www.ccsa.ca • www.cclt.ca
Canada’s Low-Risk Alcohol
Drinking Guidelines
Presented by
Name of Presenter(s) and Organization(s)
On behalf of the
National Alcohol Strategy Advisory Committee
Event, Month ##, Year
National Alcohol Strategy
• Developed through consensus by the
National Alcohol Strategy (NAS)
Working Group, including 25
representatives from federal,
provincial and territorial governments,
non-governmental organizations,
researchers and alcohol industry
• The 41 NAS recommendations
collectively impact policies and
behaviour to address alcohol harms
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Implementing the NAS
National Alcohol Strategy Advisory Committee (NASAC)
• 25 multi-sector experts lead the implementation, monitoring and
evaluation of the NAS recommendations, including those dealing
with:
– Low-Risk Alcohol Drinking Guidelines (LRDGs); screening, brief
intervention and referral; standard drink labels; price policies;
and municipal alcohol policies
• Co-chaired by the Nova Scotia Department of Health and Wellness,
Mothers Against Drunk Driving Canada and CCSA
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Why LRDGs?
These national guidelines were developed:
• To provide consistent advice to all Canadians to reduce longand short-term health risks
• To increase awareness of safer drinking levels and to educate
about standard drink sizes
• To reflect the latest scientific literature that identifies both
significant risks and some possible benefits from low levels of
alcohol consumption
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History of LRDGs in Canada
Source
Limits for Men
Limits for Women
aLPHa, CAMH, OPHA
(1997)
2 per day
14 per week
2 per day
9 per week
CARBC
(2007)
4 on single day
20 per week
3 on single day
10 per week
CFPC
(1994)
4 per day
12 per week
3 per day
12 per week
Educ’alcool
(2007)
5 on single occasion
14 per week
4 on single occasion
9 per week
LRDGs (2011)
3 per day
15 per week
2 per day
10 per week
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Evidence-informed Guidance: Expert Advisors
Expert Advisory Panel
• Chaired by Dr. Peter Butt, College of Family Physicians of Canada
• Researchers from each Canadian organization that previously
issued low-risk drinking guidelines: CCSA, Centre on Addiction and
Mental Health (CAMH), Centre for Addictions Research of BC
(CARBC), College of Family Physicians of Canada (CFPC) and
Educ’alcool
Peer Review: International experts and NASAC members
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Evidence-informed Guidance: Literature Review
• Search conducted on multiple bibliographic databases for:
•
•
•
– Systematic reviews and meta-analyses on impact of alcohol
on disease and injury (17 found)
– Emergency department research examined for short-term or
“acute” risk of injury after drinking within previous 6-hour
period
Critical appraisal of reviews and single studies
Relative risk preferred to absolute risk
All-cause mortality studies used to find balance point between
risks and benefits
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Criteria for “Low Risk” Drinking
• The complexity of risk and presence of health benefits
complicate the analysis of risk
• The national LRDGs identify daily limits based on the point
where the risk of dying prematurely because of alcohol-related
causes is equal to that of lifetime abstainers
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If Everyone Followed the LRDGs …
If everyone in Canada followed the LRDGs and light
drinkers did not increase consumption, then it is estimated
that:
• Alcohol consumption would decrease by approximately
50%
• Alcohol-related deaths would decrease by
approximately 4,600 per year
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LRDG Brochure
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LRDG Brochure
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Why Do Limits Differ for Men and Women?
• Because of biological and other reasons, women's risk of
many types of alcohol related harm are higher than men's
for any given level of consumption
• For example, at even one drink per day on average, a
woman's risk of getting liver cirrhosis increases by 139
percent as compared with 26 percent for males
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Risk of Premature Death (males)
Rehm, Kehoe, Taylor, & Patra (2009). Evidence base for the development of Canadian Drinking Guidelines.
Rehm et al. 2003, 2006 and 2010.
13
Risk of Premature Death (females)
Rehm, Kehoe, Taylor, & Patra (2009). Evidence base for the development of Canadian Drinking Guidelines.
Rehm et al. 2003, 2006 and 2010.
14
A Drink Is …
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Your Limits
Reduce your long-term health risks by drinking no more than:
– Women
• 10 drinks a week
• 2 drinks a day most days
– Men
• 15 drinks a week
• 3 drinks a day most days
Plan non-drinking days every week to avoid developing a habit
These are limits NOT targets!
If you’re not drinking this much now, don’t increase
Context is critical
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Special Occasions
Reduce your risk of injury and harm by drinking, on any single
occasion, no more than:
– Women
• 3 drinks
– Men
• 4 drinks
Plan to drink in a safe environment. Stay within the weekly limits
outlined in Your Limits.
