Knowledge is power, right? Yet new guidelines from the Canadian Centre on Substance Use and Addiction (CCSA) have sparked debate among many Canadians.
According to the guidelines, no amount of alcohol is totally safe to consume — and even what’s generally considered low-risk drinking comes with health risks. The new advice replaces a starkly different guideline from 2011, which considered 10 alcoholic drinks per week for women and 15 per week for men to be low risk.
Now, the CCSA says consuming more than two drinks per week, for anyone, increases the risk of developing some cancers, with added risk of heart disease or stroke at more than seven drinks per week.
Indeed, the CCSA notes in its report, many people are unaware alcohol is a group 1 carcinogen, having been identified as such by the International Agency for Research on Cancer (IARC) back in 1988, joining the ranks of tobacco and asbestos.
Alcohol is also linked to cancers such as liver, breast and esophageal, and a study published in The Lancet Oncology found 4.1 per cent of new global cancer cases in 2020 were linked to alcohol.
The CCSA’s revision came after considering many new sources, examining evaluations from several countries, conducting literature reviews and public consultations.
So, how does the health-conscious drinker adjust? Especially when 40 per cent of people living in Canada aged 15 and older consume more than six standard drinks per week, according to the report.
With the new guidelines warning that even two drinks a week comes with risks, how are we to successfully make, in some cases, drastic behaviour changes?
UCalgary harm reduction support adviser Yasmeen Nosshi and Dr. Victoria Burns, PhD, an associate professor in the Faculty of Social Work, offer this advice.
1. Understand the risks
Burns and Nosshi say people need to be informed about why the change is warranted in the first place.
“Many people don’t realize the harms of alcohol — it's an inherently addictive drug. We can’t make decisions about it without proper informed consent,” says Burns.
Although the updated guidelines are a big shift, “at least now we can more strongly identify with the health risks involved,” says Nosshi, an adviser with Student Wellness Services.
“The more you increase your consumption, your risk of injury increases as well.”
Nosshi says the guidelines will help guide policy, adding she hopes this includes warning labels being added to alcohol, something that was attempted in the Yukon in 2017.
“Cigarettes and cannabis have warning labels. They aren’t rules, and people will do what they want to do, but they should be informed,” she says.
“Even if the new guidelines are just making you think about your consumption, that is harm reduction. It’s planting seeds. People have the right to know about what they’re consuming.”
2. Know your consumption habits
According to the guide, one of the reasons for the update was because people were under-reporting how much they drank in previously cited studies.
“Many people don’t realize what constitutes a standard drink,” says Burns. According to the CCSA, a standard drink in Canada is:
- a 12-ounce (341 ml) bottle of five per cent alcohol beer or cider
- a five-ounce (142 ml) glass of 12 per cent alcohol wine
- a 1.5-ounce (43 ml) shot glass of 40 per cent alcohol spirits
For those that might want to track their use over a week or month, Nosshi suggests recording into a journal or app. This sort of self-reflection not only helps you track usage, it may also help you identify events affecting your drinking, as well as situations that may trigger drinking.
This doesn’t mean everyone has to suddenly go cold turkey. Nosshi and Burns stress the importance of starting small. Says Nosshi:
Any reduction is good. Even one drink less a night, one less a week. There are benefits there.
3. Explore the why
Burns suggests examining your relationship with alcohol. “Ask yourself why you drink, do you think you need it to relax, socialize, have fun?” she says.
“Also ask if alcohol is still serving you the same way it has in the past? Am I drinking more than I want to? Is it affecting my work or relationships? Do I feel discomfort or ‘hangxiety’ the day after drinking? These are all important questions to assess your relationship with alcohol and do some compassionate readjusting.”
For those in-the-moment situations, Nosshi and Burns suggest getting mindful and questioning what basic needs may require addressing instead, using the acronym HALT: Asking yourself if you’re Hungry, Angry, Lonely or Tired.
Understanding the benefits of drinking less may also support behaviour change — whether that be positive health impacts, saving money, sleeping better or feeling better. (A weekend without a hangover or a ’shameover‘ might be reason enough for many.)
“Personalize your motive and write it down,” suggests Burns. “It helps that the motive has some teeth to it that you resonate with.”
4. Find ways of reducing that work for you
When Burns became alcohol-free 10 years ago, she found transitioning from her workdays into the evenings the hardest. “I had to learn how to ease into the evenings, go out to dinner, socialize, basically do any activity without alcohol,” she says.
One of her tips: “Don’t deprive yourself of fun drinks! I have lots of different cans of non-alcoholic beverages to choose from, such as a variety of sparking water, Diet Coke, juices and kombucha. Mix yourself up a mocktail. One of my favourites these days is ginger kombucha with ginger ale, or lime soda water and a wedge of lime.”
Nosshi points to mindful reduction as a way to combat overconsumption: “Have a set amount of money you spend on a night out, avoid shots and drinking games, buy individual amounts of wine rather than a bottle, buy short cans over tall cans. A student once shared that they found pouring beer into a cup helped them sip slower and drink more mindfully.”
For those worried about the social impacts of a habit change so intimately tied to socializing, Burns and Nosshi suggest reflecting on social activities to keep, switch up and even add, to help reduce drinking. These can include adding activities that lessen or avoid drinking like workouts, board games, cultural activities, getting a coffee, going for a walk, going to a movie or theatre performance, picking up a volunteering gig.
New routines can also introduce new friendships, and ones that already centre around not drinking.
“Reducing isn’t going to work for everyone right away, either,” adds Nosshi, who recommends seeking professional support for those who have serious alcohol dependency issues.
In post-secondary environments, it’s estimated that more than 20 per cent of students may experience a substance use disorder. Burns suggests it may be helpful to go over the standardized assessment for alcohol use disorder.
5. Have compassion for yourself and others
For Burns, becoming alcohol-free was the best and hardest decision she made. “It changed my life and my identity completely,” she says, so she empathizes with anyone wanting to make similar changes to their behaviour.
It’s especially hard, Burns says, when dealing with an addictive substance that is essentially a norm — socially acceptable, even encouraged. In workshops Nosshi runs on harm reduction, she notices the same.
“We often talk about how alcohol is the only substance you have to justify not taking,” she says.
For these reasons and more, Nosshi and Burns emphasize the need for compassion for self and others. “It can feel insurmountable,” says Burns. “But setbacks are part of behaviour change.
Don’t be ashamed to reach out for help. A problem shared is a problem cut in half.