5.7 Alcohol

Alcohol Facts and Statistics

Alcohol Use in Canada:

• Prevalence of Drinking: General population (age 15+): According to data collected from the 2017 Canadian Tobacco, Alcohol and Drugs Survey (CTADS), 78.2% of Canadians aged 15 and over reported drinking alcohol at least once in the last year. This level has remained relatively stable since 2013 (75.9%) (CCSA) Canada’s Guidance on Alcohol and Health: Final Report (Jan 2023)
• Prevalence of Binge Drinking and Heavy Alcohol Use: In 2018, 19.1% of Canadians aged 12 and older (roughly 5.9 million people) reported alcohol consumption that classified them as heavy drinkers.The proportion of people classified as heavy drinkers remained stable between 2017 and 2018 (19.5%, 19.1%).Overall, males were more likely (23.5%) to report heavy drinking than females (14.8%) in 2018. The highest proportion of heavy drinking for both sexes was among those aged 18 to 34. In this age group, 33.5% of males and 23.8% of females were heavy drinkers (Chart 1). Statistics Canada

Alcohol Use Disorder (AUD) in Canada:

• Adults (ages 18+): Approximately 21.6% of Canadians (about 6 million people) met the criteria for a substance use disorder during their lifetime (Table 1). Alcohol was the most common substance for which people met the criteria for abuse or dependence at 18.1% Statistics Canada
• Adults (65+): Alcohol is the most commonly used and misused substance among older adults (Kuerbis et al., 2014). Alcohol Use Disorder (AUD) and risky alcohol consumption is common among older adults, with reported problem drinking rates ranging from 1–22% (Woodruff et al., 2009). CCSMH
• Youth (ages 12–17): The overall prevalence of alcohol use in the past 12 months among students in grades 7–12 for 2016–2017 is 44.0%. 17 This rate is similar for males (44.2%) and females (43.8%) (Figure 3) (CCSA)⁽¹⁾ Canada’s Guidance on Alcohol and Health: Final Report (Jan 2023)

Alcohol-Related Deaths

• In 2014, alcohol contributed to 14,826 deaths in Canada, representing 22% of all substance use attributable deaths. CCSA

Economic Burden:

• In 2017, the rate of hospitalizations entirely caused by alcohol (249 per 100,000) was comparable to the rate of hospitalizations for heart attacks (243 per 100,000) and the rate was thirteen times higher than for opioids.
• Healthcare costs in Canada associated with the use of alcohol in 2014 were estimated to be 4.2 billion and accounted for 38% of all healthcare costs attributable to substance use.3 Healthcare costs include inpatient hospitalizations, day surgeries, emergency department visits, substance use treatment, family physician time and prescription drugs. Per-person healthcare costs associated with alcohol increased by approximately 25% from $95 per person in 2007 to $119 per person in 2014. CCSA

Brief Interventions with Alcohol Abuse Disorder

FRAMES Model

When working with brief interventions with Alcohol or Substance Abuse the FRAMES model is a great brief intervention that can be used in many different setting.  It is very client-centred, non-judgemental, supportive that is a harm reduction strategy that is effective if the client is interested.  It can be used in many different settings (outpatient or primary care settings) and in applied in many different ways, depending on the individual.

FRAMES stands for:

• provide Feedback about the persons drinking
• stress personal Responsibility for change
• provide clear Advice to cut down on drinking
• provide a Menu of options for reducing drinking
• use an Empathic approach in interacting with the client
• support Self-efficacy by enhancing beliefs about ability to change (Cunningham & Hodges, 2014, Outpatient Addiction Settings)

Global Burden:

• In 2012, 3.3 million deaths, or 5.9 percent of all global deaths (7.6 percent for men and 4.1 percent for women), were attributable to alcohol consumption.¹²
• In 2014, the World Health Organization reported that alcohol contributed to more than 200 diseases and injury-related health conditions, most notably DSM–IV alcohol dependence (see sidebar), liver cirrhosis, cancers, and injuries.¹³ In 2012, 5.1 percent of the burden of disease and injury worldwide (139 million disability-adjusted life-years) was attributable to alcohol consumption.¹²
• Globally, alcohol misuse was the fifth leading risk factor for premature death and disability in 2010. Among people between the ages of 15 and 49, it is the first.¹⁴ In the age group 20–39 years, approximately 25 percent of the total deaths are alcohol-attributable.¹⁵

Family Consequences:

• Approximately one in 10 Canadian children under the age of 12 lives with a parent with a substance use disorder according to a 2014 study CCSA

Underage Drinking:

