Alcohol Use and Impact

ALCOHOL

Extent of Alcohol Use

  • Almost 80% of Canadians (15 years or older) consumed alcohol in 2013.
  • Approximately 22 million Canadians.
  • Alcohol is the most commonly used psychoactive drug, except for caffeine.

Drinking Rates by Age

  • Alcohol use is most common in the 30-34 age group.

Figure 2a: Drinking Rates in Canada in 2013

  • Estimated percentage of alcohol consumption by age group:
    • 15-19: 0%
    • 20-24: 60%
    • 25-29: 60%
    • 30-34: 80%
    • 35-39: 60%
    • 40-44: 40%
    • 45-49: 40%
    • 50-54: 20%
    • 55-59: 20%
    • 60-64: 20%
    • 65+: 0%

Definition of a Standard Drink

  • A standard drink or serving of alcohol is defined as:
    • 12 ounces (341 ml) of regular beer (5% alcohol)
    • 5 ounces (142 ml) of wine (12% alcohol)
    • 1.5 ounces (43 ml) of spirits (e.g., gin, rum, vodka, whisky, tequila) (40% alcohol)
  • Most individuals underestimate the number of drinks they actually have.
  • Underreporting of alcohol consumption is common.

Dysfunctional Alcohol Use

  • Between 16.7% and 38.6% of Canadians drink alcohol enough to risk immediate injury or harm.
  • Between 6.8% and 27.3% drink enough to pose a risk of longer-term negative health effects.

Risky Drinking Defined

  • Risky drinking is defined as:
    • Consuming more than 15 drinks per week for men or 10 drinks per week for women, which increases long-term health risks.
    • Consuming more than 4 drinks for men or 3 drinks for women per occasion (binge drinking), which increases short-term health risks.
  • Risky drinking behaviors are most prevalent in the 20-29 age group.

Figure 2b: Risky Drinking Rates in Canada in 2013

  • Estimated percentage of risky drinking rates by age group:
    • 15-19: 5% (short-term), 5% (long-term)
    • 20-24: 25% (short-term), 15% (long-term)
    • 25-29: 30% (short-term), 15% (long-term)
    • 30-34: 20% (short-term), 10% (long-term)
    • 35-39: 10% (short-term), 10% (long-term)
    • 40-44: 5% (short-term), 5% (long-term)
    • 45-49: 5% (short-term), 5% (long-term)
    • 50-54: 0% (short-term), 0% (long-term)
    • 55-59: 0% (short-term), 0% (long-term)
    • 60-64: 0% (short-term), 0% (long-term)
    • 65+: 0% (short-term), 0% (long-term)

Diseases and Disorders Linked to Alcohol Use

Direct Effects

  • Alcohol dependency.
  • Korsakoff syndrome - a type of amnesia characterized by memory loss and blackouts.
  • Delirium tremens - symptoms include tremors, hallucinations, anxiety, and disorientation.
  • Fetal Alcohol Spectrum Disorder (FASD) - a direct result of alcohol consumption during pregnancy.

Long-term Effects

  • Increased risk of:
    • Other drug use disorders
    • Brain damage
    • Liver disease
    • Certain cancers
    • Pancreatitis
    • Mental health disorders
    • Suicide
    • Stomach ulcers
    • Hypertension
    • Stroke
    • Cardiovascular disease
    • Diabetes
    • Sexually transmitted infections

Mortality Due to Alcohol Use

  • Alcohol is one of the top ten risk factors for disease in Canada.
  • The top risk factor for disease among those aged 15-49.
  • In 2002, 4,258 deaths were attributed to alcohol use, primarily from:
    • Alcoholic liver disease
    • Motor vehicle accidents
    • Alcohol-related suicides
  • This represents 1.9% of all deaths in Canada.
  • In 2008, impaired driving was the leading cause of criminal death in Canada.

Long-term Impacts of Alcohol Use

Alcoholic Liver Disease

  • Chronic and excessive alcohol use leads to scarring of liver tissue, known as cirrhosis.
  • Approximately 50% of deaths and disabilities due to liver disease are attributable to alcohol consumption.
  • Rates of alcoholic liver disease have risen since 2000.

Fetal Alcohol Spectrum Disorder (FASD)

  • A lifelong chronic disorder and the leading known preventable developmental disability in Canada, resulting from alcohol use during pregnancy.
  • Children with FASD may encounter issues with judgment, planning, memory, impulsivity, and communication.

Cancer

  • Alcohol is classified as a carcinogen, increasing the risk for:
    • Colorectal cancer
    • Possibly breast cancer
    • Cancers of the central nervous system
    • Cancers of the larynx, pharynx, esophagus, and liver
  • The effect of excessive alcohol on these cancers varies based on gender.

