The current provincial government of Ontario is implementing a policy to sell alcohol in over 300 new outlets in Ontario over the next few years. This will largely include selling wine and beer in grocery stores. The plan is part of the liberal government’s intention to decrease ‘red-tape’ for the alcohol sector.
This blog does not advocate for criminalization or moral condemnation of alcohol use but an evidence-based view of how harm from alcohol can be reduced. The prohibition of alcohol, like the prohibition of drugs, would likely create more harm and violence than it prevents. Morality or religious-based arguments are less compelling than economic, public health, and safety concerns presented here in regards to maintaining the regulatory model in Canada.
The Facts on Alcohol
Alcohol has historically been the only legal psychoactive drug in Canada and also the most popular, with around 80 percent of adults having drank in the past year. It is likely that alcohol is your favorite psychoactive drug and the drug you have taken the most in your lifetime. It is by far the most widely consumed substance in human history and entrenched in most cultures.
Many drink without harming themselves or others and there is little negative impact. However, the legal status and social acceptability of alcohol are largely responsible for its disproportionate amount of drug related harm. Alcohol is a causal or co-causal factor in over 7 types of cancers, diabetes, fetal alcohol syndrome, assaults, drunk driving deaths, homicides, sexual crimes, suicides, accidents, days taken off work and a variety of other public health problems. Harm reduction for alcohol is necessary because of its popularity and acceptability compared to all other mind altering drugs.
The new policies of increased alcohol availability and density of outlets and the further relaxation of the liquor control monopoly by the current Liberal government of Ontario goes against the evidence on how to best reduce alcohol harm. Canadian and international public health organizations have stated that increasing density and availability of alcohol increases consumption rates and related harms in the long term. The new alcohol sales policies will increase the human and economic cost of alcohol and should be protested by citizens and taxpayers as a shortsighted policy with real world consequences.
Profits and Costs of Privatization
Alcohol is not an ordinary commodity that should be dictated by standard economic market principles. Alcohol is a dependence-causing substance classified as a depressant that leads to many individual and population-level negative outcomes. It does not just harm individual drinkers. In multiple provincial surveys, one in three Canadians report having experienced harm in the past year as a result of someone else’s drinking. The magazine The Economist rankings show that alcohol is the most harmful drug in the UK, ahead of tobacco and heroin, and causes the most damage to populations and the economy.
British Columbia has implemented partial privatization over the past 15 years and Alberta has been the only province to have fully privatized alcohol sales since 1993. One of the most compelling arguments in favor of a government monopoly is that since alcohol has many external costs dispersed to society, the tax revenue gained from alcohol can offset the damage by being partially directed to the justice and healthcare systems. It is estimated that the government of Alberta has lost $1.5 billion since privatization due to not maintaining prior public tax revenues. As well, privatization in Alberta and B.C. has also been correlated with increased rates of drinking and driving and per litre consumption.
Therefore, the capitalist profit motive shouldn’t function as it normally does. The government should not promote cigarette smoking because of the enormous cost to taxpayers, which sits at 17 billion dollars per year. Alcohol works on the same principle but there has not been a policy change or as much of a normative social shift against alcohol as there has been with smoking. Multiple policy initiatives have decreased smoking rates, such as raised prices, minimum pricing, bans in private and public spaces, less visibility and labelling on packages. Lowering prices and making cigarettes more available would increase smoking rates and acceptability. Some of the same logic and policy initiatives apply to alcohol.
The social and economic costs of alcohol in Canada are substantial. Alcohol killed 4258 in Canada in 2002. In the most comprehensive study on alcohol harm in Canada to date, alcohol costs the country $14.6 billion annually. This comes from $4 billion in direct justice system costs, $3 billion in direct healthcare costs and $7 billion in indirect loss of production due to death, disability, and disease. Economic models do not include things such as emotional suffering or depression due to drinking. Surprisingly, those classified as non-risky or moderate drinkers account for at least half of total alcohol harm. Alcohol and tobacco cost the Canadian government over $31 billion dollars a year while all illicit drugs combined cost 8 billion annually.
