Stigmatizing moderate, low-risk drinking isn’t a viable public health strategy

Since the Centre for Substance Use and Addiction (CCSA) released its new alcohol guidelines in August, headline after headline has repeated its claim that anything more than two drinks per week is seriously bad for your health.

The shifting of the goalposts on alcohol consumption radically changes who is considered a problem drinker. Under the old guidelines of upwards of 15 drinks per week for men and 10 drinks per week for women approximately 85 per cent of Canadian drinkers qualified as responsible. Under the new guidelines the vast majority of Canadian drinkers are now considered to be drinking “beyond acceptable risk thresholds.”

Life is all about taking risks, of course, and some risks are more than worth taking. So what are the actual risks of consuming within the old guidelines? Kiffer George Card, an epidemiologist who teaches health sciences at Simon Fraser University, reports literature reviews that suggest consuming between seven and 14 drinks per week may lower your overall life expectancy by six months to a year on average compared with people who have zero to seven drinks a week.

Given the enjoyment that alcohol either provides or enables, many people will think that level of risk is more than worth it, especially considering the other risks we assume daily without batting an eye, whether it be eating the foods we do, driving the highways or for that matter simply crossing the street.

In setting its two-drink limit the CCSA did not take into account any of the benefits of moderate alcohol consumption, primarily from the role it plays in releasing endorphins and enhancing social bonding. In fact, according to the American Journal of Public Health, limited social bonding is as, or even more, dangerous than most of the major public health issues Canadians face.

Poor social health, as Kiffer George Card points out, is just as, if not more, harmful than smoking, drinking, being obese, living sedentarily and breathing poor-quality air. You might think that after years of rolling lockdowns to curb the spread of COVID public health lobbyists would appreciate the risks associated with a more isolated lifestyle and adjust accordingly. Unfortunately, the neo-temperance approach ignores this very inconvenient truth.

What makes the renewed discussion about alcohol even more puzzling is that it runs directly counter to Canada’s other harm-reduction efforts, which focus on saving lives by removing the stigma of substance abuse. Whether it be safe injection sites, free drug-testing facilities or even the availability of safe supply, the federal government attempts to help those who suffer from addiction, not chastise and stigmatize them.

British Columbia has taken harm reduction one step further with its decriminalization of the possession and use of small amounts of hard drugs like heroin and cocaine. But while some public health officials are trying to remove the stigma from heroin use, others are labelling almost all Canadian drinkers as high-risk and shaming them for what is in fact very low-risk behaviour. The cognitive dissonance is concussing.

For any number of reasons you might enjoy having a glass of wine or a beer or two, and you shouldn’t feel guilty about that, despite what the CCSA may say. Stigmatizing moderate, low-risk drinking isn’t a viable public health strategy. It’s time to put the CCSA’s report back on the shelf. Behind the whisky.

Originally published here