Women and alcohol: To your health?

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Publication Date: 
Wed, 2012-06-06

Addiction needs the same advocacy: prominent individuals who are willing to own the issue. We’re long overdue for an anti-stigma campaign. People overcome addiction. They get well. They need to speak up, and they need to be heard.

Who will play the Michael Wilson role? Who will play the supporting roles? With a convergence of voices, so much could be won. I look forward to the day when “Jennifer” might speak to me, on the record, using her real name.

And I look forward to a time when market-friendly governments pay more attention to the true costs of alcohol-related issues. Take the treatment system. When it comes to a fully integrated treatment network, the essential structure is missing in Canada. Seeking help? Too often, it’s a matter of where you live or who you know. The attention paid to problematic substance use is inadequate; the dedicated services are poorly funded and badly co-ordinated. Says Black in Thunder Bay: “The infrastructure built 20 years ago is not sufficient to meet the challenges today. Each system is doing their best, but there is no co-ordinated, integrated response to this social need. And there is no mandate for action. We need an injection of resources.”

A hot potato

Politically, alcohol is a hot potato: who wants to take the fallout for fiddling with our favourite drug, or the issues surrounding it?  Very few, it would seem. Only two provinces have alcohol strategies in place: Alberta and Nova Scotia.

The good news? Late last year, Canada’s first national low-risk drinking guidelines were given the green light. Says Michel Perron, CEO of the Canadian Centre on Substance Abuse (CCSA), which oversaw the shaping of the guidelines: “If a country has a $14 billion-a-year problem, and much of it stems from the use of a legal product, the first step is to explain how the product can be used, and how to decrease that avoidable cost.”

More than two years in the shaping, the guidelines are significant because they were the first priority of the National Alcohol Strategy, an intelligent blueprint which has yet to be fully endorsed by the federal government. The strategy was shaped in 2007 by an expert working group convened by the CCSA, Health Canada and what was then known as the Alberta Alcohol and Drug Abuse Commission. This group, together with representatives from public health agencies, alcohol manufacturers, treatment agencies and alcohol control boards, produced the “Reducing Alcohol-related Harm in Canada: Towards a Culture of Moderation.” This was a milestone effort, presenting 41 recommendations.

Canada has more than its fair share of brilliant researchers working on the alcohol file. Arguably, the best known is CAMH’s Rehm, and he minces no words. He cites a long list of countries that have made alcohol policy a priority: Sweden, Thailand, France, South Africa and Ireland, to name a diverse few. Says Rehm: “When you consider the science, alcohol is doing the most harm in our society. Unless we start seeing leadership on alcohol policy, our life expectancy will decrease compared to other countries. We should move on taxes, on pricing, on advertising, on the general availability of alcohol. Canada is missing the boat on alcohol.”

Make no mistake: this is a public health issue, and it’s crying out for true leadership. One key area: we’re just beginning to understand how differently women respond to alcohol. Historically, women have consumed less than men. For that reason, we have considered them less at risk, Alcohol affects women’s bodies differently, and we need to use sex-specific criteria for calculating risk. We need to reframe the research agenda on this subject. All regional and national alcohol surveys need to use sex-specific criteria for monitoring risky drinking, which translates to four or more drinks on any one occasion for women. We need to invest in sex and gendered research.

Meanwhile, given the high rates of risky drinking by underaged girls, we need research that helps with this problem. Says Poole: “We need to understand what supports are needed to delay their uptake of alcohol use. Some international research shows interventions that may be helpful, ones that address such protective factors as computer-based interventions, all-girl groups and programming that helps girls critically analyze media messages It is the issue affecting girls’ health, and it’s going sideways--especially for those 13 to 15. And it’s being marketed as girls’ liberation!”

Wilsnack, who oversees the GENACIS project, believes we are now witnessing a “global epidemic of women’s drinking.” Her greatest concern? Women in developing countries. “The highest risk is for the higher educated women in lower resourced countries. We need to design targeted intervention and tie it into the empowerment of women. If women can develop a means of enjoying alcohol in a healthier, low-risk manner, then we have succeeded.”

Ann Dowsett Johnston is an award-winning Canadian journalist, living in Toronto. Most recently, she was the recipient of the Atkinson Fellowship in Public Policy 2011, focusing on Women and Alcohol.

Additional resources:

The Canadian Centre on Substance Abuse (CCSA) - http://www.ccsa.ca/Pages/Splash.htm

Alcohol Policy Network (APOLNET) - http://www.apolnet.ca/Index.html

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