Do trends in alcohol harm mirror consumption? An analysis of adolescent ambulance attendances

OBJECTIVES: Adolescent alcohol consumption has declined across many high-income countries since the early 2000s, yet it remains unclear whether these reductions have led to less alcohol-related harm, particularly among higher-risk groups. METHODS: Using the National Ambulance Surveillance System, we examined ambulance attendances for alcohol intoxication among adolescents (10-19 years) in Victoria, Australia, from January 2012 and December 2023. Multivariable regression, stratified by gender, assessed monthly changes in attendance rates per 10 000 by remoteness, adjusting for seasonality and COVID-19 lockdowns. RESULTS: A total of 25 928 attendances were recorded. A small but significant monthly decline in alcohol intoxication ambulance attendance was observed among males in major cities (B = -0.01 [0.01], P < .001). No significant trends were identified for males in regional areas or for females in metropolitan or regional areas. CONCLUSION: Despite declining adolescent alcohol consumption, intoxication-related ambulance attendances have remained largely stable over the past decade. The modest decline among males in metropolitan areas was considerably smaller than survey-reported declines in consumption, suggesting that population surveys capture different drinking patterns than those leading to acute harms. These findings highlight the need for ongoing monitoring and targeted prevention strategies, particularly for high-risk subgroups and regional populations.