What you need to know
Using psychoactive substances including drinking alcohol, has been a part of human cultures across the globe for millennia.
People have used substances to do better, feel better and enhance performance. Alcohol has been used for religious observances, to celebrate milestones and special occasions such as birthdays and holidays as well as relax and enjoy the company of others. Many people do not experience problems from consuming alcohol. Some people, including those who use alcohol or other substances to cope with stress or other personal issues, to party or are dependent on alcohol can experience diffculties such as damaged relationships, addiction, early death, cancer, and birth defects, especially as the amount they consume increases. Canada’s Low Risk Drinking Guidelines (LRDG) were first published in 2011 by the Canadian Centre on Substance Use and Addiction (CCSA) to provide Canadians with information to help them make informed decisions about their alcohol consumption with respect to their health. The guidelines were distributed and taken up to varying degrees across the country. Since that time, patterns of alcohol intake in Canada have changed along with our understanding of the harms associated with its use. With this in mind, beginning in 2020, with funding and a mandate from Health Canada, the CCSA led a two-and-a- half-year process to update the guidelines. That process resulted in Canada's new Guidance on Alcohol and Health released in January 2023 which replaced the 2011 LRDG.
How was the guidance developed?
Canada's Guidance on Alcohol and Health was developed by a group of researchers from across Canada many of whom specialize in understanding the effects that drinking alcohol can have on human health. The group followed a comprehensive process. The method included reviewing and evaluating the 2011 Canadian guidelines as well as those from the United Kingdom and Australia, reviewing and evaluating associated research, gathering current information from across the world, consulting with researchers in related health areas, other interested groups and the public to provide feedback on the work done. This effort culminated in the report released in January 2023.
In simple terms, what does the guidance say?
Here are some key ideas to take away from the new Guidance:
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If you use alcohol, less is better in terms of health. The level of risk for harm is related to the amount of alcohol consumed.
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It is okay not to drink alcohol. Though drinking alcohol is common in Canada (75% of those over age 15 do so), you do not need to drink if you do not wish to.
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Any level of alcohol consumption carries some risk; Canadians have the right to know this.
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Drinking alcohol is linked to an increased risk of several major illnesses including some cancers (e.g., colon, breast) as well as cardiovascular (heart) and liver disease. There are harms for the drinker and like secondhand smoke from cigarettes, potentially for people around them.
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Women face unique risks when they drink alcohol. They become intoxicated more quickly on smaller amounts of alcohol than men. They metabolize alcohol more slowly than men, thus the levels of alcohol in their blood remain elevated for a longer period. If pregnant, trying to get pregnant or breastfeeding, it is safest for women not to drink alcohol as doing so can have serious negative impacts on the child.
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Men are more prone to certain harms when they drink alcohol. Men tend to drink more alcohol than women and are more likely to do so excessively. Thus, men are also more likely to be involved in motor vehicle accidents, require hospital care for alcohol related incidents and health issues, and die for alcohol related reasons. Men's use of alcohol is also more strongly associated with violence toward others. On any single occasion, men’s drinking more often results in injury, violence, or death than that of women. Overall, men account for 75% of all alcohol caused deaths.
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Youth should delay alcohol use as long as possible. Alcohol is the psychoactive substance most frequently used by youth and is often consumed while binge drinking (having more than five drinks on any one occasion for males and four for females). The risks of alcohol use are generally greater for youth than adults as youth are less physically and emotionally mature, can be impulsive, and are commonly less experienced with complicated tasks such as driving.
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There are times when you should not drink alcohol at all:
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Driving a motor vehicle
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Using tools or machinery
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Taking medications/drugs that interact with alcohol (and there are many)
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When you are responsible for the safety of others (e.g., driving a car with passengers)
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When making important decisions (e.g., family life concerns that can affect yourself or others such as having sex, severing a relationship or financial decisions)
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Alcohol consumption per week
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0 drinks per week Not drinking has benefits, such as better health, and better sleep. |
No risk |
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1 to 2 standard drinks per week You will likely avoid alcohol-related consequences for yourself and others. |
Low risk |
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3 to 6 standard drinks per week Your risk of developing several different types of cancer, including breast and colon cancer, increases. |
Moderate risk |
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7 or more standard drinks per week Your risk of heart disease or stroke increases. Each additional standard drink Radically increases the risk of these alcohol-related consequences. |
Increasingly high risk |
Aim to drink less: Drinking less benefits you and others. It reduces your risk of injury and violence, and many health problems that can shorten life.
