Ruminations

Availability and Consequences : Alcohol and Hospitalizations

"Alcohol deregulation appears to have resulted in increased alcohol-related harms in Ontario." "Deregulation [with the relaxation of alcohol sales and extension to stores and longer hours of sales] has likely had negative impacts far beyond the reported emergency department visits."
"[The situation of expanded alcohol sales outside the more highly-regulated Liquor Control Board of Ontario should be studied as a [natural experiment that can be used to better understand the relationship between alcohol availability and harms."
"[Placing limits on the number of alcohol outlets and their weekly hours of operation] should be part of any alcohol strategy."
New study on Deregulation of Alcohol and Hospital Admissions

In Ottawa alone, alcohol led to 6,100 emergency department visits between 2013 and 2015, 1,270 hospitalizations during the same time and 140 deaths (between 2007 and 2011), according to Ottawa Public Health. Ashley Fraser / The Ottawa Citizen

The convention of alcohol sales in the province of Ontario has long baffled and irritated provincial residents who look abroad envying the availability of wines and beers in supermarkets just across the border in the United States. In Ontario's neighbouring province of Quebec, liquor is sold in depanneurs (convenience stores) and they will even deliver to the customer's home. In Ontario, spirits have been sold in provincially-regulated stores; Brewers Retail for beer and LCBO-controlled outlets for wines and hard liquors.

Ontarians have chafed at the indignity of it all, at the lock on their freedom to shop anywhere for a product that is popularly consumed and recognized as a part of any food-and-drink culture. Where a dour Presbyterian outlook on liquor consumption means that bars and restaurants must make application to the LCBO for a license to enable them to serve alcohol. Bars wishing to qualify had to make a measure of foods available; restaurants knew that without a liquor license their eating establishment would fail to draw customers.

Finally, appeals to the government to relax what has been seen as Draconian and outdated laws on
'protecting the public' by making it difficult to buy a product heavily taxed to provide government with a reliable revenue stream was mismatched with the current, more relaxed culture, less driven by an atmosphere of general alcohol-consumption disapproval far removed from the prohibition years that ended in dismal failure. The move to deregulation was initiated in 2015 when a Liberal government expanded beer and wine sales across the province to grocery stores.

The current Conservative government is set to expand that initiative and loosen restrictions to an even greater degree. According to the authors of the study published in the journal Addiction, that further expansion will result in greater harms to the public, attributable to more alcohol availability. Dr. Daniel Myran, a public health resident at University of Ottawa, lead author of the study expressed the opinion that further expansion of alcohol sales in the province would "lead to more emergency department visits due to alcohol".

According to the province's finance minister, it is time for the government "to treat people like responsible adults". An further relaxation of alcohol-sales-restrictions is therefore in order where beer and wine sales are to be expanded to corner stores, big box outlets and a larger choice of grocery stores across the province. Dr. Myran's research undertook the study of a link between alcohol access and emergency department visits attributable to alcohol use, by comparing hospital emergency department visits before deregulation and after.

Geographic areas where grocery stores were licensed to sell alcohol were brought into the study equation, as compared with areas where no such sales took place in grocery stores. Alcohol-related rates of visits to hospital emergency departments the study revealed, rose by 17.9 percent during the period of the study (2012 to 2017), a number in excess of all other emergency visit for various other reasons. The regions with grocery stores selling alcohol post-2015, showed in addition, a six percent greater increase for hospital emergency visits in comparison with those areas absent alcohol sold in grocery stores.

While previous research had associated increased alcohol access with health harms associated with alcohol use, this study is the first to focus on Ontario alone.Over 23 million Canadians over the age of 15 reported the use of alcohol in 2017. The consumption of alcohol has been estimated as the cause of 6.6 percent of deaths in men and 2.2 per cent in women. Of the total number of Canadians using alcohol, 21 percent reported having consumed enough that they would be at risk of chronic and immediate alcohol-related harm.

Alcohol has led to 6,100 emergency department visits between 2013 an 2015 in Ottawa alone, during the same period. According to Ottawa Public Health, 140 deaths that occurred between 2007 and 2011 were attributable entirely to alcohol consumption. The takeaway to which is the indelible impression that many people indeed are not prepared to behave in a manner recognized as "responsible".