Thursday, March 7, 2013

Speaking out against the abuse of alcohol in Canada

Giesbrecht says the lack of attention to the problem of alcohol runs contrary to statistics: Alcohol accounted for 8 per cent of all deaths (under 70 years old) and 7 per cent of all hospital stays in 2002, and between 1996 and 2010, total consumption increased by 13 per cent.
He estimates this translates to a burden of $14.6 billion on health care and law enforcement services, when coupled with costs associated with a loss of productivity in the workforce. (from
"Alcohol one of Canada’s top health threats: Study" by Alex Consiglio, Toronto Star, March 6, 2013, below)
And the statistics tell only a small segment of the problem.
Secret or closet drinking literally ruins relationships, families and workplaces as well as costing millions of dollars in lost or reduced productivity.
And so much alcohol consumption is engaged in by people whose capacity to keep their secret is legendary and epic; they deploy multiple strategies and tactics for concealment: including refilling bottles they have partially emptied in the middle of the night with water so their families will not 'catch on', deploying every breath-cleanser on the market, denying their addiction, along with becoming extremely resistant, even sometimes violent, when confronted by family members and professionals.
Many medicate their depressions, anxieties, loneliness, grief, guilt, failures, tragedies and losses of all varieties, with their favourite easily-accessible pain-killer in a fancy, even elegant glass. And they do it without having to "get permission" from their medical practitioner, since there is no need for a prescription for an LCBO purchase.
The research evidence now points fairly conclusively to a human illness, characterized by a biological insatiability for the ingredients found in alcholic beverages. Whether that illness will eventually be found to be linked to some DNA evidence which has so far not become clear is still mute.
However, dependencies, including profoundly deep dependencies, abound in all professions, in all communities, in all kinds of families with all kinds of economic, social, cultural and faith backgrounds.
A few years back, I learned from a recently minted dentist, that alcohol abuse was prevalent in his new profession. His explanation, "Everyday, with every patient, I have to deal with pain management; I wish I had studied optometry instead of dentisty!"
And while those working with or living with others dependent on alcohol for their very survival very much want to "help" by hiding their booze, or by asking them to stop drinking, or by giving them the "silent treatment" as a form of passive aggressive resistance....there is literally nothing that others can do except look after themselves, and the other members of the alcoholic's circle, without assuming responsibility for the alcoholic's dependence. And that kind of "boundary" setting is often extremely difficult.
Some of you may have seen the Betty Ford movie, documenting the former First Lady's dependence on both prescription drugs and alcohol, in which all family members, plus professionals, confronted Mrs. Ford about the impact on their lives of her dependencies. She was furious, denied their "charges" at first, and only later did she enter treatment, and subsequently established the Betty Ford Centre for the treatment of other people who are also dependent on alcohol and/or drugs.
Yet, while the treatment centres are active, rigourous and disciplined, because they know the serious problem that accompanies alcohol addiction, the public dialogue about the subject is virtually non-existent, even, sometimes, frivolous, comedic and trivial.
So there is an public ambivalence about the issue. On the one hand, we know someone whose family or workplace has been impacted negatively by alcohol dependence. And with those colleagues we empathize. On the other hand, we also know that public "distaste", discomfort and disdain of the problem appears as "holier than thou" and counter-intuitive to resolving the dependence. Consequently, most people merely walk in a wide path around both the dependent person and the problem.
We all also know someone, or perhaps more than one, whose dependence is funded by public funds, because they receive a social welfare cheque on a regular basis, and spend a good portion of that cheque feeding their dependence. And, for some, that is another negative aspect of the issue.
There is a phrase in the report to the effect that "alcohol is the new tobacco" in that we now have calculated how many dollars the dependence on alcohol costs the Canadian treasury, including law enforcement, health care and lost productivity.
