Aggression and violence at ambulance attendances where alcohol, illicit and/or pharmaceutical drugs were recorded: a 5-year study of ambulance records in Victoria, Australia

Background: This study describes the frequency and characteristics of aggression and/or violence in ambulance attendances involving alcohol, illicit and/or pharmaceutical drug use in Victoria, Australia between January 2012 and January 2017. Methods: Patient characteristics, context, and substance use involvement in ambulance attendances were examined to determine associations with attendances where aggression and/or violence was recorded. Results: There were 205,178 ambulance attendances where use of alcohol, pharmaceutical drugs or illicit substances contributed to the reason for the attendance. Paramedics recorded acts of aggression and/or violence in 11,813 (5.76 %) of these attendances. Aggression/violence was more likely to be recorded in certain contexts. Compared with attendances where aggression/violence was not recorded, attendances where aggression/violence was recorded were significantly more likely to involve younger and male patients, and occur on Friday and Saturday nights. Alcohol intoxication was involved in more than half of attendances where aggression/violence was recorded, and was almost twice as prevalent as those involving illicit drug use where aggression/violence was recorded. This pattern was consistent across all hours, high-alcohol hours only, by metropolitan/regional location, and by police co-attendance. Conclusions: Aggression and violence are frequently recorded in ambulance attendances involving alcohol, pharmaceutical drugs or illicit substances, and, most often involve alcohol. This violence poses a recurring threat to the health and safety of paramedics, bystanders, and patients. Greater priority should be given to reducing alcohol-related violence through evidence-based policy measures targeting high-risk groups (e.g. young adult males) and contexts (e.g. weekends, late at night) where harm is most likely to occur.