Ontarians are visiting hospital emergency departments at a growing rate for intoxication and other issues arising from alcohol use, and women and young people account for the sharpest increases, researchers have found.
In a study, published in the CMAJ on Monday, researchers examined data for all individuals, aged 10 to 105, living in Ontario between 2003 and 2016. They found the number of emergency-department visits directly attributable to alcohol use grew by around 7 per cent year over year during that period.
While the majority of these visits were made by men, the rate of visits made by women ages 25 to 29 jumped 240 per cent. And starting in 2007, girls below the legal drinking age (ages 10 to 18) had a higher rate of emergency-department visits because of alcohol use than their male peers.
Earlier this year, the Canadian Institute for Health Information reported that alcohol contributed to more than half of the 156,108 hospital stays in Canada between April, 2017, and March, 2018, that were a direct result of substance use.
Some of the researchers point to broader retail availability of alcohol, marketing to young drinkers and the perceptions of the relative danger of alcohol as a drug as reasons behind the increases in hospital visits.
These statistics back up concerns by some health experts over the high rates of alcohol consumption among Canadians. In her 2018 report on the state of public health in Canada, Theresa Tam, Canada’s Chief Public Health Officer, stated that Canadians aren’t paying attention to the dangers of alcohol. She said that 80 per cent of Canadians aged 15 or over had reported drinking alcohol in the past year.
In the CMAJ study, among individuals between 25 and 29, the rate of visits because of alcohol jumped from 17.3 to 58.74 per 10,000 individuals among women, while for men the rate rose from 37.48 to 91.72.
“What our study shows is that alcohol is a rapidly growing problem in Ontario,” said lead author Daniel Myran, a family physician and resident at the Ottawa Hospital and Bruyère Research Institute.
A separate study by Dr. Myran and his colleagues, published in March in the journal Addiction, found a nearly 18-per-cent increase in alcohol-attributed emergency-department visits in Ontario between two time periods, 2013 to 2014 and 2016 to 2017. The researchers linked this rise to the previous provincial Liberal government’s move to deregulate alcohol sales. In 2015, Ontario began allowing the sales of beer, wine and cider in some grocery stores.
In the new study, Dr. Myran and his team from the University of Ottawa, the Ottawa Hospital, ICES (formerly known as the Institute for Clinical Evaluative Sciences) and the Bruyère Research Institute set out to examine which segments of society are most affected by alcohol-related harms, and to identify patterns of change over time.
They analyzed data for 15 million Ontarians, and found 765,346 emergency-department visits were attributable to alcohol use during the study period. These were visits for which doctors used diagnostic codes indicating issues such as intoxication, harmful use, withdrawal and alcohol dependence.
Dr. Myran noted these did not include health issues that are harder to directly attribute to alcohol use, such as cancers and injuries because of violence and motor-vehicle collisions.
When the researchers analyzed the data by income, they found that while lower-income individuals made up a large share of emergency-department visits because of alcohol, the rates of their visits remained relatively steady over time. Dr. Myran said this suggests the increase in alcohol harms that he and his team identified affect all members of society, regardless of income.
Although the researchers did not study the causes of the trends they identified, Dr. Myran said the surge in emergency-department visits by women appears to reflect reports of rising alcohol consumption and heavy drinking among women in Canada. He said he believed increased marketing and promotion of alcoholic beverages to women may play a role. Similarly, he said, marketing may also contribute to the rising rates of emergency-department visits by young people.
At Toronto-based Skylark, a charity that provides mental-health services for children, young people and their families, harm-reduction project co-ordinator Jordana Rovet said alcohol use is common among the young for many reasons, including the notion that alcohol is generally not regarded in the same way as other drugs.
“It’s legal, not stigmatized, glorified in media, easily accessible and seen as less harmful than other substances because of these reasons,” Ms. Rovet said, saying teens are often introduced to alcohol at parties and family gatherings around the time they reach the legal drinking age.
She added that young people also face a myriad of stressors, which may contribute to them self-medicating with alcohol.
“Jobs are few and far between, often pay minimum wage and do not provide sufficient work hours,” she said. “This has resulted in young people, in general, feeling more discouraged and disenfranchised than ever before, which also leads to increasing mental-health challenges.”
Dr. Myran noted he and his team examined data that, until the final year of the study, predated changes to alcohol-control policies in Ontario by the previous Liberal government and more recent efforts to liberalize alcohol sales by the current Conservative government. As such, he said price and availability did not likely drive the changes they observed. However, he said, since the price and availability of alcohol have been shown to be good predictors of how much people consume and the harms they suffer, he suggested alcohol-attributed emergency visits may rise further.
“I think we should be very concerned that policies that make alcohol more available and that make alcohol cheaper have the potential to dramatically increase harms,” he said.
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