February 2008

 

Whose Guidelines to Follow?

Earlier this month, Marianne Kobus-Matthews and Branka Agic moderated a teleconference for the Alcohol Policy Network on a new program which culturally adapted and translated the Low-Risk Drinking Guidelines for specific audiences. These guidelines, printed and endorsed over a decade ago by leading public health agencies including the Ontario Public Health Association, the Centre for Addiction and Mental Health, and the Association of Local Public Health Agencies, among others, were highlighted during this teleconference as the model to follow when drinking.

Ontario's Low-Risk Drinking Guidelines (LRDGs), endorsed nationally by the Canadian Centre on Substance Abuse and co-provincially by the Addictions Foundation of Manitoba and the Alberta Alcohol and Drug Abuse Commission, recommend that drinkers should consume no more than 2 standard drinks on any one day — a standard drink defined as 13.6 grams of alcohol. Women should consume a maximum of 9 standard drinks a week and men should stop at 14. The guidelines highlight that these are "low-risk" guidelines - not ‘no-risk’ guidelines - reminding that avoiding alcohol is the surest way to lower the risk of an alcohol-related problem.

However, during the last couple of years, other provinces of Canada have released guidelines as well, with some being different from Ontario's.

For example, Quebec recently released the document, Alcohol and Health; Low-Risk Drinking: 2, 3, 4, 5, 0, through the educational organization Éduc'alcool. This document recommends that daily drinks should stop at 2 for women and 3 for men, and women should have no more that 4 drinks, men no more than 5, to avoid intoxication and associated complications. Rounding out the recommendations is the advice to have no alcoholic drinks at least one day a week, this practice referred to as "a good habit."

The province of British Columbia, through the Centre for Addictions Research of BC, released guidelines advising to avoid intoxication [PDF], women should not have more than 3 drinks per day and men should stop at 4. Weekly limits are set at 20 standard drinks for men and 10 for women, allowing one or two days of the week to be free of alcohol.

All of these guidelines contain drinking caveats as well, including warnings that alcohol should not be consumed if you:

• have health problems such as liver disease or mental illness
• have a personal or family history of drinking problems
• are pregnant, trying to get pregnant, or breastfeeding
• will be operating vehicles such as cars, trucks, motorcycles, boats, snowmobiles, all-terrain vehicles, or bicycles
• are told not to drink for legal, medical or other reasons

So, what about National Low-Risk Drinking Guidelines?

This was a strong recommendation made in the report, Reducing Alcohol-Related Harm in Canada: Toward a Culture of Moderation. Recommendations for a National Alcohol Strategy [PDF]. Health Canada has since taken the lead on this initiative with national guidelines planned to be released in Spring 2008.

Which guidelines should be followed?

Well, as predicted, the answer differs depending on who you ask.

Each province will inevitably support the guidelines put forth by their respective provincial bodies, even though guidelines differ slightly between provinces. The International Center for Alcohol Policies reasons differing guidelines stating that "research data supporting low-risk guidelines are subject to different interpretations due to local culture and the populations' current drinking standards".

Perhaps some of the best advice to follow is that from Marianne Kobus-Matthews, organizational lead on low-risk drinking guidelines. Kobus-Matthews reiterates caveats from Ontario's guidelines by highlighting "if you want to improve your health, you're better off eating a healthier diet, getting more exercise, and giving up smoking, rather than drinking more or starting to drink". She reminds us "These are low-risk guidelines. They are not ‘no-risk’ guidelines."

That is a truly low-risk approach.

Provincial Low-Risk Drinking Guidelines Comparison

	Max. drinks per day		Max. drinks per week		No. of days alcohol-free
	Men	Women	Men	Women
Ontario	2	2	14	9	1-2
Québec	3	2	18*	12*	1
British Columbia	4	3	20	10	1-2

* these values calculated by multiplying the number of daily drinks by 6 (7 days of the week – 1 alcohol free day)

 

New to the Substance Abuse Prevention field?

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— Participant, Newbie 101 Teleconference, 2007

Please join us for the Newbie Orientation 101: An Orientation to the Substance Abuse Field for New Professionals on February 28, 2008 from 10:00 a.m. to 11:30 a.m. EST. This teleconference is free of charge and is geared to those in Ontario working in public health.

From 2007 evaluation data, 78% of attendees felt the teleconference either met or exceeded their intended expectations. Additionally, 100% of those surveyed said they would recommend this session to others new to the field.

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