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"I get the weirdest things from single malt," declares Geoff Kahnert, holding his glass of amber liquid aloft as if it were holy water. "I just got roasted marshmallow."

It's a Wednesday night at the liquor store and the 52-year-old product consultant is leading a class of 17 connoisseurs on the finer points of Scotch whisky.

Some of these dedicated students can name their favourite brands simply by their aroma. Others know the variety of wood used in the barrels where they age. The die-hards have even made pilgrimages to Scottish distilleries.

It never used to be like this. Thirty years ago when Mr. Kahnert started in liquor retail, purchasing alcohol was like stepping into the old Soviet Union. No credit cards. No tastings. Customers filled out orders with a pencil chained to the counter and surly clerks disguised bottles in brown paper bags.

But times change. Provincial governments now invest millions in advertising. And, putting the lie to its big-brother name, the Liquor Control Board of Ontario holds classes almost every week in grandiose stores such as Toronto's Summerhill location -- a 35,000-square-foot shrine to alcohol built in a renovated train station with marble floors, a tasting bar and more than 6,000 labels in stock.

"It's part of our lifestyle now," says John Begley, general manager of the Summerhill LCBO. "It's okay to go home at the end of the day and have a glass of wine with your dinner."

Or more. A lot more. In 2005, Canadians downed the equivalent of 7.9 litres of pure alcohol for every drinker and teetotaller over age 15. And many of us drink often -- consuming about 30 per cent more than the world average.

The social cost of our new lifestyle is staggering: $14.6 billion in 2002, and no doubt more in the years since. The health care bill alone is $3.3 billion -- higher than the price tag to treat cancer.

We spent 1.6 million days in the hospital because of illnesses and accidents caused by people under the influence of alcohol.

For the first time, more people died from liver cirrhosis -- regarded as a benchmark of a country's problem drinking -- than on the roads in drunken car crashes.

And the International Agency for Research on Cancer is about to announce a link between alcohol and two of the most commonly diagnosed cancers as well.

Yet government has treated alcohol like a gold mine, with policies that encourage us to drink and even handicap the struggle for sobriety once people become addicted.

Until now. Health Canada is set to unveil a proposed National Strategy on Alcohol that will include 41 recommendations drafted by experts in alcohol treatment, addiction research, provincial liquor monopolies -- even distillers and breweries -- to shift alcohol's innocent image as a benign indulgence and curb dangerous drinking.

"Alcohol has a huge toll on society, and that toll is slowly increasing," says Juergen Rehm, chair in addiction policy at the University of Toronto's faculty of medicine.

"It is always surprising why a society like Canada is willing to tolerate such a high cost. The majority of Canadians drink, and in their heads, 'The cost of alcohol is the alcoholics. It's not us.' And that's just wrong."

We suspected frat boys were prone to binge drinking. And this is backed by the Canadian Addiction Survey, a major study of drinking and drug habits. It found that young men, including teenagers below the legal drinking age, imbibe at least five drinks at a time -- a level researchers deem hazardous.

A bigger surprise is what the survey reveals about the rest of us. In 2004, 79.3 per cent of Canadians confessed to drinking, which, contrary to our growing obsession with fitness and diet, is nearly a 10-per-cent jump from a decade ago.

And these numbers tell only part of the story: The level of drinking professed in the survey accounts for just 32 per cent of the bottles actually sold in liquor stores, bars and restaurants. Whether we are deluded or deceptive, Canadians grossly underestimate the number of drinks we quaff.

At the LCBO, business is certainly booming. Since the liquor monopoly began its renovations 11 years ago -- geared to women, who drink less than men but shop more -- it has handed over richer and richer dividends to the Ontario government. Last year, it reported sales of $3.68 billion and poured $1.5-billion in profits and taxes into provincial coffers.

After slumping in the 1970s and 1980s due to growing awareness of health issues and the perils of impaired driving, alcohol sales have also staged a spectacular recovery in the rest of the country. Statistics Canada reports that we purchased $16.8-billion in wine, beer and spirits in 2005 -- and that excludes the market in home brew and make-your-own beer and wine (which accounts for an estimated 10 per cent of alcohol consumption).

Just who the big spenders are is another surprise from the addiction survey: The wealthiest Canadians were more likely to rank with the one in four drinkers who consumed in excess of guidelines considered safe. And the most educated, with university degrees, were among those likely to drink frequently, though seldom excessively.

This could explain why -- in the country that introduced the world to the beer-swilling culture of Bob and Doug Mackenzie -- sales of high-brow wines and imported beers are up while blue-collar domestic brews have gone flat.

"We always think of people drinking heavily as a response to problems, and it mainly isn't," says Tim Stockwell, director of the Centre for Addictions Research of British Columbia. "The bulk of people are drinking as a recreational activity, and it's limited mainly by their disposable income and the price. In a boom economy, people will be drinking a lot."

