Drug Rehab Center

By Daniel Jordan, General Manager
Sunshine Coast Health Center

It is often easy to overlook the damage alcohol causes in our society since, unlike other drugs like cocaine, it is legal. Alcohol continues to be encouraged as a social “lubricant” in our busy world as a way to unwind or to have fun. However, as Emergency Services prepares to gear up for another high school graduation, perhaps it is time to review some important statistics about the alcohol-related health and social harms in BC and Canada.

Types of Harms Related to Alcohol

According to the BC Provincial Health Officer, alcohol-related health and social harms derive largely from four properties or effects of consumption:

1. Toxicity – alcohol poisoning (overdose)

Death from acute cardiac arrhythmia or acute pancreatitis. More often than not, alcohol overdoses affect the inexperienced drinkers who tend to be under age.

2. Intoxication – injury or crime

Death or injury resulting from violence, sexual assault, crime, alcohol-involved traffic casualties, etc.

- According to the BC Injury Research and Prevention Unit, approximately one-quarter of the 400+ fatal motor vehicle crashes that occur every year in BC are alcohol-related (Rajabali & Pike, 2008).

- According to a 2002 study (Pernanen, Cousineau, Brochu, & Sun, 2002), one-third of all crimes, charges, and prison sentences in Canada involve alcohol.

- A recent study by the Canadian Medical Association Journal showed that more than 21 per cent of sexual assaults are facilitated by drugs, up from 12 per cent in 2003. While this is a huge increase, an equally important finding from the Canadian Medical Association Journal research is that almost 90 per cent of these victims had used alcohol before the attack.

- Deaths due to toxicity (poisoning) and intoxication (injury)combined accounted for 2.7 per cent of all deaths in BC between 2001 and 2005 (Source: BC Alcohol and Other Drug Monitoring Project).

3. Dependence – alcoholism

Long-term excessive use of alcohol is directly linked to cirrhosis of the liver, some types of cancers, diabetes, hypertension (high blood pressure), brain damage, and wasting of the limb and heart muscles.

- In a 2002 Canadian Community Health Survey, 3.6 per cent of the BC population (122,400 people) were estimated to be alcohol dependent.

- There is a strong correlation between heavy alcohol use and mental health conditions, such as major depression and anxiety disorders. It is estimated that 1.3 per cent of Canadians age 15 and older (approximately 336,761) reported experiencing co-occurring major alcohol use and mental health disorders in the previous year (Rush et al., forthcoming).

- Deaths due to chronic drinking accounted for 2.1 per cent of all deaths in BC between 2001 and 2005  (Source: BC Alcohol and Other Drug Monitoring Project).

4. The Intergenerational Effect of Alcohol - Fetal Alcohol Spectrum Disorder (FASD)

A fourth source of harm that involves alcohol is alcohol consumption by pregnant women. Fetal Alcohol Spectrum Disorder, or FASD, is the leading cause of preventable mental disability in Canada. FASD is unique in that the harm inflicted is to the unborn fetus rather than to the alcohol-consuming individual or other members of society. Estimates are for every 1,000 babies born up to 3 will have the full features of FASD, while an additional 5 or 6 will have significant long-term disabilities. In BC, between 200 and 320 infants may be born affected by alcohol each year (Provincial Health Officer, 2002). A substantial protion of the costs of special needs education, youth justice, adult incarceration, homelessness, and adddiction can be attributed to FASD (Provincial Health Officer, 2002).

Conclusion

The ripple effect of alcohol in Canadian society is revealed in the statistics. According to the 2004 Canadian Addiction Survey , 10 percent of Canadians reported at least one harm during the past year from one’s own drinking (age 15+) and nearly 4 in 10 reported at least one harm * during the past year from others’ drinking (18+).