Cardiovascular Disease

  • Excessive alcohol use is correlated with increased rates of:
    • Coronary heart disease
    • Peripheral artery disease
    • Heart failure
    • Stroke
    • Hypertension
    • Abnormal cholesterol levels in the blood

Short-term Impacts of Alcohol Use

Alcohol Poisoning

  • Elevated levels of alcohol in the bloodstream can result in severe brain function impairment characterized by:
    • Confusion, stupor, or coma
    • Inability to wake up
    • Vomiting, seizures
    • Slowed or irregular breathing
    • Hypothermia and suppressed vital functions

Homicide

  • Alcohol and other drug usage are often prevalent in homicide cases, with statistics revealing:
    • 40% of accused individuals had used alcohol at the time of the crime.
    • 32% of homicide victims had also consumed alcohol.

Impaired Driving

  • Impaired driving represents the leading cause of criminal death in Canada, accounting for 1/3 of all motor vehicle fatalities in 2012.

Mental Health and Alcohol Use

Depression

  • Heavy drinking per occasion is linked with an increased risk of major depression, particularly in women.
  • Alcohol dependency can also lead to depression.

Post-Traumatic Stress Disorder (PTSD)

  • There is a notable link between alcohol use and PTSD; individuals may use alcohol as a coping mechanism for PTSD, providing only temporary relief.

Anxiety

  • Alcohol can temporarily reduce anxiety, but withdrawal may lead to heightened anxiety levels.

Personality Disorders

  • Alcohol use is associated with:
    • Antisocial personality disorder
    • Narcissistic personality disorder

Risky Behaviors Associated with Alcohol

Dose-Response Relationship

  • There is a direct relationship where increased use leads to increased health impacts, which are also dependent on the type of alcohol consumed.

Alcohol Use Disorders

  • Alcohol abuse indicates risky use and associated social and occupational impairments.
  • Alcohol dependence reflects health problems, psychological dependence, cravings, and lack of control over use.
  • In 2012, 18% of Canadians met the criteria for alcohol abuse or dependence.
  • Individuals often consume alcohol to deal with stress, although alcohol negatively affects the body's ability to cope with stress, leading to further stress and increased alcohol consumption.

Figure 5: The Widespread Impacts of Alcohol on Risky Behavior

  • Increased risk of long-term impacts due to:
    • Decreased inhibitions
    • Other short-term impacts including hospitalizations and fatalities due to alcohol poisoning, accidents, homicide, and aggression.
    • Risky behaviors including unwanted or unprotected sex, unplanned pregnancies, exposure to sexually transmitted infections, and impaired driving.

Costs of Dysfunctional Alcohol Use in Canada (2002)

  • Healthcare costs: $3.3 billion
  • Lost productivity: $7.1 billion
  • Law enforcement: $3.1 billion
  • Total costs: $14.6 billion
  • Traffic accident damage: $757 million
  • Fire damage: $156 million
  • Administrative costs: $66 million
  • Prevention and research: $53 million
  • Workplace damage losses: $17 million

Potential Benefits of Alcohol Use

Social Benefits

  • Alcohol can play a strong role in cultural traditions and positively influence social experiences, fostering friendships and the formation of new social ties.
  • Such benefits may primarily arise from social drinking practices.

Health Benefits

  • Low to moderate alcohol consumption may:
    • Reduce the risk of ischemic stroke by lowering blood clotting risks.
    • Potentially lower the risk of diabetes and cognitive impairments.
  • These benefits have not been observed among youth, and comprehensive literature on the precise effects is inconclusive.
  • It is challenging to discern the appropriate quantity of alcohol that is safe for individual consumption.

The Social Determinants of Health

  • Socioeconomic Status: Individuals with high socioeconomic status are more likely to engage in drinking and take part in risky drinking behaviors, while those with lower socioeconomic status often experience the negative effects of alcohol use at higher rates.
  • Occupation: Risky drinking is connected to workplace stress, overwork, harassment, long hours, and job insecurity.
  • Sex: Women show higher blood-alcohol concentration levels than men when consuming the same quantity of alcohol.
  • General Determinants: Factors such as poor housing, low education, low income, and social exclusion contribute to increased stress, which can result in higher alcohol consumption and risky drinking as coping measures.

Alcohol Use in Indigenous Populations

Adult Alcohol Use

  • There is a lower rate of alcohol use among First Nations people living on reserve compared to the Canadian average (65% vs. 80%).
  • Problem drinking rates are higher on reserves compared to the national average (60% vs. 20%).

Youth Alcohol Use

  • Only 40% of Indigenous youth consume alcohol on reserve, lower than the Canadian average of 60%.
  • 50% of those who consume alcohol on reserve report problem drinking, higher than the Canadian average (20%).
  • Poor social determinants of health are often linked to elevated alcohol consumption in certain Indigenous communities.

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