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You don't have to be drunk to enjoy being Australian

Of all the issues raised by yesterday's Australia Day and Citizen of the Year awards one cuts across almost all the rest.

It is the problem of binge drinking and alcohol-fuelled violence which was brought to the fore by the choice of Professor Gordian​ Fulde​ as our Senior Australian of the Year.

Professor Fulde, 67, the director of emergency at St Vincent Hospital and Sydney Hospital for more than 30 years, lives and works with the consequences of alcohol and drug abuse on a daily basis.

While not playing down the damage caused by illegal drugs, the medical veteran singled out alcohol for special mention on Monday night.

"We really do not need to be drunk and ugly or out of it to enjoy this fantastic country," he said.

His often strongly worded views, which have been echoed by emergency department doctors in Canberra and elsewhere, are right up there with Shakespeare's "O God, that men should put an enemy in their mouths to steal away their brains".

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Binge drinking is a major factor in domestic violence. It also impacts on the broader issue of women's rights by creating a problematic street culture that puts females at risk of unwanted advances and even assaults.

Both problems are exacerbated by the fact that, according to the Australian Institute of Health and Welfare, males are almost three times as likely to drink at risky levels as females.

There is also the broader issue of alcohol's contribution to crime and antisocial behaviour. The AIHW​ found between 4 million  and 5 million Australians [about 26 per cent of the population aged over 14] had been verbally abused by a drunk. Just under 9 per cent had been victims of physical abuse.

Excessive alcohol consumption impacts on national health services in two ways.

The first, and most obvious, is the expense of treating people who have either been assaulted by a drunk, fallen over while drunk themselves or been in a car accident in which alcohol was a factor.

The second, and costlier​, impact is the expense of treating the damage heavy drinkers have done to themselves over years of alcohol abuse. Negative outcomes include heart disease, some cancers, diabetes, weight-related and nutritional issues, mental health conditions, cognitive impairment and liver disease.

Professor Fulde's​ desire to curtail our culture of excess and to end the carnage caused by mindless drunken violence is particularly topical given holidays such as Australia Day have increasingly become a focus for national binges.

Advertisements pushing discounted liquor are ubiquitous in the lead-up to every holiday period or long weekend with the unspoken agenda being that "getting wasted" with your mates is a wonderful way to attack the issue of unstructured time.

On the positive side, Dr Fulde​ said there was some good news coming through with Sydney's most recent New Year's Eve distinctly less warlike than some that had gone before.

While happy the message appears to be starting to get through, he recognises there is still a long way to go and remains committed to sharing his stories of working in the "urban warzone" however.

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