Visions Journal

Adam Sherk, PhD

Reprinted from the The Many Faces of Neurodiversity issue of Visions Journal, 2023, 18 (3), pp. 42-43

As a member of the scientific committee that helped write Canada’s Guidance on Alcohol and Health, I was as surprised as most people about how much the research connecting alcohol and our health has evolved in the 10 years since the last guidance was written.

A key takeaway of the process, for me, was that drinking alcohol is more harmful for our health than we previously thought. We should learn more before deciding what level of risk we might be comfortable taking when it comes to using alcohol. As we reviewed the research in this area, we found that, in addition to causing known health issues like injuries, car collisions and liver cirrhosis, drinking alcohol also causes many other chronic health conditions, like colon cancer, breast cancer, heart disease and stroke.

As alcohol is Canada’s most common drug and often takes a central role in our society, I was struck by how few of us know about these risks. One of these knowledge gaps is that less than 50% of Canadians know that drinking alcohol increases the risk of cancer, despite the scientific community reporting this for over 30 years. Another gap: the new Guidance recommends limiting our intake to a certain number of standard drinks per week, but the number of standard drinks isn’t labelled on alcoholic beverages, making it difficult for us to follow the new Guidance if we choose to do so.

So, what’s the new advice on alcohol and health?

The main takeaway for all of us in Canada is that, when it comes to alcohol and our health, drinking less is better. Contrary to what we may have heard about a glass of red wine per day, there’s no amount of alcohol that is good for health. Many things we do in our lives carry some risk, so many of us will probably continue to drink. The new alcohol advice recognizes this and gives us information about the health risks to help us consider how much alcohol we drink in a week. Something else to keep in mind is that this new guidance is about alcohol and health—it doesn’t consider the social and cultural uses of alcohol in Canadian society.

What’s in a drink?

Drinking advice is described in terms of “standard drinks,” which we can think about as a serving size of alcohol. A standard drink looks at the pure alcohol our drink contains. How much liquid you actually drink depends on the beverage, so it’s different for beer, wine and hard spirits like whisky, vodka or rum. A standard drink is contained in a bottle of 5% beer, a 5-ounce pour of 12% red wine, a 1 1/2 ounce shot of spirits or a can of 5% cider or cooler.

No-risk and low-risk drinking

The scientific process we followed to write the new alcohol advice found that the only way to completely avoid health risks from alcohol is to not drink. This is true for all our behaviours that involve some risk to our health without any balancing health benefit, such as driving a car. To build out this comparison a bit, and strictly in terms of health, we can say that driving a car is an activity that has no health benefit but brings some risk for health every time we do it, both in terms of a possible accident and, especially, due to physical inactivity when we miss a chance to exercise. For both alcohol use and driving, the only way to completely avoid health risk is to not expose ourselves to the activity. But just as no one will order you to avoid driving completely for your health, the new Guidance on alcohol will not tell you what you must do. But it does say that having one or two drinks per week carries little health risk, and you’ll likely avoid health consequences for yourself and others.

Moderate-risk drinking

Drinking between three and six standard drinks per week carries a moderate risk of developing health conditions caused by alcohol, such as cancer, heart disease and stroke. To reduce the risk, we should spread these drinks over several days. To keep our risk moderate, the advice recommends that, whenever possible, we shouldn’t have more than two drinks on any day.

Higher-risk drinking    

When we drink more than about one drink per day, or seven drinks or more in a week, the chances that we’ll develop cancer, heart disease or stroke, or that we’ll be injured or injure others because of our drinking, begins to increase more steeply.

Takeaways

Drinking alcohol is more harmful for health than was previously thought, so it may be time to rethink the way we drink. All types of alcohol—beer, wine, hard liquor—convey the same amount of risk based on how much pure alcohol they contain, so learn what a standard drink is and, if you drink, count your drinks. The new advice doesn’t tell us how much to drink, but it does provide risk information based on how much alcohol we use in a week to support our decisions in regard to alcohol. Have a look at the new Canada’s Guidance on Alcohol and Health if you’re interested in learning more.

Another takeaway for me is that Canadians have a right to know the potential harms that drinking alcohol can cause, like cancer and heart disease. A cancer warning and standard drink information could be required on products containing alcohol. That way, those of us who drink can have more information about health.  

Learn more about Canada’s Guidance on Alcohol and Health at ccsa.ca/canadas-guidance-alcohol-and-health.