Total yearly government revenue from the alcohol industry is roughly 5 billion dollars. Every dollar the government makes from alcohol, it spends nearly three on the harm created. While it may be not be on the mind of people when discussing economic growth, alcohol harm reduction strategies would make a significant positive net difference. The costs from the new Ontario alcohol policies will likely be seen in the decades to come.
Reducing the Harm of Alcohol
Alcohol is a factor in over 30 percent of all crime in Canada. All illegal drugs combined account for 5 percent of police reported crime. Drunk driving is the most common criminal offence in Canada. The pharmacological effects of alcohol intoxication leads to increased likelihood of aggression in people with a pre-existing personality disposition for violence. Posting police outside of entertainment districts at last call and limiting alcohol past certain hours has been shown to be an efficient way to decrease homicides and assaults.
Medical studies conclusively show alcohol intoxication, even in comparison to other substances, increases risky and impulsive decision-making and decreases the ability to properly assess dangerous situations. Alcohol is by far the most common drug used to facilitate date rape. It is estimated that alcohol is involved in 35-65 percent of all sexual assaults. Shaming the victim of a sexual crime for willful consumption of alcohol is a common narrative and a factor in low reporting and conviction rates. Drinking alcohol until intoxication is a significant risk factor for being violently or sexually victimized and for perpetrating a violent or sexual criminal offense. While only the individual perpetrator is responsible for their violent actions and no one anywhere deserves to be harmed, the data shows that alcohol as a risk factor for vulnerability of victimization should not be ignored.
Another issue with privatizing alcohol sales is that private vendors are not as responsible dealing with underage buying. Once a profit motive is introduced, retail outlets rationally seek to sell as much as possible, and competitive economic pressures will inevitably lead to easier access for youth. Mystery shopper research shows that publicly owned alcohol outlets ID at much higher rates and turn back many more teenagers than convenience or grocery stores.
While many admire the ‘relaxed drinking culture’ of Europe, WHO Europe studies show that it is actually a public health epidemic. Europe spends over 130 billion dollars per year on alcohol harm. Evidence shows that a history of liberalized alcohol policy, which in turn creates a cycle of social acceptability and increased consumption, has led to the worst alcohol harms on Earth. At the global level, alcohol killed 3 million people in 2012, with Eastern Europe and Russia in particular being the regions with highest rates of death and disease. Alcohol is currently the 3rd leading preventable risk factor for death or lost years of life, significantly ahead of illegal drug use.
Consumption rates, the way people drink, harm and total cost to the economy are all affected by socio-economic and cultural factors. For example, majority Catholic countries drink significantly more than majority Muslim countries. Developed countries consume more than developing countries but unregulated alcohol consumption problems are higher in poorer nations. Men are 2 to 3 times more likely than women to drink in risky ways and consume more drinks on average. However, consumption by younger women aged 15-24 is currently increasing dramatically.
Alcohol and Public Health Policy
Policy greatly affects consumption and harm from alcohol and different policies are more effective than others. The WHO as well as many other Canadian and international health organizations have declared that limiting availability, decreasing density of outlets and maintaining existing government monopolies are the most effective ways to reduce consumption and the overall cost to Canadians. If the mandate for governments is to promote the public good and security, it should not be privatizing and actively promoting increased alcohol consumption.
Public opinion in Ontario shows that a slight majority are in favor of maintaining the current government liquor monopoly. The vast majority reported that it was currently easy and convenient to obtain alcohol when they wanted it. Surveys show that men, Caucasians, young people and heavy drinkers are more likely to favor liberalized alcohol policies. The demographics who most support liberalized alcohol policies may be the group who engages in the most harmful behavior. Women, visible minorities and older people are more likely to support the traditional Canadian system of government regulation.
The Liberal government of Ontario is prioritizing short-term profits at the expense of the overall health and well being of the province. Increasing the availability and density of alcohol will do long term damage to the economy and health of Canada. It is contrary to good evidence-based public health policy and is in violation of public trust.
A 4th year University of Toronto undergrad majoring in political science and sociology, Kyle's aims to get his master’s degree in public policy, currently works for a criminologist researching recidivism in the USA, and has been involved with CSSDP Toronto for the past year. Find out more.