Just look at oil-rich Alberta. A few months back, private liquor stores suddenly ran out of stock after an unexpected 13-per-cent surge in the demand for booze among a growing work force flush with cash.

"Alcohol is near and dear to people's hearts. It's Canada's drug of choice, without a question," says Gerald Thomas, a senior policy analyst at the Canadian Centre on Substance Abuse. "It's legal and promoted and we're inculcated to use it. People defend their use of it."

All of this imbibing would be good, clean fun were it not for the repercussions -- that whopping $14.6-billion in deaths, disease, disability, hospital stays, missed days at work and police time in 2002 alone.

In fact, the tally from booze -- cheerfully marketed and sold by government in almost every neighbourhood in Canada outside Alberta (where alcohol is sold in private liquor stores) -- dwarfs the cost of illicit street drugs.

In the courts, more than 30 per cent of criminal offences have been linked to alcohol, with more federal inmates committing violent crimes addicted to alcohol than to drugs. On the roads, an average of four people a year are killed and about 200 injured in crashes sparked by impaired driving.

And it is not only the falling-down alcoholics who are ringing up most of the bills. Most of the damage -- ranging from suicide to fetal alcohol syndrome to the incalculable social costs of broken marriages -- is inflicted by people without an addiction tying one on.

"Most of the harms are problems of intoxication," says Dr. Stockwell, who calculates that 73 per cent of alcohol purchased in Canada is consumed at levels above the albeit conservative Canadian guidelines for safe drinking. (No more than two drinks a day; nine a week for women, 14 for men.) "And a lot of those are just regular people in the population, not people in clinics. They're just occasional heavy drinkers. It's not just focused on a small number of alcoholics. It's spread right across the population."

This might account for the $3.3-billion medical bill for injuries and diseases such as liver cirrhosis resulting from drinking -- which exceeded the $2.7-billion spent on treating cancer in 2002.

And explain why, according to a major study on the cost of our drinking habit published last year, alcohol killed 8,103 people in 2002 -- a 20 per cent jump in a decade. More than 1,200 hard-core drinkers died from liver cirrhosis. Hundreds of others committed suicide, which is more often triggered by alcohol than by either depression or schizophrenia.

Researchers are discovering more and more evidence to implicate alcohol in our rising cancer rates too.

The World Health Organization has long ranked alcohol as one of the top 10 risk factors for disease on the planet, and its cancer research agency has included ethanol -- the alcohol we drink -- on a hotlist of the 100 nastiest, Class 1 carcinogens for two decades.

But now the International Agency for Research on Cancer is about to finger alcohol as a cause of even more types of cancer than previously understood. In coming days, the agency is set to announce that breast and colorectal cancers -- two of the most common diagnosed worldwide -- will officially join the list with mouth, larynx, throat, esophageal and liver cancers.

The IARC scientists who reviewed the international research and made this call were stunned not only at how convincing alcohol's link to these two cancers was, but also by the low levels of drinking that raise risk.

"In our view, it's quite remarkable that alcohol consumption is related to female breast cancer," says Dr. Robert Baan, a senior scientist at the IARC's headquarters in Lyon, France. "The literature with breast cancer is with tens of thousands of patients. That's an enormously large study, and they have been able to establish with statistical confidence that already a very moderate consumption of alcohol increases the risk for breast cancer."

A casual drink or two a day, he says, raises a woman's risk of being diagnosed with breast cancer by 13 per cent.

"It's estimated that 2 billion people around the world are regular alcohol consumers, and there are 76 million people around the world who have a diagnosable disease or disorder connected to their habit," he says. "From a public health perspective, the global burden related to alcohol consumption in terms of morbidity and mortality is really considerable."

All of which raises a troubling paradox. When Ottawa and the provinces rake in liquor revenues -- $7.68-billion in taxes and profits in 2004 -- it's a bonanza for our schools, our hospitals, and our highways. But if we are drinking ever more, with most alcohol being consumed at risky levels and more of us becoming sick and disabled, should our governments be feeding our habit?

At the LCBO, being socially responsible is part of the corporate mission statement. On every sleek advertisement is an admonition to "drink responsibly." And the retailer takes enormous pride in the 1.7 million people its trained staff challenged at the cash register last year for appearing intoxicated or below the provincial drinking age of 19.

Still, addiction experts charge that the lure of lucrative profits and the nagging threat of widespread privatization of liquor stores have blinded governments and their alcohol empires to their original role of controlling -- not promoting -- the sale of booze.

"I see the LCBO as having a social role of trying to help minimize the risks of drinking," says Dr. Rehm. "And all those other activities which directly or indirectly promote the image of alcohol being a necessary part of our lifestyle and having no negative consequences is not helping the overall society and it's not helping to reduce the social costs associated with alcohol."

