Ask the Pharmacist

Q. I heard there are new alcohol guidelines that were released last month. Can you enlighten as to the details?

A. The Canadian Centre on Substance Use and Addiction (CCSA), with the blessing of Health Canada, updated the risks associated with alcohol use and released the new drinking guidelines. It should come as no surprise to learn that alcohol does indeed pose a health risk and that a higher intake of alcohol equates to a greater danger. Most people might think of alcoholism and subsequent liver damage when it comes to the health risks associated with alcohol, but there are may others as well. Some other commonly known concerns related to alcohol use that are considered short-term health risks are:

· More than two standard drinks per event leads to an increased risk of harm to yourself and to others such as vehicle accidents, falls, burns, drownings
· violence
· risky behaviours
· alcohol poisoning
· If you are breastfeeding, pregnant or even trying to get pregnant, no amount of alcohol use is considered to be safe.

These most recent guidelines shed more light on the long-term health risks associated with alcohol. Many of you will read on and not be surprised to learn these risks and in fact might argue that they have been common knowledge for years, which is true. Others however may just be hearing about this and beginning to understand that there are risks to drinking alcohol, even in small amounts.

This recommendation is not based on some new study that may or may not be flawed. Rather it is an amalgamation of numerous studies done over many years on 100’s of thousands of people giving it more credibility from a reliability standpoint. It took into account alcohol’s effects on a number of different disease states such as:

Cancer:  In terms of our health, we need to be aware that alcohol is indeed a class A (the worst category) carcinogen which has been linked to at least seven different types of cancer. It is thought that alcohol is responsible for causing about 7,000 deaths due to cancer each year in Canada alone, the most prevalent types being breast and colon cancer followed by rectal, mouth, throat, liver, esophagus and larynx cancers. These risks are associated with even minimal amounts of alcohol consumption.

Heart Disease:  This new report may be confusing for some. In the past we have all been told that a regular glass of wine may offer cardiovascular protection from ischemic heart disease. The latest research has not only debunked that myth by stating that alcohol does not decrease this risk but it in fact has been shown to increase the risk of other types of heart disease such as high blood pressure, heart failure, atrial fibrillation and hemorrhagic stroke.

Liver Disease:  Consuming excessive amounts of alcohol, even for just a few days may cause your liver to have a build-up of fat, termed alcohol- associated fatty liver. With continued excessive drinking, your liver may develop alcohol-associated hepatitis. This in turn may progress to scar tissue in the liver (fibrosis) and ultimately cirrhosis and liver cancer.

So, the report is suggesting that abstinence or zero alcohol is best. There is no “safe” amount of alcohol that can be consumed without fear of repercussions. Failing that, limiting yourself to two standard drinks a week for both women and men would reduce your risk of the above-mentioned alcohol related issues.

Below is a summary of the weekly consumption of alcohol from the latest report as per Canada’s Guidance on Alcohol and Health:

· 0 drinks per week = no risk of harmful effects and may lead to better health and sleep
· 2 standard drinks or less per week = low risk and thus likely to avoid major alcohol related negative effects
· 3 to 6 standard drinks per week = moderate risk and an increased risk of developing various types of cancer such as breast and colon cancer
· 7 standard drinks or more per week = increasingly high risk of cancer and a significantly increased risk of heart disease or stroke
– Each additional standard drink above and beyond this = increased risk of alcohol-related consequences

To put this into perspective, you really need to understand what the definition of a standard drink is. For starters, the large bottles/cans of beer or a very large wine glass filled to the rim does not constitute a standard drink, despite the fact that they are sold as a “single” drink. Rather, the Canadian definition of a standard drink is 17.05ml or 13.45 grams of pure alcohol. This is equivalent to 341ml (12oz) of 5% beer and cider or 142ml (5oz) of 12% wine or 43ml (1.5oz) of 40% spirits.

Now while alcohol has no direct beneficial effects on our health, for many Canadians it does have some indirect ones. Alcohol has an effect on the way in which we interact with our social and cultural environment and some of these are positive. There are social benefits to consuming alcohol which is based upon our evolutionary driven needs to interact with others. Many of us like to celebrate events or milestones with friends or family which may include an alcoholic beverage or two.

Living through the last three years of the pandemic has shown all of us too well the negative implications isolation has had on our personal health, mental or otherwise. If you were to look up the bad health outcomes associated with loneliness, the list would not look much better. Alcohol can help us with our social connectedness and there is value in that.

It is naïve to think that this report will entice everyone to abstain from alcohol for the foreseeable future. But it is important to keep this information in the backs of our minds if/when we decide to consume alcohol. If you do choose to have a drink, do so responsibly, both for the benefit of others and yourself in the decades to come.

For more information on this or any other health topic, contact your pharmacist.