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Nearly 80% of British Columbians aged 15 and older drink alcohol, according to the 2004 Canadian Addiction Survey. Most drinkers enjoy moderate amounts of alcohol when relaxing or celebrating a special occasion. However, a significant number of people sometimes drink in hazardous ways, and some do so regularly.
For this reason, in 2005, the Centre for Addictions Research of BC (CARBC) developed a set of low-risk drinking guidelines for the benefit of British Columbians.
How serious a problem is risky drinking in BC?
Just over 40% of the population drinks too much at least occasionally. Drinking to the point of getting drunk—or binge drinking—is often the cause of short-term harms such as domestic violence, sexual assault and injuries or death from falls or vehicle accidents. Young British Columbians comprise the largest group of binge drinkers.
The financial burden of excessive drinking in BC is over $2.2 billion every year. This immense price tag includes health care costs, lost work productivity and a host of other expenses including the cost of law enforcement. The emotional toll of loved ones who are unwell, injured or lost to alcohol is even greater.
Many British Columbians believe that individuals with severe dependence cause most of the alcohol-related drain from provincial coffers. But the fact is that 50% of the harms and costs associated with alcohol are caused by casual drinkers (not all of them young) who only sometimes drink beyond a reasonable limit.
A smaller number of British Columbians drink in ways that lead only to long-term harms such as illness and disease. However, over 20% of people regularly drink in ways that could cause both short- and long-term problems. The numbers are highest for young adults: approximately 50% of males aged 19 to 24 and about 33% of females of the same age say they routinely drink above low-risk levels.
What do ‘drinking guidelines’ aim to achieve?
The purpose of low-risk drinking guidelines for this province is to:
help British Columbians learn enough about effects from drinking that they can make informed choices about how, when and where they use alcohol
assist health professionals in providing clients with evidence-based information on alcohol use and related health concerns
reduce alcohol-related harms in our society
What do the ‘drinking guidelines’ include?
A typical set of alcohol guidelines includes:
daily and weekly recommended maximums (elevated risk thresholds) for the adult drinking population in general
a listing of groups of people who would benefit from drinking less or even no alcohol, given their circumstances
tips on how to avoid immediate harms, such as falls and accidents
information on how to avoid long-term harms, such as dependence and illness
Guidelines quantify advised limits in numbers of “standard drinks.” This is done to help people better monitor the amount of alcohol itself they absorb through various beverages. These are examples of one standard drink:
350 ml/12 oz (regular sized can or bottle) of beer or cooler (5% alcohol)
150 ml/5 oz (small glass) of wine (12% alcohol)
50 ml/1.5 oz (typical shot) of spirits (40% alcohol)
85 ml/3 oz serving of sherry or port (18% alcohol)
What are the low-risk drinking guidelines for BC?
There are three basic guidelines, described in brief below. (For a detailed explanation of the guidelines, see Low-Risk Drinking Guidelines at www.carbc.ca.)
Avoid intoxication. One way to avoid getting drunk is to drink slowly. For men of average weight this usually means drinking no more than two drinks in the first hour, and afterward only one drink per hour. Women, on the other hand, should consume no more than one drink in both the first hour and later on. In any one sitting—and in any one day—the maximum amount of alcohol consumed should be no more than four standard drinks for men, and three for women. People who are elderly, lower than average weight or below the legal drinking age should drink less than these amounts to avoid intoxication.
Choose abstinence in situations where “no alcohol” is the most sensible option. It is never wise to use alcohol before operating a vehicle or while using medications or other psychoactive substances. Women who are pregnant, trying to get pregnant or breastfeeding are encouraged not to drink any alcohol. Alcohol should never be used by people with severe mental or physical health issues or with a history of serious alcohol dependence.
Put limits on your drinking frequency and amounts. Regular heavy drinking over a long period of time increases a person’s chances of developing long-term health problems and alcohol dependence. A person can generally avoid health damage by limiting their weekly intake to 20 drinks or fewer for men, and 10 or fewer for women. It is also recommended that regular drinkers build “no alcohol” days into their week.
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Do the guidelines apply to each and every person in BC?
No set of guidelines, whether related to food, fitness or human behaviour, fits every person in every situation. By their very nature, guidelines provide general advice that is broadly applicable. They are intended for the public at large and do not speak to individual particularities or anomalies.
The guidelines are not a substitute for personalized clinical advice from a qualified family doctor, health professional or substance abuse counsellor. Instead, they offer a realistic target for those who are consuming excessive amounts of alcohol and would like to cut down without quitting entirely. They also serve the average British Columbian who enjoys drinking but may not know how much alcohol is too much, and how often is too often.
The guidelines can even be useful for people who do not drink or are already drinking at low-risk levels. They confirm in a person’s mind limits appropriate for both themselves and those around them. People already consuming within the reduced risk range are not encouraged or expected to drink more in order to reach the maximum limit indicated in the guidelines.
Low-risk drinking guidelines cannot take into account every context in which a person might drink. Some environments and situations are usually safer. For example, bars that are well-managed and maintained are better than those that are not. Also, drinking while alone and/or down is not advisable.
Studies show that a person’s mood and their drinking atmosphere influence the way their body responds to alcohol. In other words, a person could drink the exact same amount of alcohol on two different occasions and feel its depressant effects more strongly on one day than the other.
By providing valid boundaries, guidelines are a supplement to good sense and sound instincts.
How were the low-risk drinking guidelines for BC developed?
Like most sets of low-risk drinking guidelines, the recommendations for BC are based on scientific research into the positive and negative effects of onsumption patterns on public health. Other considerations include:
cultural dynamics and norms
beliefs about public roles and responsibilities in educating citizens and in regulating their behaviour
economic and other political interests
The guidelines for BC draw on internationally-accredited research on risk thresholds. They were applied to the BC case in response to problem drinking patterns identified in the 2004 Canadian Addiction Survey. This was done under the supervision of director Dr. Tim Stockwell, a world-renowned specialist in alcohol-related research and previously a member of the working party responsible for review and revision of Australia’s alcohol guidelines in 2001.
As evidence-based guidelines, they are subject to periodic review as new research results are confirmed. CARBC can be expected to carefully consider significant findings from such initiatives and respond in an appropriate manner.
Until updating is required, the present low-risk drinking guidelines remain well-founded and can help to protect health and reduce harm in British Columbia.
Definitions of drinking levels
Low-risk drinking: the range at which there is minimum risk of harm. There is debate about whether this level of drinking also has some health benefits to some of the population.
Risky drinking: the range at which risk of harm is greatly increased beyond any possible benefits.
Types of risk
Intoxication: the state of being that results when the amount of alcohol a person drinks dangerously impairs their mental and physical abilities
Short-term health risks: harms associated with excessive drinking on a single day (e.g., injuries due to vehicle accidents, alcohol poisoning, sexual assault, self-harm and other forms of violence, and problems with work, relationships and the law)
Long-term health risks: harms associated with heavy drinking that is sustained on a very regular basis over an extended period of time (e.g., ulcers, liver disease, various forms of cancer, chronic gastritis and pancreatitis, high blood pressure, malnutrition, depression, cognitive problems, impotence and alcohol dependence)