Mind you, most of us are not exactly lobbying the government to restrict our access to booze. Who among us strolls along the aisles of abundance, with their promise of good cheer, and wishes there were less choice and higher prices?

Consider a study on our perceptions of alcohol released this week by the Canadian Centre on Substance Abuse. It found that while the social and economic costs of drinking are more than double those of illicit drug use, only one in four Canadians rate alcohol abuse as a "serious problem" while close to half consider drugs as such. And the more people drink, the less apt they were to regard alcohol abuse as a pressing issue.

Or take smoking. "We almost religiously hunt smokers in the public and we glorify alcohol," observes Dr. Rehm, "even though on a world scale, alcohol and smoking have about the same net burden of disease."

But the party could finally be winding down. When the proposed national alcohol strategy is unveiled it will push for Ottawa and the provinces to scrap the dozens of alcohol taxes and duties and replace them with a few simple taxes that would be tied for the first time to inflation and alcohol content.

Many studies worldwide have linked alcohol consumption to price, and Canada appears to be no different: The cheaper liquor has become, the more parched we have grown.

Not only has alcohol become cheaper, but the tax rate on light beer and lower-alcohol wines and spirits is actually higher than on hard liquor. This means that the low-alcohol versions of our favourite drinks -- hot commodities in countries such as Australia, where tax incentives to purchase lower-proof booze are in place -- remain a little-promoted sliver of the Canadian alcohol market.

Now government, which has long treated alcohol as a matter of finance, is for the first time looking upon the tax system as an issue of public health.

"It's the strongest lever, the most effective lever government can pull to influence how many Canadians die and what the health care costs are," insists Dr. Stockwell in B.C.

Ireland is a recent example. Not long ago, it was one of the hardest-drinking countries in the world with soaring rates of liver cirrhosis. When the government boosted taxes in 2003, there was an immediate drop in alcohol consumption and a decline in deaths from the liver disease.

In Canada, higher prices promise to deter party-hearty but budget-minded young men from binge drinking. This is no small measure: While most beer-guzzling university students outgrow the habit, those who later become alcoholics start down this slippery slope in these early years.

But not only boozy teenagers are in danger of turning into alcoholics. The more we drink, the more hard-core drinkers will be slipping over the edge into the abyss of addiction, and the more people will turn to under-funded alcohol treatment centres in Canada that are already swamped with people whose lives have been ruined by the bottle.

It's no wonder we love our booze.

Alcohol mixes with our brain chemistry to make us feel a little more relaxed after a drink. Among the many neurobiological changes it triggers -- some of which scientists are still grappling to understand -- booze trips the switch releasing dopamine, a neurotransmitter that binds with receptors in our brains to reward us with feelings of pleasure.

But scientists are discovering that our genes play a role in how intoxicated, sedated or euphoric we feel after drinking. Our genes produce proteins that influence the signals sent between the neurons of the brain -- hardwiring some of us to become alcoholics.

When we drink, we also temporarily alter brain receptors and molecules. If we become chronic heavy drinkers, that circuitry changes -- from the chemical messengers to the actual cellular structure of the brain -- and the damage may be irreversible.

"My brain is changed forever as a result of my addiction," says Graeme Cunningham, a former cardiologist and recovered alcoholic who now heads the addiction division at one of the country's largest treatment facilities, Homewood Health Centre in Guelph, Ont.

"If I pick up a drink today, I will tickle a phenomenon called craving, whereby I could well be drunk by the weekend. That's addiction, and that's why you cannot take an alcoholic and have them drink controllably in the future."

Yet even as science is showing alcoholism to be a biological disease -- not just a psychosocial one -- treatment in Canada is limited to the psychologists and therapists who provide counselling while the medical establishment turns a blind eye.

Medical students are taught next to nothing about addiction. Few doctors bother to talk to patients about their drinking. And none of the growing repertoire of cutting-edge drugs on the market to short-circuit alcohol cravings and highs is covered by provincial drug plans, even though at least four medications are routinely prescribed in the United States and elsewhere.

"It's outrageous," says Mel Kahan, director of addiction medicine services at St. Joseph's Health Centre in Toronto and head of the Centre for Addiction and Mental Health's alcohol clinic. "If [it] were a drug that improved hypertension, it would be there. But because the drinking population doesn't have a popular voice, they're marginalized."

While depression is understood to require medical and psychological treatment, alcoholism is still widely regarded as a moral defect, a weakness of willpower, and public investment in its treatment reflects this ethic. From the billions government coins via liquor sales, nothing is plowed back into addiction treatment -- as provinces such as Ontario willingly do with the lucrative spoils from its casinos.

"It really is an under-funded system given the burden of illness," says Dr. Kahan. "We see patients all the time in the emergency departments, and we have nowhere to send them. Even relative to other illnesses, whether it's diabetes or heart disease, it's under-funded, particularly given the effectiveness of treatment."

