There were more hospital admissions in Canada last year for alcohol-related conditions than for heart attacks.
Alcohol poisoning, alcohol withdrawal, liver disease, chronic alcohol abuse and other conditions that are "100 per cent caused by the harmful consumption of alcohol" accounted for about 77,000 admissions, according to a report released Thursday by the Canadian Institute for Health Information (CIHI).
That's 212 each day, on average, not including those who were treated in emergency departments and released.
The 2015–2016 year was the first time CIHI has looked at this statistic, believing that its impact on the health system can provide insight generally into the harms caused by alcohol.
"Our expectation is that this will be an important indicator for monitoring public health," said Geoff Hynes, manager of the Canadian Population Health Initiative for CIHI. "We can look at patterns, which could inform what governments and the health system can do to address these high numbers."
In the absence of any previous data to compare, CIHI related the figure to that of admissions for heart attacks in the same period, which was 75,000.
Leading cause of injury and death
Excessive drinking carries a number of known health risks, including illnesses such as pancreatitis, liver cirrhosis, diabetes and cardiovascular disease — not to mention the risk of death.
In 2015, there were 5,082 alcohol-attributable deaths in Canada, according to a study by the Institute for Health Metrics and Evaluation cited by CIHI.
In fact, the Public Health Agency of Canada says alcohol is a leading cause of injury and death in Canada, including those resulting from impaired driving and from illnesses with known links to alcohol, like certain types of cancer.
Costs to the health care system, to society
Alcohol abuse doesn't harm just the abuser; there are measurable societal costs, too.
For instance, in 2014–2015, the average cost for hospitalization that was entirely caused by alcohol was estimated at $8,100, compared to the average hospital stay for other causes at $5,800. That's mostly because of longer stays (11 days on average compared to seven days, respectively).
Taking into account law enforcement, lost productivity as well as prevention and research initiatives, the estimated total cost of alcohol-related harm in Canada was more than $14 billion in 2002, the most recent year for which this data is available, CIHI said. About $3.3 billion of that was directly related to health care.
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There are also broader social implications, the report said, such as unemployment, crime and the "substantial" impacts on people other than the drinker. These include injuries related to assault, workplace accidents, motor vehicle collisions, family disruption, violence and lost income.
The toll on families, coworkers and communities is impossible to tally because the relationships between consumption and harm are complex, Hynes said. These are influenced by things like individual, cultural and social factors, as well as how government regulates consumption and accessibility.
Provincial, territorial variations
On average, there were more alcohol-related hospitalizations in the territories than in the provinces, and more in the west than in the east, with the exception of Nova Scotia. But regional variations can't be easily explained.
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Generally, where sales of alcohol are higher — measured in volume of litres per capita — there was also a higher prevalence of heavy drinking (five or more drinks for men and four or more drinks for women on one occasion at least once a month over a one-year period). And the rates of hospitalization typically followed: B.C., Alberta, Northwest Territories and Yukon had high rates of all three.
But in Quebec, where rates of sales and heavy drinking were both higher than the Canadian average, hospitalizations were low.
"So we know there is something else playing out," Hynes said.
While no one factor accounts for the differences, CIHI pointed to significant variations in the "alcohol policy landscapes" across Canada.
For instance, B.C. had the highest rate of alcohol-related hospitalizations among the provinces. It also had a period of rapid growth in privatization of alcohol sales, which one study suggested was associated with an increase in alcohol-related deaths.
Pricing controls are another area that varies from region to region: some have minimum prices for items at retail, others have minimum prices set at bars and restaurants, and still others index the price of liquor to inflation or to alcohol content.
"For us, those differences represent opportunities for potential improvement," Hynes said. "Measuring this, and monitoring these rates can help us identify whether the policies and approaches are effective in reducing alcohol harm."
And pricing, Hynes said, is "one of the most effective and cost-effective ways to reduce alcohol harm, population-wide."
Basically, making liquor more expensive should curb consumption, as it did with cigarettes. Reducing hours of availability and number of stores, the report said, is also associated with reducing consumption.
It will take "a strategy that brings together multiple effective policies," Hynes said.