Mandatory alcohol treatment is not an appropriate measure to address public drunkenness, but a well-designed and implemented model may provide some benefit to a tiny group of people who are at risk of death or serious disability, according to a new report by the Menzies School of Health Research.

Menzies researcher, and one of five authors of the Mandatory Alcohol Treatment discussion paper, Dr Cassandra Wright, said alcohol treatment programs need to be line with international evidence, because mandatory treatment involved the removal of a person’s liberty, and the evidence showed it should only be used in lifesaving circumstances, where voluntary treatment had not been effective.

She said mandatory treatment did not save money, with the cost of mandatory treatment being between three and ten times more costly, but no more effective, than voluntary treatment.

The report said a version of mandatory alcohol treatment was last seen in the Northern Territory in 2017, with that program focused on mandating treatment for repeated public intoxication, rather than as a last resort measure, and an evaluation of it found little difference in outcomes for people who went to mandatory alcohol treatment compared to those who didn’t.

“Research shows that mandatory treatment has benefits limited in scope and is costly to deliver. It is vital that governments carefully consider the nature of problems being experienced and use the evidence available to match measures that help keep Territorians safe,” Dr Wright said.

The CLP has said it would reintroduce mandatory alcohol treatment if it wins the August 24 election. It said it would be reintroduced as a policy to provide one long term solution to the continuing problem of alcoholism in the NT.

In 2013, the former CLP Giles Government introduced a similar program, but it was scrapped in 2017 by the Gunner Labor Government after a CLP-commissioned review found there were indirect short term benefits such as providing dental or other health care, but there were minimal long-term benefits.

That review, done by PwC’s Indigenous Consulting and Menzies, pointed out that the program was implemented without logic or a theory-of-change model, and with no evaluation framework. It also said that in 2015 -16, the government shelled out at least $18 million to deliver forced rehabilitation of 339 people at a median cost of $53,915 per person.

Lead author of the most recent report Sarah Clifford, said: “Mandatory alcohol treatment can be appropriate for a tiny cohort of people who are at risk of death or serious disability but should not be considered as an intervention for other alcohol-related behaviours or harms.”

The latest report was a collaboration between Menzies University, La Trobe University’s Centre for Alcohol Policy Research, and New South Wales University’s Drug Policy Modelling Program, and funded by NT Health.

The report said the NT has the highest percentage of Aboriginal and Torres Strait Islander people in its total population in Australia, so any treatment model should take into account additional ethical concerns related to colonization and institutionalization.

The report also stressed that Aboriginal and Torres Strait Islander experts should be involved in co-designing any treatment model, with a strong emphasis on bi-cultural care.

Co-author, and University of NSW drug policy modelling program researcher Keelin O’Reilly said: “Voluntary alcohol treatment should be available for people who need it when they seek it. Mandatory alcohol treatment is expensive and should only be used for people experiencing life-threatening harms from their alcohol dependence,”

Last year, the NT Government passed the Liquor Amendment Act 2023, which requires remote communities to make community alcohol management plans, which need to be sanctioned by 60 per cent of the community and by the Director of Liquor Licensing to protect the public interest and ensure that it has no major adverse impacts to communities.

However, no community plans have yet to be approved from more than 400 remote communities in the NT.

This amendment to the act followed a period of higher crime and anti-social behaviour, particularity in Alice Springs, after intervention-era alcohol bans expired in remote communities and town camps in mid-2022. The Fyles Government was forced to introduced a temporary opt-out alcohol protection scheme in remote communities and town camps, after Prime Minister Anthony Albanese was forced to visit Alice Springs in January 2023 because of political pressure stemming from crime.

Click here to read the Mandatory Alcohol Treatment: discussion paper.