuries. Admissions among young people living in the most deprived areas were more than three times more common than admissions among those from the least deprived areas. Admissions were twice as likely to be males as females. The impact of alcohol on our tertiary health services, and in particular the extent to which alcohol-related injuries divert resources away from other health needs, was graphically demonstrated in a study of patients treated at Christchurch Hospital’s specialist Oral   and Maxillofacial Surgery Service over an   11 year period. Of the 2,581 patients who presented with facial fractures between 1996 and 2006, almost half of the injuries (49 per cent) were alcohol-related. Males accounted for 88 per cent of these, and   78 per cent of the alcohol-related fractures were due to interpersonal violence.³⁸ Surgeon Kai Lee, who was one of the research authors, told the Law Commission injuries sustained in alcohol-fuelled violence most frequently involved fractures of the lower jaw or cheek bones. Depending on the severity of the facial fractures, surgery may last anywhere from under an hour to three or more hours and may involve wiring of the jaw and the insertion of plates and screws. Patients are typically off work for two weeks and unable to take part in sport for six weeks. Some suffer nerve damage and scarring,   and in more severe cases require cosmetic   or orthodontic work. These costs are   borne by the taxpayer via the Accident Compensation Corporation (ACC). Patients waiting for elective oral and maxillofacial surgery were also affected   if the surgeons were unable to find   the theatre time required for the acute alcohol injury cases. Dr Lee states: You can imagine the disruption to   people’s lives when they are told their   long planned surgery has had to be AcuTe   injury   is   one   oF   our   MosT siGniFicAnT  heAlTh  issues  in  relATion To  Alcohol. “You can imagine the disruption to people’s lives when they are told their long planned surgery has had to be cancelled in order to accommodate these acute alcohol cases.” – Surgeon Kai Lee.