Here is a good way to do it: Count how many drinks you have in a week. Set a weekly drinking target. If you're going to drink, make sure you don't exceed 2 drinks on any day.
Drinking alcohol has negative consequences. The more alcohol you drink per week, the more the consequences add up.
Tips to help you stay on target
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Stick to the limits you've set for yourself.
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Drink slowly.
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Drink lots of water.
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For every drink of alcohol, have one non-alcoholic drink.
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Choose alcohol-free or low-alcohol beverages.
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Eat before and while you're drinking.
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Have alcohol-free weeks or do alcohol-free activities.
Why are the recommendations for numbers of drinks per week so much lower in the new guidance than in the old (2011) LRDG?
The 2011 LRDG were devised with the best knowledge available at the time. That guidance recommended no more than 10 drinks per week for women and 15 for men. In the intervening period, researchers have learned more about the physical and mental health effects of alcohol and their bearing on a range of harms including disease and death. A review of studies that informed the 2011 LRDG coupled with new data that accounted for significant differences in alcohol consumption not addressed in the older research, along with new guidelines from Europe, Australia, and the UK, prompted an update of Canada’s drinking guidance. When considered together, all the information pointed to the need for a drastic reduction in the numbers of drinks per week for adults that might be considered low, moderate, or increasingly risky consumption. That is, when older work was reviewed considering new evidence, it became clear that the number of drinks per week that could be consumed with minimal risk was much too high. Thus, the numbers of drinks related to various levels of risk for harm are greatly reduced in the new guidance.
How do I decide how much alcohol I can drink and not hurt myself or others?
That is a very personal decision. People use substances including alcohol, for many reasons. It is important to remember that although your drinking is your responsibility, you are part of a community that includes your friends, family, colleagues, work mates and all those around you. Your decisions affect them, and their decisions affect you. It may take some time for you to decide what is right for you and that is okay. To begin thinking about your use of alcohol you may wish to consider:
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The amount of alcohol (or other substances) you are currently consuming
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The impacts your consumption may be having on your physical, mental, and emotional health, family, job, friends, or any aspect of your daily life
The following resources may assist you in thinking about your use of alcohol:
If you would like to explore your alcohol use in more detail:
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Visit: KnowAlcohol.ca, a website from the Canadian Institute for Substance Use Research (CISUR)
If you would like to talk to someone about your own or a family member's use of alcohol:
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BC 211 connects you to a range of programs and services, including substance use supports, in your community
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First Nations Health Authority (FNHA) provides wellness and treatment resources for First Nations peoples in BC
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Foundry BC provides mental health and substance use supports to youth 12-24 and their caregivers
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Helplines for Adults in BC. If you need immediate assistance, call 9-1-1, anytime day or night
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Helplines for Youth in BC. If you or someone you know is crisis in the Greater Vancouver area you can call: 604-872-3311
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Help Starts Here - connects you to mental health and substance use resources in BC
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Free or low-cost counselling services in BC or in the Greater Victoria area
Source
Paradis, C., Butt, P., Shield, K., Poole, N., Wells, S., Naimi, T., Sherk, A., & the Low-Risk Alcohol Drinking Guidelines Scientic Expert Panels. (2023). Canada's Guidance on Alcohol and Health: Final Report. Ottawa, Ont.: Canadian Centre on Substance Use and Addiction.
About the author
The Canadian Institute for Substance Use Research, formerly CARBC, is a member of the BC Partners for Mental Health and Substance Use Information. The institute is dedicated to the study of substance use in support of community-wide efforts aimed at providing all people with access to healthier lives, whether using substances or not. For more, visit www.cisur.ca.
