Does Canada have a drinking problem? Some of the country's medical specialists think so.
Based on per capita consumption, Canada ranks among the top 50 drinking nations, consuming slightly less than the U.S. but twice as much as Cuba.
Uganda ranks No.1, with an average of almost 20 litres (measured in pure alcohol) per person per year. Canadians drink an average of more than eight litres annually.
Broken down by provinces and territories, people in the Yukon spend the most on alcohol, and Manitobans spend the least.
Sales of beer and spirits have grown slowly over the past few years, but total sales of wine have sky rocketed over the same period.
But the numbers don't reveal the effects of all that alcohol.
It's impossible to measure some of the social benefits of drinking, but the harm it causes is obvious.
Researchers, physicians and social workers say alcohol is responsible for much more health and social damage than any other substance or drug in Canada.
Although there is some evidence that alcohol can be good for your health, a recent report by Ontario's Centre for Addiction and Mental Health (CAMH) concludes that "the net health consequences are overwhelmingly detrimental."
Some Canadians are damaged by exposure to alcohol before birth.
It's estimated that one in 100 babies in Canada are born with fetal alcohol syndrome disorder (FASD), which can cause severe mental deficiencies.
That's why some people, like Newfoundland and Labrador's Dr. Ted Rosales, a pediatric geneticist who specializes in FASD, say more must be done to keep women from drinking when they're pregnant or planning to become pregnant.
He's calling for more education and warning labels on alcohol containers with the message that alcohol and pregnancy don't mix.
Alcohol classified as carcinogen
Drinking also has a powerful effect on the overall health of Canadians.
The health costs of long-term, heavy drinking are high.
Since 2001, the U.S. Department of Health and Human Services has included alcohol on its list of carcinogens.
It's known to cause liver damage, cancer, ulcers and reproductive problems. Heavy drinkers are also at risk for coronary heart disease, high blood pressure and stroke.
A recent report published by CAMH estimates that more than six per cent of all deaths among Canadians under the age of 70 are due to alcohol.
It also estimates that alcohol consumption is responsible for more than 8,000 deaths every year in Canada.
The health effects of light, regular drinking are less clear.
Decades of research have shown that it can protect some people from cardiovascular disease, but many studies suggest it also elevates the risk of breast cancer as much as 40 per cent. Recent research suggests that even light drinking reduces brain volume and leads to memory problems.
Dr. Arthur Klatsky is a researcher with Kaiser Permanente in Oakland, Calif. He's the author of some of the first studies that suggested alcohol protects the cardiovascular system. Last year, he published research that found regular drinking increases a woman's risk of breast cancer.
Klatsky says there's no simple answer about whether people should drink or not but he gives general advice to two broad groups.
"Young people don't get heart attacks, and by and large, young people shouldn't drink for health reasons, and that's particularly true for women because they're at risk for breast cancer, " he says.
Middle-aged, light drinkers are the people most likely to get cardiovascular benefits from drinking, says Klatsky.
Klatsky says he wouldn't tell anyone to take up drinking to improve their health. He says there are many better ways to improve your cardiovascular health, such as eating healthy food and exercising regularly.