One of the most effective -- and cheapest -- treatments is the family doctor. Research shows that when physicians set aside a few minutes to talk to patients they suspect drink heavily, the conversation is a wake-up call that frequently brings the drinker back from the verge of alcohol dependence.

The national alcohol strategy proposes that family doctors play a bigger role in preventing addiction, talking to their patients about alcohol and ordering lab tests to measure biochemical markers such as liver enzymes in the blood that, when elevated, provide clues that people are overindulging.

"If family doctors or nurses give even brief advice to patients with alcohol problems, there are measurable benefits in terms of reduced drinking and improvements in health outcomes," says Dr. Kahan. "It's very effective, more so than most things we do as doctors. And yet it isn't done very often."

Back at the Summerhill liquor store, Reuven Spiegel and his long-time friend Michael Zeldin sit at the back of the Scotch class, chasing their single-malt with a glass of dark Scottish beer and dark chocolate -- a treat that only true aficionados know pairs sumptuously with the aftertaste of the spirit.

Many wee drams of Scotch and tall cans of beer later, these two have consumed a good few drinks more than the addiction experts contend they should, and on a weeknight no less.

But this is not their usual Wednesday night. While the friends collect Scotch whisky like rare coins, they insist they reserve drinking to weekends, and even then no more than a few drinks at a time. And this event means the chance to sample expensive Scotches neither could otherwise afford.

"From that perspective, I think it's a fantastic opportunity," Mr. Spiegel says. "Knowing a little bit about Scotland and a little bit about the distillers and the history, I think there's a true art to what goes on in Scotland and what we're privy to share on this side of the pond."

These are the customers the LCBO is trying to cultivate: sophisticated drinkers willing to spend a little more on a good bottle of their favourite beverage. Far from rapaciously pushing people to drink more, the monopoly argues, it is catering to the shifting tastes of consumers just like any respectable business.

"It's not a matter of taking home a bottle at the end of the day and consuming the entire bottle," says Mr. Begley, the store general manager. "It's an enhancement of your lifestyle and it's certainly healthy."

At least, healthier for some.

"Alcohol is the key to an awful lot," Dr. Stockwell says. "There's a lot of revenue in Canada. It's a huge industry with hundreds of thousands of people employed across the country -- major manufacturers with lots of power and influence. And it's a commodity which most of us use and really value and enjoy.

"And so, if the government gets uppity and increases the price or restricts our access, we're not happy . . . There have been general elections lost over government raising the tax on alcohol."

Margaret Philp, who loves a glass of wine now and then, is a Globe feature writer in Toronto.

Total social cost of drinking in 2002

$14.6-billion

Total liquor profits in 2004

$7.68-billion

HOW MUCH IS TOO MUCH?

Canadian guidelines

14 drinks a week maximum for men

9 drinks a week maximum for women

World Health Organization guidelines

21 drinks a week maximum for men

10 drinks a week maximum for women

SOURCE: CENTRE FOR ADDICTIONS RESEARCH OF BRITISH COLUMBIA PROFIT AND LOSS

Healing hurdles

As scientists discover more about alcohol's impact on brain chemistry and the genetics that predispose some of us to addiction, they are pioneering drugs to disrupt the brain signals that produce pleasure from or craving for a drink.

While these new medications are hardly magic pills, studies show that the high rate of relapse in addiction treatment drops when they are combined with counselling.

But few Canadians in alcohol treatment are receiving these cutting-edge drugs. The four on the market currently approved by the Food and Drug Administration in the United States -- and in dozens of other countries -- are not covered by provincial health plans and are very seldom prescribed:

Disulfiram: More commonly known as Antabuse, this drug was approved for alcohol treatment in the United States more than 50 years ago. It used to be covered by provincial drug plans in Canada too, but is now sold only by select pharmacies. Different than the other drugs, it triggers nausea and vomiting when an alcoholic takes a drink by blocking an enzyme involved in the body's metabolizing of alcohol. No surprise that patients hesitate to take it.

Oral naltrexone: These pills contain molecules that bind to a receptor in the brain that, when activated, produces the high from drinking. The drug blocks the euphoria of a drink and the craving for more that afflicts alcoholics. While clinical trials have found reductions in the number of people falling off the wagon, though, this appears to work only for those alcoholics genetically predisposed to experience more euphoria from the bottle.

Injectable naltrexone: Just approved a few months ago in the U.S., the injectable version of this drug works for more than a month. This is a boost for those reluctant to take pills every day, such as prison inmates.

Acamprosate: Widely used in Europe and Australia, this drug also blocks the rewards of alcohol -- but through a different path in the brain. It helps alcoholics to abstain by relieving the withdrawal symptoms (the tremors, sweating, anxiety and insomnia) that often follow detox.

-- Margaret Philp