At our treatment center, alcohol is still the drug of choice for over three-fifths of our clients. For those whose drug of choice is cocaine, alcohol is often their second drug of choice. Even though we don’t treat for date-rape drugs since few develop a dependence to them, our date-rape drug section accounts for four of our top 10 search terms for people visiting our Sunshine Coast Health Center website. We believe there is a need for public education on how alcohol is a factor in sexual-related assaults.

Hopefully, Canadians will begin to appreciate that there are many ways to get hurt, directly or indirectly, from alcohol. One does not need to develop alcoholism to be negatively impacted. This message needs to be conveyed to high school students who often have a very narrow understanding of the harms associated with alcohol.

(*) Note: Harms associated with others’ drinking include (1) being insulted or humiliated (22.1%), (2) verbal abuse (15.8%), (3) serious arguments or quarrels (15.5%), (4) being pushed or shoved (10.8%), (5) family or marriage problems (10.5 %), and (6) being hit or physically assaulted (3.2%).

Source

This blog article is a summary of Public Health Approach to Alcohol Policy: An Updated Report from the Provincial Health Officer issued in December 2008 by P.R.W. Kendall, Provincial Health Officer. 

Dedication

This blog is dedicated to Richie Dowrey who is in grave condition in hospital following a punch to the face from a fellow patron at the Fountainhead Pub on Davie Street in Vancouver on St. Patrick’s Day. Richie was punched without warning or any apparent reason. Richie has two children. Our prayers are with him and his family for a speedy recovery.

References

Du Mont, Janice; Macdonald, S.; Rotbard, N.; Asllani, E.; Bainbridge, D.; and Cohen, M. (March 2009)
Factors associated with suspected drug-facilitated sexual assault
Can. Med. Assoc. J., 180: 513 – 519 ; doi:10.1503/cmaj.080570

Pernanen, K., Cousineau, M., Brochu, S., & Sun, F. (2002) Proportions of crimes associated with alcohol and other drugs in Canada. Ottawa, ON: Canadian Centre on Substance Abuse.

Provincial Health Officer (2002) Public health approach to alcohol policy: a report of the Provincial Health Officer. Victoria, BC: Ministry of Health Planning.

Rajabali, F., & Pike, I. (2008) Alcohol-related motor vehicle crash deaths in British Columbia: 2003-2005. Vancouver, BC: BC Injury Research and Prevention Unit.

Rush, B., Urbanoski, K., Bassani, D., Saulo, C., Wild, C., Strikes, C., et al. (forthcoming) Prevalence of co-occurring substance use and other mental disorders in the Canadian population. Canadian journal of psychiatry.

By Daniel Jordan, General Manager

A new report issued by the Provincial Health Officer, PRW Kendall, reveals some troubling statistics on drinking in British Columbia. Interestingly, this December 2008 report, Public Health Approach to Alcohol Policy: An Updated Report from the Provincial Health Officer, received very little attention in the media. This is too bad since the public needs to know that alcohol consumption, and the harms associated with it, has been on a steady increase since 2002.

What’s so special about 2002? That is the year that the provincial government decided to increase accessibility to alcohol.  Since 2002, the total number of liquor stores in BC has increased from 786 to 1,294. This is important since 73 percent of alcohol consumed in BC originates from liquor stores. 

To give the provincial government credit, the Public Health Approach to Alcohol Policy report was commissioned to measure the effects of making alcohol more widely available and suggest ways to minimize the health and social harms associated with increased alcohol use in BC.

Here are some of the highlights of the report:

Interesting Stat #1 – Drinking is on the Rise in BC

Since 2002, alcohol consumption has increased 8 percent overall. Government revenue from alcohol sales has increased 4 per cent per year from 2003 to 2007. Little wonder the provincial government has been slow to reverse the trend since alcohol sales provides much-needed revenue.

Interesting Stat #2 – A Small Minority of Drinkers Account for Most of the Drinking

Often lost in the statistics is how much of the alcohol is consumed by problem drinkers and alcoholics (aka alcohol dependent).  This is known as the concentration of drinking.

