By Kyley Alderson, HC Link - Parent Action on Drugs
Last week, I was fortunate enough to attend the forum An Alcohol Strategy for Ontario: Promoting Public Health and Community Safety put on by the Working Group for Responsible Alcohol Retailing. The purpose of the forum was to bring together a variety of stakeholders to raise public awareness about the potential social and health impacts from expanding access to alcohol (i.e. alcohol being sold in grocery stores) and build political will to adopt an evidence-informed provincial alcohol control strategy that prioritizes community safety.
The forum certainly did bring together a variety of stakeholders – and while everyone there could agree on wanting safe communities, there was definitely some interesting conversations that were had.
The honourable Dipika Damerla, Associate Minister of Health and Long-Term Care discussed how Ontario has expanded beer sales to an additional 450 locations across the province to give Ontarians more convenience and choice while still maintaining a strong commitment to social responsibility through strict controls over how the beer is sold in these new locations (i.e. restricted hours, designated section of the store, certified and trained staff). During a Q&A period, concerns were raised about how the evidence has shown us that increased access to alcohol results in higher alcohol consumption and higher harms associated with alcohol use. Concerns around enforcement were also raised, as there are very few AGCO Inspectors assigned to large geographic areas. Damerla assured participants that the government wants to get an alcohol policy right for Ontario, and that the strategy will be robust and will require a cross-government approach.
Ann Dowsett Johnston, author of Drink: The Intimate Relationship Between Women and Alcohol shared why the alcohol file is so urgent. She spoke about how despite all the known harms associated with risky drinking, it is still a conversation that no one wants to have because alcohol is entrenched in our culture. We drink to relax, we drink to celebrate, we drink to de-stress, we drink to impress (i.e. if you know your vodkas you’re hip). She was passionate about her concern for how normalized drinking is in our society, and how it is slowing down progress for a successful alcohol control strategy.
Dr. Tim Stockwell, Director of the Centre for Addiction Research of British Columbia, tackled the myth that low-risk drinking can have actual health benefits (i.e. a glass of wine a day is good for your heart). Stockwell also touched upon the dimensions of a successful alcohol policy, including: price, control system, physical availability, drinking and driving, marketing and advertisement, legal drinking age, and screening and brief intervention. Increasing the minimum price of alcohol has been shown to have the greatest impact in reducing risky alcohol consumption and its associated harms.
Dr. Tim Stockwell (Centre for Addiction Research of British Columbia)
Pegeen Walsh (Ontario Public Health Association)
Dr. Robert Mann, shared trends in alcohol use and problems among adolescents. In Ontario, the most stunning statistic was the decreased rate of drinking and driving among grade 11 drivers (from 46% in 1977 to 3% in 2015). Since 1977, the three major drops in drinking and driving are seen when: the legal age for drinking was increased, when graduated licensing was established (where a blood alcohol level of zero is the law), and when a blood alcohol level of zero was required in all drivers under 22. While there are many programs and initiatives working towards reducing drinking and driving (and working well!), this data does show the profound effects that policies can have. While Ontario has always been the best performing province in motor vehicle fatalities involving alcohol (meaning the lowest numbers), the new data shows that Ontario has the highest rates for drug-present fatalities. There was discussion around how a zero tolerance for drugs policy for drivers under 22 years of age needs to occur.
Dr. Lisa Simon, Associate Medical Officer of Health, spoke about equity as it relates to alcohol consumption and associated harms. While those with the highest income level report the highest alcohol consumption, those with the lowest income have 2x the harms (alcohol-attributed hospitalizations). Furthermore, low income areas tend to receive disproportionate amounts of alcohol outlets. Perhaps not surprisingly, policies that increase the minimum price for standard drinks have been shown to have the most positive impact on those with a lower socio-economic status.
One participant from the audience asked the question to a few of the presenters, what ONE POLICY should be reflected in an alcohol strategy, the answers were:
SES should be considered when siting alcohol outlets
A minimum price for standard drinks should be set at $1.65
Guidelines for low-risk drinking should be on all drinks
Reduced availability of alcohol outlets
Brenda Stankiewicz, Public Health Nurse at the Sudbury & District Health Unit spoke about 3 specific challenges in the North regarding alcohol:
Much higher percentage of underage youth reporting parental permission to drink (42% vs 26% in the rest of Ontario)
Transportation issues. With limited or no public transit or taxis available – there are far fewer options for getting home safely after drinking... causing more drinking and driving.
Very limited enforcement. There is the prevailing attitude that if you drive home on dirt roads or long stretches of deserted highways, you will not get caught. Also, because everyone tends to know each other – there is the attitude that no one will report them. Furthermore, there is only 1 AGCO in all of Sudbury, which means – enforcing and monitoring even more alcohol outlets will be even more challenging.
There were many other great attendees who presented, asked thoughtful questions, and engaged in stimulating dialogue. All in all it was a worthwhile forum, and hopefully a stepping stone in the direction of developing an alcohol control strategy for Ontario.
Although the discussion of the forum was focused on a provincial strategy, the role for local players was highlighted. To support your efforts CAMH HPRC is offering free promotional materials to public health and health promotion professionals in Ontario who are interested in supporting low risk drinking: https://www.porticonetwork.ca/web/camh-hprc/resources/substance-use. You can also check out the Parent Action on Drugs website for information and resources on issues that impact substance use and youth geared towards youth, parents, and professionals.