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Finally, appeals to the government to relax what has been seen as Draconian and outdated laws on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".

Beer on shelves. ERIC THOMAS / AFP/Getty Images

Preparing for the Consumer Pot-Acquisition Onslaught

"[The study's purpose is to provide a] comprehensive outline of the scope and scale of cannabis consumption in Canada."
"Actual demand remains unknown and there is no statistically proven method to know demand with statistical certainty."
Health Canada-commissioned report on cannabis consumption in Canada 

"[There will be a] huge curiosity spoke [of those waiting to buy legal cannabis in the early days of legalization across Canada]."
"I don't think there will be empty shelves, but there might be shortages of some strains."
Brad Rogers, president Canntrust cannabis growers

Concerns are being raised over the ability of Canada's licensed medical marijuana producers to supply enough cannabis for a legal recreational market. (Julie Gordon/Reuters)

An air of expectancy is palpable among recreational drug users in Canada. The country is set to become the first to legalize recreational marijuana right across the country, by an act of Parliament. Cannabis growers have been revving up activities with frenzied determination. Investment in infrastructure for marijuana production has been driven on overtime. Advertising and public relations campaigns have been very visible over the past year. Suddenly, cannabis, a herb whose growth, production, sale, acquisition has been illegal save for prescribed medical services, is set to become readily available to consumers.

Cannabis-growth operators are confident they are able to spin the demand into amply-provided products to satisfy the drive by consumers to have their fix and smoke it too. And then, the stunning
news out of a report commissioned by Health Canada predicting that demand will outstrip supply in the first year of legalization. This, at a time when producers have been slavering to get their product to market, ramping up production with the happy visions of dollar signs twinkling in their bedazzled eyes.

With the use of a 2017 federal survey on cannabis use to enable the study's estimation of the numbers of Canadians and their appetite for readily-acquired, legal weed will be in the initial year of legalization, the calculation of 926,000 kilograms was arrived at inclusive of recreational and medical cannabis use; 41 percent higher than the Parliamentary Budget Officer's estimate in 2016 of 655,000 kilograms. The outlook, should the new number accurately reflect demand, augurs shortages from October 17 forward.

To industry experts this will not come as shocking new news, since they have predicted Canadian cannabis growers would be unable to produce sufficient product from the outcome, until the situation stabilizes and producers prove themselves equal to the difficult task of putting their production skills to the test, enabling them to satisfy demand and in the process build their singularly successful pot-production empires.

"We all know there is not going to be enough product on Day One, not nearly enough", pronounced Greg McLeish, a financial analyst who specializes in cannabis, with Mackie Research Capital Corp. His prediction is that it won't be until 2020 that supply will finally match demand. Even now, provinces preparing for an unprecedented demand in reflection of a product that was illegal until October 17, have updated their orders from 10,000 kilograms to 17,000 kilograms.

The issue, of course, is to be able to adequately stock legal stores and at the same time determine anticipated tax revenue collected from cannabis sales. Spinoffs such as job creation, and regulatory services to come out of the entire experience all require attention, from licensing to public education and policing related to matters such as driving infractions. If it all seems somewhat 'on the fly', that's because it is, despite the long window of preparation, given the many ponderables involved.

The study, commissioned by Health Canada had a price tag of $90,000 reflecting the combined research of Marijuana Policy Group located in Denver, and BOTEC Analysis research firm also in the U.S.There is uncertainty over how many pot users will simply continue supplying themselves from familiar illicit sources, from known dealers, dispensaries and friends. The anticipated shift to the legal market will rely upon competitive pricing and convenience, the variety of products and whether illegal dispensaries will successfully be shuttered by the law.

According to an estimate from a CIBC World Markets report, cannabis growers currently produce roughly 350,000 kilograms annually even while the large grow operations are expanding at a frantic pace and new companies vie for licences. Billions in investments are announced along with plans by ambitious companies to become leaders in the field. "Construction and production promises in this industry are a dime a dozen", the report by CIBC published in May, noted.