Increasing access to screening at clinics for adults at risk of alcohol abuse would help, researchers say. (Jim Hollander/Reuters)

The disease and social burden of drinking too much alcohol is so high that provinces ought to price alcohol based on its strength, a journal article says.

The analysis paper in Monday's issue of the Canadian Medical Association Journal aims to reduce alcohol's toll through steps such as:

• Imposing a moratorium on private retail sales outlets (outside of bars and restaurants).
• Increasing effectiveness of drinking and driving penalties.
• Eliminating discount pricing.
• Increasing access to screening at clinics for adult drinkers at risk of alcohol abuse.
• Raising the minimum drinking age to 19 in all provinces. The legal purchase age is 18 in Alberta, Manitoba and Quebec and 19 elsewhere in the country.

Dr. Norman Giesbrecht, of Toronto's Centre for Addiction and Mental Health and his co-authors pointed to an international project linked with the World Health Organization. It found that "disincentive pricing" of alcohol has a strong basis in research with a wide impact, including lower consumption, and fewer traumas, social problems and chronic disease tied to alcohol use.

Alcohol pricing should increase as alcohol content increases, charged at rates indexed to the cost of living, the authors suggested.

A 2002 study estimated the direct health care costs of alcohol use in Canada at $3.3 billion and the total direct and indirect costs were $14.6 billion compared with $17 billion from tobacco and $8.2 from illegal drugs, they noted.

Alcohol control

"Alcohol is often not 'on the radar screen' as a major public health issue in the broader public health community," the authors wrote.

"Whether the next decade will see a further increase in alcohol consumption, high-risk drinking and damage from alcohol will depend largely on whether the public health community and those responsible for alcohol control step into a leadership role, draw attention to this issue and take the steps needed to reduce the health and safety burden in Canadian communities. Are they up to the task?"

Evidence shows the suggested measures have worked in other countries, the researchers said.

In Canada, a study published in 2009 found that after British Columbia partially privatized its alcohol retail system, there was an increase in alcohol sales and more privately run outlets opened.

Given those findings, Giesbrecht and his team strongly recommended that private systems be regulated and monitored to ensure public-health interests are pre-eminent.

The authors also suggested rating provinces and territories on their measures against drinking and driving, such as escalating penalties for blood alcohol infractions.

One of the paper's authors has served as a paid consultant for the federally funded Canadian Centre on Substance Abuse.