One of the main differences, however, between tobacco and alcohol, is the nature of the impact on others. With tobacco, we can demonstrate that secondhand smoke is linked to the physical illness of others. With alcohol, we can demonstrate that dependence distorts the ethos, the trust and the security of the situation, all of which can and does negatively impact the emotional and psychological lives of others, without directly impacting the physical health of the other. Consequently, there will be a steeper hill to climb to bring the "elephant in the room" (the person who is dependent on alcohol) to sobriety.
And none of us can be another's sobriety!
And the many attempts by too many of us, including the writer, to serve as another's sobriety, only grew profound resentment, alienation and contempt on both sides, as the refuse of the attempts. I have been in a relationship with an alcoholic, and in a different relationship with the spouse of an alcoholic, in both cases thinking or believing that somehow I was providing some support, and some comfort and some positive impact on the lives of those individuals, only to learn, very painfully, that my efforts were nothing short of hollow attempts at the heroic. Not only did I fail the other parties in those relationships, more importantly, I failed myself, in somehow permitting their issues to become my issues, blurring the boundaries that would have been more helpful to both parties, and others in the immediate circles.
Relationships are not and cannot be substitutes for treatment. Relationships are not and cannot be "used" to replace professional treatment, where the professional and the client are clearly separated, clinically, objectively and professionally.
And there are legions of failed attempts to disprove that observation, tragically.
I am deeply sorry for the failed attempts I have made to "alleviate" pain when, in fact only the person addicted if and when they become ready and willing, can take effective action to reduce the dependence, and from most theorists and practitioners, the dependence can only be reduced, but never eliminated.
We hear others say, "I am a recovering alcoholic" but never do we hear, "I am a recovered alcoholic"...because once dependent, one is forever potentially dependent.
I have also worked in industrial situations, attempting to forge "leadership teams" only to learn, in one case, that two of the five members of the "team" were active alcoholics, and when I brought that truth to the CEO, I was summarily ushered off the property, for "finding only the negative" in people, while he sat in his large office reading some Mormon guru on positive traits of leadership.
I have had supervisors whose dependence on alcohol impeded their effectiveness, without anyone being able to penetrate their world, until finally, after some very rough intervention(s) they finally agreed to treatment.
I have ridden in cars whose trunks were literally crammed with booze, as the driver/owner could not wait to return home to begin the process of emptying all those bottles, in the privacy of his home, without the public being even vaguely aware of his dependence. I have attempted to chair meetings in which, because of my strong and public opposition to alcohol dependence, some participants entered the room wreeking of the smell of booze, in their unsubtle attempt to snub their noses at my "intolerance" of booze and to demonstrate their contempt for my apparent "self-righteousness."
I have also picked up parishioners who were too drunk to walk from their car into a church service, helped them inside, and later visited them in their home, with witnesses, to urge them to seek treatment.
This problem, while it is being reviewed from a national budget perspective, has plagued too many chapters in the lives of too many people for far too long.
The public debate about how to deal effectively with "demon rum" is long overdue.
And if that sounds, to some, holier than thou, and self-righteous in the extreme, then so be it.
Putting a drunken roomate to bed, because he was too drunk even to know where he was, while living in a fraternity, and was sick all over the room, is a scene unable to be erased from my memory. His eventually rise to corporate prominence will never erase my impression of that experience.
Perhaps, there are still overtones playing out in my life, of my maternal grandmother, deceased prior to my birth, who harrangued a convention in a church in central Ontario in the thirties, against the 'demon run' and if that is true, I can neither erase her memories, nor my own, nor can or will I apologize for either of us. If our methods have been misguided, our motives have not been!

