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Editorial: Sober thought needed on alcohol guidelines

Study doesn’t address some crucial issues
The Canadian Centre on Substance Abuse and Addiction's new alcohol recommendations are vague and possibly overly restrictive, our editorial board writes, and Health Canada should consider releasing updated guidelines that reflect real-world experience. NATHAN DENETTE, THE CANADIAN PRESS

The Canadian Centre on Substance Abuse and Addiction has released a report calling for a major narrowing of the guidelines for safe alcohol consumption.

The existing guidelines, published in 2011, advised that adult males should limit their consumption of alcohol to 15 drinks a week, and women to 10.

The Ottawa-based centre now says that reams of international research show conclusively that these amounts are too high.

The authors state that even moderate quantities of alcohol consumption are increasingly linked to a wide variety of damaging health conditions, including seven types of cancer, heart disease and cirrhosis of the liver.

Two proposals are made. First, Health Canada should set new guidelines, with two drinks a week confirmed as low-risk, and three to six a week as moderate risk.

Second, beverage containers should state clearly the number of standard drinks each contains, as consumers are often uncertain on this point.

The report raises serious issues, and deserves a full and receptive hearing. Yet the new guidelines come close to placing alcohol off limits, even in the most modest quantities.

They go far beyond the measures adopted in 20 other countries that report their guidelines. Australia’s guidelines, published in 2020, cite 10 drinks a week as the recommended maximum. Britain uses 14 drinks a week as the upper limit.

And here the report must be read with care, because the way in which the statistics are presented tends to maximize the risks associated with alcohol consumption.

First, all of the risk factors are given for individuals who began their alcohol consumption at age 15, and continued unabated throughout life.

There certainly are individuals who fit this category. And binge drinking in the teenage years is a definite health risk.

But what about people who take up social drinking later in life? What is their risk? The authors do not say, and the report offers no guidance on this point.

Second, in the main the calculations give only the percentage of increased risk associated with higher levels of consumption, but not the actual risk.

That’s an important omission, because if the baseline risk is minimal, several times that risk will still be very low.

For example, we’re told that women who consume one drink a day face three and a half times the risk of contracting liver cirrhosis than a non-drinker. But what is the actual risk? We’re not told.

There is another consideration. Understandably, given their mandate, the centre looked only at the risks associated with drinking.

Since clinically speaking any amount of alcohol carries with it at least some degree of risk, that led the authors to establish near-zero guidelines.

Yet alcohol, used sensibly, is also a source of pleasure to many. This is given no weight in the study.

Health Canada, which has a broader view, will have to incorporate some of the social factors missing here.

Since the report was published to solicit public comment, it would help if the centre could rework its numbers to make the absolute risks more clear. We understand an effort is underway to meet this need.

As it stands, readers can decide for themselves. The report can be found by searching for Lifetime Risk of Alcohol-Attributable Death and Disability at the website

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