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Consequences of Chronic Heavy Drinking
Percentage change in long-term relative risk by average standard
units per day, males and females less than 70 years of age
850
750
650
Oral cancer (1:200)
550
Rectum cancer (1:200)
450
Liver cancer (1:200)
350
Larynx cancer (1:500)
250
Ischemic heart disease (1:13)
150
Epilepsy (1:1000)
Pancreatitis (1:750)
50
Low birth weight (1:1000)
-50
one
two
three - four
five - six
Standard units of alcohol (17.05 mL of ethanol)
six +
Source: Butt, P., Beirness, D., Gliksman, L., Paradis, C., & Stockwell, T. (2010). Alcohol and health in Canada: A
summary of evidence and guidelines for low-risk drinking. Ottawa: Canadian Centre on Substance Abuse.
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When Zero’s the Limit
Do not drink when you are:
•
•
•
•
•
•
•
•
Driving a vehicle or using machinery and tools
Taking medicine or other drugs that interact with alcohol
Doing any kind of dangerous physical activity
Living with mental or physical health problems
Living with alcohol dependence
Pregnant or planning to be pregnant
Responsible for the safety of others
Making important decisions
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Pregnant? Zero is Safest
If you are pregnant, planning to become pregnant, or about
to breastfeed, the safest choice is to drink no alcohol at all
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Delay Your Drinking
• Alcohol can harm the way the brain and body develop
• Teens should speak with their parents about drinking
•
 If they choose to drink, they should do so under parental
guidance; never more than 1-2 drinks at a time and never
more than 1-2 times per week
Teens should plan ahead, follow local alcohol laws and
consider the Safer Drinking Tips
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Daily Guidelines for Young Adults
Daily guidelines for young adults are lower than for adults
• Risky drinking peaks in young adults with approximately 50% of
drinkers consuming above the upper daily limit of the LRDG (i.e.,
more than four drinks per occasion for men and more than 3 for
women) monthly or more often in the past year
• The new guidelines recommend that young adult males never
exceed 3 drinks on a single occasion and women never exceed 2
drinks up to age 24
• This lower threshold reflects growing evidence of the detrimental
effects of risky alcohol use on the developing brains of young
adults
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Safer Drinking Tips
•
•
•
•
•
•
Set limits for yourself and stick to them
Drink slowly, no more than 2 drinks in any 3 hours
For every drink of alcohol, have one non-alcoholic drink
Eat before and while you are drinking
Always consider your age, body weight and health
problems that might suggest lower limits
While drinking may provide health benefits for certain
groups of people, do not start to drink or increase your
drinking for health benefits
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Official Supporters
•
•
•
•
•
•
•
•
•
•
•
•
Association of Canadian Distillers
Association of Local Public Health
Agencies
Brewers Association of Canada
BC Council of Substance Abuse
BC Ministry of Health
Canadian Association of Chiefs of Police
Canadian Centre on Substance Abuse
Canadian Medical Association
Canadian Paediatric Society
Canadian Public Health Association
Canadian Society of Addictions Medicine
Canadian Vintners Association
•
•
•
•
•
•
•
•
•
Centre for Addiction Research of British
Columbia
Centre for Addiction and Mental Health
College of Family Physicians of Canada
Council of Chief Medical Officers of
Health
Educ’alcool
MADD Canada
Nova Scotia Department of Health and
Wellness
Public Health Physicians of Canada
Society of Obstetricians and
Gynaecologists of Canada
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Resources to Promote LRDGs
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Resources (cont.)
A new alcohol Screening, Brief Intervention and Referral (SBIR)
web resource was developed based on the Low-Risk Alcohol
Drinking Guidelines:
• Developed by CCSA and expert advisory committee
• Offers a simple, three-step process to family physicians and
healthcare professionals for detecting and addressing
problematic alcohol consumption
• CCSA transferred ownership of SBIR to College of Family
Physicians of Canada in November 2012
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The SBIR Website
www.sbir-diba.ca
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Questions for Participants
• Are you actively promoting the Guidelines?
• Do you have plans to promote the Guidelines?
• Do you need support?
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Contact Information
For further information on the National Alcohol Strategy, including
the LRDGs, please contact:
Canadian Centre on Substance Abuse
75 Albert Street, Suite 500
Ottawa, ON K1P 5E7
613-235-4048
alcohol@ccsa.ca
Twitter: @CCSAcanada
www.ccsa.ca
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