Managing health risks and harm in B.C.’s alcohol hot spot

Despite being legal and socially accepted, alcohol is a psychoactive substance that has serious health risks. Alcohol ranks as one of the leading causes of preventable deaths, disability, injuries, and accidents Canada-wide.

Some health risks associated with consuming alcohol include:

• Injuries
• Violence
• Chronic disease (heart disease, high blood pressure, inflammation of the gut)
• Stroke
• Interference with normal fetal development (can lead to malformation, brain injury, birth defects, learning disabilities, behavioural problems, etc.)
• Decrease in breastmilk production
• Alcohol dependence (alcohol use disorder)
• Cancers including breast, colon, mouth, throat, and liver

To add to the health concerns surrounding the Interior region’s already elevated alcohol consumption is the increase in alcohol use by British Columbians during the COVID-19 pandemic and the recent trend by local governments to pass bylaws that allow consumption of alcohol in public spaces.

In August 2022 the Canadian Centre on Substance Use and Addiction released Canada’s Guidance on Alcohol and Health, which is intended to replace Canada’s Low-Risk Alcohol Drinking guidelines published in November 2011. Perhaps the most notable update to the guidelines is the recommendation to limit alcohol consumption to two standard drinks or less per week to avoid any alcohol related harms. This amount is significantly lower than the previous “low risk” guideline that recommended no more than 15 standard drinks per week for men, and no more than 10 standard drinks per week for women.

There are simple yet powerful ways to support people in better informed individual choices when it comes to drinking alcohol.

For example, to better inform consumers the federal government could mandate that alcoholic beverages list the number of standard drinks on the label. Liquor stores, restaurants and bars could be required to display social responsibility posters or tent cards with the updated guidelines and alcohol health risks in a prominent location in their establishments.

Creating awareness by displaying information however, is not enough when alcohol consumption is promoted and even encouraged by social norms and policies. There are a variety of evidence-based strategies that have been proven to reduce alcohol use, including regulation of the number and density of alcohol retailers, limiting the hours of alcohol sales and increasing the price of alcoholic beverages.

Incentives for alcohol-free events could be introduced in our region by offering lower price booking at some venues, or offering alcohol-free sections at events, with lower ticket prices. Enforcement of bylaws restricting public drinking should continue to be a priority, upholding consequences for non-compliance.

Limiting or banning happy hour or two-for-one pricing, introducing commercial host liability rules, capping the number of stops on wine and brewery tours, and increasing the minimum sale price of alcohol could also be explored as disincentives.  

Finally, it would be important that physicians and other health-care providers be familiar with the new guidelines and discuss alcohol’s risks with their patients. There are many resources to support these discussions, such as the Canadian Alcohol Use Disorder Society.

The new Canada’s Guidance on Alcohol and Health guidelines have the potential to create a huge impact nation-wide, but I believe that the Interior region will be affected to a greater extent. It is time that the Okanagan area in particular recognize the real and serious risks of alcohol and steps are taken to limit the chokehold that alcohol sales have on both the economy and on the health of the community that we are so lucky to call home. 

Alex Myshak-Davis is an MD Candidate with the UBC Faculty of Medicine (2023). She lives in Kelowna.