• Prevalence of Underage Alcohol Use:
  • Prevalence of Drinking: Close to 80% of young Canadians 15 years and older have reported drinking alcohol during the past year. It is the substance that the majority of young people in grades 7 through 12 will try first
  • Prevalence of Binge Drinking and Heavy Alcohol Use: The overall prevalence of alcohol use in the past 12 months among students in grades 7–12 for 2016–2017 is 44.0%. 17 This rate is similar for males (44.2%) and females (43.8%)
• Consequences of Underage Alcohol Use: Whatever the reason, the younger the person is when they begin drinking, the higher the risk for poor health and problems related to alcohol consumption later in life.
  • At higher risk for:
    • blackouts
    • alcohol poisoning
    • developing or worsening depression
    • anxiety & other mental health problems
    • physically sick and possibly dying from alcohol poisoning
    • getting into a fight or being assaulted
    • unwanted sex or pushing unwanted sex on others
    • suicide
    • injured or killed while driving

Alcohol and College Students:

• Prevalence of Alcohol Use:
  • Prevalence of Drinking: In general, young adults consume substances at higher levels than the general population. In the past 12 months, 84% of students had consumed alcohol. Alcohol consumption in the past 12 months was higher among females and students in their third year or higher. majority of survey participants had consumed alcohol in their lifetime (88%), in the past 12 months (84%) and in the past 30 days (77%)
  • Prevalence of Binge Drinking: Male respondents drank more frequently in the past 30 days. The proportion of males drinking once per week or more often was 46%, compared to 35% among females in the past 30 days. The most common response was spirits and liquors (69%), followed by beer (67%). In the past 30 days, 60% of respondents had consumed alcohol in a pattern consistent with heavy drinking. Among past-12 month drinkers, the proportion of students who reported driving within two hours of consuming at least two drinks was 9%, with males more likely to do so than females (12% males; 6% females). One in six (16%) of students reported ever being a passenger with a driver who had recently consumed alcohol.
  • Prevalence of Heavy Alcohol Use: students who drank alcohol within the past 12 months, 56% had experienced at least one alcohol-related harm in the past month and the top five harms reported they experienced a hangover (33%), less energy or felt tired (25%), drank on nights when planned not to (22%), said or did something embarrassing (22%), or felt sick to their stomach or threw up (17%). 31% of all respondents experienced at least one harm within the past month as a result of another student’s drinking. five most commonly reported secondary harms were the need to take care of another student (14%), sleep was affected (13%), another student upset or disappointed them (11%), studies were interrupted (8%) another student caused an argument with them (7%).

Source: “Canadian Postsecondary Education Alcohol and Drug Use Survey, 2019/2020 Published:(2021-05-10)” by Government of Canada is in the Public Domain

Alcohol and Pregnancy

The guidelines for consumption limits for Pregnant Women

• Always Avoid Drinking Alcohol
• Government of Canada – Healthy Pregnancy
• Prenatal Education – Ontario
• Alcohol use during pregnancy and fetal alcohol spectrum disorder in Canada: who, what, where – Government of Ontario

Alcohol and Women:

Women are generally more sensitive to the effects of alcohol than men, and all adults become increasingly sensitive to alcohol’s effects as they age. When someone is more sensitive, it takes less alcohol to cause intoxication and more time for the body to eliminate the alcohol consumed.

The guidelines for consumption limits for Women

The guidelines for consumption limits for Women

Group	Limit Alcohol to no more than:	Avoid Drinking Alcohol
Women	2 standard drinks per day 10 standard drinks per week 3 standard drinks on special occasions	on some days

The guidelines for consumption limits for Men

Group	Limit alcohol to no more than:	Avoid Drinking Alcohol
men	3 standard drinks per day 15 standard drinks per week 4 standard drinks on special occasions	on some days

Alcohol and the Human Body:

Definitions

Alcohol Use Disorder (AUD): AUD is a chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. AUD can range from mild to severe, and recovery is possible regardless of severity. The fourth edition of the Diagnostic and Statistical Manual (DSM-IV), published by the American Psychiatric Association, described two distinct disorders—alcohol abuse and alcohol dependence—with specific criteria for each. The fifth edition, DSM-5, integrates the two DSM-IV disorders, alcohol abuse, and alcohol dependence, into a single disorder called alcohol use disorder, or AUD, with mild, moderate, and severe subclassifications.

Binge Drinking:  CAMH says Researchers define binge drinking as having many drinks on one occasion: five or more drinks for a male, or four or more drinks for a female. A standard drink is defined as:

• 341 mL (12 oz.) beer, cider or cooler (5% alcohol)
• 142 mL (5 oz.) wine (12% alcohol)
• 85 mL (3 oz.) fortified wine (18% alcohol)
• 43 mL (1.5 oz.) liquor (40% alcohol)

Young people who binge drink are especially at risk. This is because they are less familiar with the effects of alcohol, and are more likely to do something impulsive or dangerous. Binge drinking is also more common among young people. Recent surveys show that:

• one-fifth (20%) of Ontario students in grades 7-12 report binge drinking at least once in the past month
• almost one in three (32%) Canadians between 20 and 34 years report binge drinking 12 or more times in the past year
• nearly one in five (19%) of Canadians between 35 and 44 years report binge drinking at this same rate.

