Drugs & Communities

In 2007, a wide range of stakeholders in Canada, including representatives from federal, provincial and territorial governments, substance use agencies, academia, non-governmental organizations, and the alcohol beverage and hospitality industries, developed the National Alcohol Strategy to promote sensible alcohol use, or developing a culture where moderation is the goal.

Recently, Canada's first national Low-Risk Alcohol Drinking Guidelines were released as one step in promoting this culture of moderation. The guidelines, based on scientific evidence related to the increased risk of developing health problems or experiencing harm from injury, are an important step in providing Canadians with clear information to use in making decisions about their drinking. No alcohol use is zero-risk. Low levels of consumption have some benefits related to heart disease for some people, but, at the same time, slightly increase the risk related to cancer. Basically, however, if people limit their weekly intake to no more than 10 drinks (or 15 for men), their alcohol use is not likely to significantly increase their risk of illness. And if people do not drink more than 3 drinks (or 4 for men) on any single occasion, they will limit their risk of alcohol-related injuries or other immediate harms. Add to this, the common sense advice about not drinking at all in circumstances where attention or clear thinking are required, and you pretty much have the formula for moderation.

These new national guidelines are tremendously useful, but they are not the whole story. Communities need to give careful attention to policy issues that minimize the potential of second-hand harm. See the Helping Municipal Governments Reduce Alcohol-Related Harms resource for examples of such policies. These policies help ensure people can enjoy an evening out, use our roads safely or not be adversely impacted by someone else's alcohol use.

But even as advice to individuals, the Low-Risk Alcohol Drinking Guidelines have limitations. Human beings have been using alcohol for thousands of years. There appear to be a variety of reasons that drive this use. One of the most common, down through the centuries, has been alcohol's ability to improve social interaction. But alcohol has also been used to improve cognitive performance (at least this is claimed by some) and to cope with psychological stress or self-medicate negative mental states. In all of these areas alcohol use has risk as well as benefit. Furthermore, the benefits can be maximized while limiting the risks through moderate consumption (i.e., following the low-risk drinking guidelines). There are, however, a group of powerful reasons some people use alcohol for which these guidelines do not work.

The pursuits of novelty, euphoria and the expansion of perceptual horizons have long been powerful drivers for the use of psychoactive substances including alcohol. Some current patterns of drinking designed to achieve high levels of intoxication are no doubt related to these drivers. The risks associated with such use can be quite significant. Within a discourse shaped by the Low-Risk Alcohol Drinking Guidelines, these reasons for use, would themselves, be judged inappropriate. But is this the best we can do?

If human beings have been driven by these desires for novelty, euphoria and perceptual shift for millennia, is it likely that we can simply declare them unsuitable for modern life and have people move on? The ancients inclined to follow a different path. They tended to enshrine these uses within controlled cultural structures that limited the potential for harm. Even though the Low-Risk Alcohol Drinking Guidelines emphasize amounts of alcohol consumed, we know that the risk for immediate harms has more to do with environmental and cultural contexts than with the amount of alcohol per se.

Therefore, we need, in addition to increased awareness of the guidelines, informed discussions of our cultural beliefs about alcohol and how we can structure drinking opportunities so as to reduce harm. Can we promote moderation even in terms of our desires for novelty, euphoria and perceptual shifts? The Centre for Addictions Research of BC is currently exploring ways to help communities have these discussions. If you are interested in sharing ideas please provide comments. Also sign up to follow this blog through Twitter or email alerts.