Most of us are willing to accept some level of risk in our day-to-day lives. We delve into a bucket of fries or get behind the wheel of a car despite the health or safety risks associated with these behaviors, as they bring us joy, and ease, and are a part of the fabric of daily life. And like almost anything in life, consuming substances, such as alcohol and drugs, comes with a level of risk.
The Canadian Centre on Substance Use and Addiction (CCSA) recently released new guidelines for alcohol consumption that outline amounts of alcohol that increase your risk for social and health consequences.
A unit refers to 5 ounces of wine, a bottle of beer (5%), or 1.5 ounces of hard liquor. These guidelines apply to both biologically female-born and male-born people. It is recommended that you do not consume any alcohol if you are pregnant or breastfeeding. The Canadian guidelines have not been updated since 2012, and these new recommendations reflect the most up-to-date science. As a psychologist, the Clinical Director of a substance use program, and a person who likes wine, these new guidelines can be difficult to ingest.
From a health perspective, no amount of alcohol is without risk. Alcohol is a known level 1 carcinogen (meaning it’s as deadly as tobacco and asbestos) linked to 7 different types of cancers, including breast and bowel cancer. Risks are particularly elevated for women who have a physiological makeup that renders alcohol more toxic. Alcohol is linked to heart disease, including coronary artery disease and heart attacks, heart failure, high blood pressure, atrial fibrillation, and strokes. These guidelines focus on severe health consequences but do not delve into other health effects such as what alcohol does to your skin, gut microbiome, sleep quality, body mass index, cell repair capability, stress response, or mental health.
The truth is most medical professionals such as oncologists and cardiologists will tell you this is old news. It is accepted that people tolerate a certain level of risk to enjoy life. The problem is that previous research told us that alcohol in moderation was good for us. Turns out that the research was flawed. It included former drinkers (aka people who had problems and quit) in the “non-drinkers” category, where many of these people would have already experienced negative health consequences. This error made it look like drinking a bit was less harmful than not drinking. Another myth commonly circulated was that resveratrol (an antioxidant in red wine) is good for health without the indication that you would have to be drinking toxic amounts of alcohol to get any significant benefit. It is much better to get your antioxidants from food. And what about the Mediterranean diet that includes wine as a protective factor? In North America, we like to parse out pieces of a Mediterranean lifestyle to suit our needs. The beneficial aspect of this lifestyle is likely moderation, where alcohol is consumed in small amounts with a meal, not binged on a Friday night.
You’re probably familiar with the concept of harm reduction when it comes to food intake, even if you don’t call it by that term. When you choose treats that have less sugar or fat, you are engaging in a harm-reduction strategy. When you decide to forgo a second helping of dinner, that is harm reduction. Harm reduction is any strategy that reduces the negative consequences of a behavior.
Ultimately that is up to you. I have heard feedback from my friends speculating that this new research is just the flavor of the day, like avocados or skinny jeans. Rest assured, this research is solid, based on global evidence from previous reports, mathematical modeling, and a comprehensive review of the current literature. For me, it means a growing awareness that my alcohol consumption could be harming my health, making an informed choice about engaging in a behavior that I enjoy and choosing a harm-reduction approach to risk. This means being more mindful about when I choose to drink and shifting my behavior most weeks to stay within recommended limits. Sadly, this means I can no longer believe that wine is making me healthier or ignore the fact that it is harmful. The most important information this report gives us is the option of informed choice. Like anything in life, I have the sticky conundrum of deciding between the risk and reward that comes from everyday decisions, but at least now I have the information to make that choice wisely.
Terri-Lynn Mackay, Ph.D., R. Psych. is the Clinical Director of ALAViDA: A LifeSpeak Company, a virtual health solution for substance use disorders. She is a clinical psychologist with expertise in providing strategic direction, clinical leadership, and system transformation in mental health and addiction. Dr. MacKay is the Provincial Director of Innovation and partnerships for the Canadian Mental Health Association (Manitoba) and serves as an advisor with The Decision Lab. Previously, Dr. Mackay served as the Director of Operations for the Canadian mental health pandemic response, Associate Director of Counselling Services at the University of British Columbia, and Associate Professor at the University of Nevada, Las Vegas.
She has been a consultant for government and private industry for over a decade with a focus on providing social justice approaches to transformational system change.
Dr. Mackay holds a Ph.D. in Clinical Psychology and a Master’s degree in Behavioural Neuroscience. Her research has been featured in journals such as Canadian Psychology, Neuropsychologia, Computers in Human Behavior and International Gambling Studies.