Heavy Alcohol Use:  SAMHSA defines heavy alcohol use as binge drinking on 5 or more days in the past month.

Moderate alcohol consumption: To reduce long-term health risks, Canada’s Low-Risk Alcohol Drinking Guidelines recommend: No more than 10 drinks a week for women, with no more than 2 drinks a day most days. No more than 15 drinks a week for men, with no more than 1 or 2 drinks a day most days for youth (with parental consent).

Definition of Drinking at Low Risk for Developing AUD: Low Risk Guidelines – CCSA

Alcohol-Impaired-Driving Fatality: A fatality in a crash involving a driver or motorcycle rider (operator) with a BAC of 0.08 g/dL or greater

In Ontario’s zero tolerance law for young, novice and commercial drivers, you cannot have any alcohol in your system if you are: age 21 or under Ontario’s zero tolerance law for young, novice and commercial drivers, you cannot have any alcohol in your system if you are: age 21 or under

Disability-Adjusted Life-Years (DALYs):  A measure of years of life lost or lived in less than full health.

Underage Drinking: 18 years of age in Alberta, Manitoba and Quebec, and 19 years in the rest of the Canadian provinces and territories

Resource:  RCMP – Alcohol

What Is A Standard Drink/How do you know how much alcohol is in your drink?

A standard drink is a measure of how much pure alcohol you are drinking. It varies based on the concentration of alcohol in a beverage.

In Canada, a standard drink is 17.05 millilitres or 13.45 grams of pure alcohol. This is the equivalent of:

• a bottle of beer (12 oz., 341 ml, 5% alcohol)
• a bottle of cider (12 oz., 341 ml, 5% alcohol)
• a glass of wine (5 oz., 142 ml, 12% alcohol)
• a shot glass of spirits (1.5 oz., 43 ml, 40% alcohol)

 

Low-risk Alcohol Drinking Guidelines – Government of Canada

 

Heavy drinking, by age group

Statistics Canada. Table 13-10-0096-11  Heavy drinking, by age group

Geography	Canada (excluding territories)3
Sex	Both sexes
Indicators	Heavy drinking6
Characteristics5, 7, 8, 9, 10, 11, 12, 13	Number of persons		Percent
Age group	2019	2020	2019	2020
Total, 12 years and over	5,802,200	5,320,500	18.3	16.6
12 to 17 years	62,100	66,500	2.7	2.8
18 to 34 years	2,249,300	1,885,900	26.9	22.4
35 to 49 years	1,595,900	1,522,000	22.2	21.0
50 to 64 years	1,414,000	1,368,600	18.8	18.1
65 years and over	480,900	477,500	7.6	7.4

Canada’s low-risk alcohol drinking guidelines

Canada’s Low-Risk Alcohol Drinking Guidelines can help you make informed decisions about drinking. The guidelines recommend setting limits to help you reduce the acute (short-term) and chronic (long-term) health risks of alcohol use.

It is important to keep in mind that:

• the intention of these guidelines is not to encourage people who abstain (for cultural, spiritual, health or other reasons) to start drinking
• these are “low-risk” guidelines, not “no-risk” guidelines. Any amount of alcohol consumption can have risks to your health

Visit the following websites for information on alcohol

• Rethinking Drinking
• Link to alcohol fact sheets from drugabuse.gov
• WebMD slideshow on How Alcohol Affects Your Body
• Canadians Under 54 Drinking More While at Home Due to COVID-19 Pandemic (CCSA)
• Alcohol Consumption in Canada – Government of Canada

Specialized Programs for Alcohol – Government of Canada

The Health Portfolio plays an important role in addressing alcohol-related harm. A number of initiatives are aimed at reducing alcohol misuse among Canadians, such as:

• Fetal alcohol spectrum disorder: About, causes and co-occurring conditions
• https://www.canada.ca/en/health-canada/services/health-concerns/drug-prevention-treatment/canadian-alcohol-drug-use-monitoring-survey.html
• Government of Canada – National Native Alcohol and Drug Abuse Program (NNADAP)
• First Nations Health Authority – Health through Wellness
• Developing an Indigenous approach to FASD
• Preventing FASD through Providing Addictions treatment and related support For First Nations and Inuit Women in Canada

Economic Burden caused by Alcohol Abuse in Canada

• CBC
• Globe and Mail
• Global News

Attribution:

Drugs, Health & Behavior by Jacqueline Schwab and Denise Salters is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, with Canadian Content