Alcohol one of Canada’s top health threats: Study
The Centre for Addiction and Mental Health published a new report Wednesday which marks alcohol as one of the greatest public health threats in Canada

 By Alex Consiglio, Toronto Star, March 6, 2013  
It’s a sobering nation-wide report with a stark conclusion: Alcohol is one of the greatest public health threats in Canada. And the provinces are not doing enough to curb its deadly potential.

The report, Strategies to Reduce Alcohol-Related Harms and Costs in Canada: A Comparison of Provincial Policies, was published Wednesday by the Centre for Addiction and Mental Health.
Lead author Norman Giesbrecht, a senior scientist at CAMH, said it is mind-boggling how lax harm-reduction policies are across the country.
Giesbrecht’s report, which notes 80 per cent of Canadians drink, ranks provinces on 10 key harm-reduction policies, including pricing, availability, marketing, legal drinking age and warning labels.
Ontario came first, Quebec ranked last, and Giesbrecht was disappointed with each province’s score — Ontario’s first-place ranking only reached 56 per cent of a perfect score.
“There’s lots of room for improvement,” he said. “Alcohol does not get a lot of attention in regards to prevention.
“We have a very high rate of alcohol problems,” said Giesbrecht. “We have to give it more attention if we want to reduce the harm.”
Journalist and public speaker Ann Dowsett Johnston would agree. An advocate for harm-reduction policies and author of the 11-part 2011 Atkinson series on women and alcohol, published in the Star, Johnson says alcohol has become the new tobacco.
“Alcohol is much more related to disease than we realized in the past,” she said. “We’re seeing an unprecedented growth in harm related to alcohol abuse.”
Johnston, whose book Drink: The Secret World of Women and Alcohol is being published in September, said she hopes Giesbrecht’s report sparks a “national dialogue” on the issue, making the public aware of alcohol’s deadly potential.
She thinks another of the report’s recommendations, that advertising be scaled back, is a no-brainier, especially in Ontario.
The report notes seven of 10 provinces meet only 50 per cent of their full potential on advertising policy, and suggests a simple solution: Shift the “focus of provincial liquor board websites away from product promotion” and towards a “health focused” message.
“The LCBO has a monopoly on alcohol, so why do they need to advertise?” asks Johnston. “It’s alarming.”
Giesbrecht says the lack of attention to the problem of alcohol runs contrary to statistics: Alcohol accounted for 8 per cent of all deaths (under 70 years old) and 7 per cent of all hospital stays in 2002, and between 1996 and 2010, total consumption increased by 13 per cent.
He estimates this translates to a burden of $14.6 billion on health care and law enforcement services, when coupled with costs associated with a loss of productivity in the workforce.
“The provinces need to put some effort into a strategy,” he said. “A strategy is not a magic bullet, but it’s a way of organizing a response to a public health issue.”
The report recommends all provinces set minimum prices to discourage excessive consumption and price alcohol by its strength. It also urges provinces to index prices in line with inflation.
It warns not to move toward privatization, which would only make alcohol more accessible, and suggests limits should be made for the density of outlets based on population to curb accessibility.
Currently, “no provinces, aside from Saskatchewan, have limits on population density that are set through provincial legislation/regulation,” the report notes.
It also proposes health warnings accompany alcohol sales, both on packages, like the shocking images that appear on cigarette packs, and at the point of sale. Bumping the minimum drinking age to 21 would also help, it says.
A separate CAMH study published in the journal Addiction this month says “Canadians drink more than 50 per cent above the global average.”
Kevin Shield, lead author of the Addiction study, said in a press release that “alcohol consumption has been found to cause more than 200 different diseases and injuries.”
“These include not only well-known outcomes of drinking such as liver cirrhosis or traffic accidents, but also several types of cancer, such as female breast cancer,” said Shield.
The epidemic rise in female drinking is the topic of the first roundtable discussion featuring top alcohol experts who are meeting March 8 — International Women’s Day — at One Yonge St. in Toronto.
Co-chaired by Anne Rochon Ford, executive director of the Canadian Women’s Health Network and Atkinson Fellow Ann Dowsett Johnson, the speakers and panelists will include top alcohol experts who will be looking at the wide range of factors affecting the steep rise in alcohol consumption by girls and women, including marketing and pricing. This will be the first in an annual roundtable which will recommend strategies going forward. Sponsors include the Atkinson Foundation, the Canadian Women’s Health Network, the Canadian Centre on Substance Abuse and the Norlien Foundation, with support from Health Canada.
— With files by Valerie Hauch

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