We need to talk about our drinking, says Dr. Robert Strang

New guidance on alcohol and health should lead to discussions many do not want to face, according to Dr. Robert Strang, Nova Scotia's chief medical officer of health. (Photo Illustration/CBC News/Shutterstock - image credit)
New guidance on alcohol and health should lead to discussions many do not want to face, according to Dr. Robert Strang, Nova Scotia's chief medical officer of health. (Photo Illustration/CBC News/Shutterstock - image credit)

The province's top doctor says now is an ideal time for Nova Scotians to talk about alcohol and its impacts, following the release of a new report that identifies the risks of consuming more than two drinks a week.

"It's really an issue we need to bring out more into the open, I would argue, and have more open conversation about it," said Nova Scotia's chief medical officer of health Dr. Robert Strang, who contributed to the new federal guidance.

The report, Canada's Guidance on Alcohol and Health, warns about the increased risk of several types of cancer for people who consume between three and six standard drinks a week.

Compiled by the Canadian Centre on Substance Use and Addiction, it also outlines other diseases drinking can lead to, in addition to injuries, violence and social problems.

A standard drink means:

The majority of drinkers will already be in what the new report advises to be risky territory, Strang said.

"This is about making sure people can now put this information in the context of other choices they are making and be fully informed about what risks might be occurring to them," he said.

Strang was on the advisory committee for the scientific group that created the new guidance.

He wants to make it clear he is not against alcohol and is not telling people what to do. However, he does think it's time people accept the harms associated with drinking.

"It has many, many negative impacts that we don't really want to face individually and collectively," he said.

Causes 1,000s of deaths every year

The most recent data referenced in the report connects alcohol to 7,000 cancer deaths each year in Canada.

Most of those cases being breast or colon cancer, followed by cancers of the rectum, mouth and throat, liver, esophagus and larynx.

When factoring in all other diseases and problems, alcohol caused a total of 18,000 deaths in the country in 2017, the report says.

"Alcohol often gets left to the side because of the way it is integrated into society. But we're talking about opioid related deaths in Canada and the crisis and epidemic of opioid related deaths. And the number of deaths from alcohol annually exceeds those deaths and we don't call it an alcohol crisis," said Mark Asbridge, a professor in Dalhousie's department of community health and epidemiology.

He was on the report's expert panel.

Strain on health-care

Another serious issue people need to consider, Asbridge said, is the impact alcohol has on the province's strained health-care system.

"My colleagues who are emergency physicians, they regularly deal with alcohol-related visits," Asbridge explained.

"Violence, falls leading to head injuries. Fights at bars, people drink driving, these kinds of things. It dominates the emerg on the weekend evenings and it's just an absolute drain to the system," he said.

Nova Scotia is now talking to the federal government about the report's recommendations, which raise the idea of placing warning labels on alcohol products.

"I think that is best addressed at the federal level," Strang said. "We have those approaches on tobacco products. It certainly was a big focus as we legalized cannabis. We should be doing the same for alcohol."

Health Canada provided funding for the report and is now reviewing the findings.

Warning labels discussed

Industry representatives contacted by CBC News said they're still digesting the new information but are not expecting any big drop in business.

"I don't think there will be any immediate impact in our industry overall. I think if it is, it will be very, very minimal," said Gordon Stewart, the executive director of the Restaurant Association of Nova Scotia which represents more than 3,000 businesses.

Adrian Wyld/The Canadian Press
Adrian Wyld/The Canadian Press

The association would not object to labelling, he said.

Neither will the craft brewers association in the province.

"We're only about social drinking, we pair it with food. It's [preservative] free. It's quality over quantity," said Debbi MacDonald, the executive director of the Craft Brewers Association of Nova Scotia. "We're all about moderation anyway."

In a statement to CBC News, the Nova Scotia Liquor Corporation said it already has a number of initiatives in place on responsible drinking and is now working with the province on next steps following the latest guidance.

"We are working in partnership with Health and Wellness and Finance to support sharing this information on responsible consumption and health warnings with our customers," the statement said.

Strang said the province will be speaking to a range of community groups as a starting point to get the discussion going.