According to the 2004 Canadian Addiction Survey:

• the top 10 per cent heaviest drinkers in Canada accounted for 53.3 per cent of total alcohol consumption
• the top 20 per cent accounted for approximately 72 per cent of the total
• the remaining 80 per cent of the drinking population accounted for 28 per cent of overall alcohol consumption, as measured by selfreporting.

The self-reported data likely underestimate the true concentration of drinking in Canada. Further analysis of the data from the Canadian Addiction Survey revealed that self-reported drinking only accounted for about 40 per cent of the alcohol sold in Canada as measured by official Statistics Canada sales data *. This, coupled with the fact that heavier drinkers tend to under-report their consumption more than lighter drinkers **, suggests that the actual concentration of drinking in society is likely even more skewed than suggested.

(*) Source: Stockwell, T., Sturge, J., & Macdonald, S. (2005). Patterns of drinking in British Columbia: an analysis of the 2004 Canadian Addictions Survey. CARBC statistical bulletin #1, University of Victoria, British Columbia. 

(**) Source: Greenfield, T., Kerr, W., Bond, J., & Stockwell, T. (2007, May).Improving graduated frequencies measures for use in monitoring surveys: Results from recent US and Australian national surveys and a diary-based validity study. Paper presented at the KBS International Research Symposium: Monitoring Alcohol and Other Drug Related Harm: Building Systems to Support Better Policy. Sidney (Victoria), BC.

 Interesting Stat #3 – Youth Drinking in BC is Usually at Dangerous Levels

Over 90 per cent of alcohol consumption reported by males age 15–24 was in excess of the Centre for Addiction and Mental Health Low-Risk Drinking Guidelines, and 85 per cent of alcohol consumed by females age 15–24 exceeded the guidelines.

If you think that having a better education means reduced levels of excessive drinking, think again. In fact, the opposite is true. According to a 2005 study *, 27 per cent of undergraduate students in BC are considered hazardous drinkers, 39 per cent report being harmed by drinking, and approximately 30 per cent report at least one symptom of dependent drinking.

(*) Source: Adlaf, E., Begin, P., & Sawka, E. (Eds.). (2005). Canadian Addiction Survey (CAS): A national survey of Canadians’ use of alcohol and other drugs: Prevalence of use and related harms: Detailed
report. Ottawa: Canadian Centre on Substance Abuse.

Interesting Stat #4 – Alcohol-related Social and Health Harms are on the Increase

Research shows that alcohol-related social and health harms * are on the increase in British Columbia.

Statistical analysis found that:

• alcohol-caused hospitalizations in BC increased 3.38 percent from 2002 to 2007, 8.1 percent in the Northern Health Authority, and 10.1 percent for the 40-59 age group
• alcohol-related or alcohol-caused deaths in BC increased 10.5 percent for adults 75 and older
• since 2004, rates of impaired driving charges in BC have surpassed the average rate in Canada by approximately 10 percent
• the percentage of night-time drivers testing at or above 0.05 BAC in BC fell substantially between 1995 and 2003, but increased to nearly 1995 levels in 2006.

Excessive alcohol consumption is the leading contributing cause of death among British Columbians 25 years of age and under, due to fatal road crashes, suicides, homicides, and poisoning deaths **.

(*) Note: Alcohol-related health and social harms include those related to (1) toxicity and intoxication - alcohol poisoning (overdose), (2)  harms derived from long-term chronic use – some cancers, cardiovascular diseases, liver disease and (3) social harms – violence, sexual assault, crime, alcohol-involved traffic casualties, and other intentional and unintentional injuries.

(**) Source: Ministry of Health (2006) Following the evidence: Preventing harms from substance use in BC.

For More Information on the Report

Copies of this report are available from:

Office of the Provincial Health Officer
Ministry of Healthy Living and Sport
4th Floor, 1515 Blanshard Street
Victoria, B.C. V8W 3C8

Telephone: (250) 952-1330 and electronically (in a .pdf file) from: http://www.health.gov.bc.ca/pho/