Psychological Dependence and Classical Conditioning

Psychological Dependence and Classical Conditioning

Psychological dependence and Classical conditioning:

Salvador Dalí said that everybody should try Hashish, but only once. This sentence summarizes society’s fear towards drugs. People are afraid of drugs, but mostly, we are afraid of ourselves. We are afraid of not being able to control our will and fall into a downward spiral of unlimited pleasure and self-destruction if we dare to do drugs just once.

Most people assume that frequent consumption of a drug can cause dependence, although most of us don’t really understand or even consider why, we just embrace the idea. That’s what we’ve been told by our parents and teachers, and they learnt it from their own parents and teachers without questioning it either, and so on. The perpetuation of this mantra, although very easy and comfortable, is not very smart. It is important to be informed in order to form our own opinions and not be manipulated.

Let’s start with the definition of “drug”. According to the FDA, a drug is:

“[…] (A) articles recognized in the official United States Pharmacopeia or formulary, (B) articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or other animals; and (C) articles (other than food) intended to affect the structure or any function of the body of man or other animals”.

Considering that in this article we are going to be talking about psychoactive drugs, we’ll take the last definition. Now, let’s review some of the symptoms of substance dependence. When someone is dependent to a drug:

  • He or she might experience tolerance towards that drug (the dependent individual has to consume higher doses to reach the same effects than before).
  • Withdrawal symptoms might occur if he or she stops using that substance.
  • The individual might be incapable of controlling his or her use of that particular substance.

These symptoms might have a physiological, pharmacological and/or a psychological origin. In the first two cases, the origin resides on the chemical interactions of the drug with the body, primarily the central nervous system. Psychological dependence is the big unknown though. However, according to some studies, psychological dependence might be the result of a form of learning process, similar to that of Classical conditioning.

 

How does Classical conditioning work?

Classical conditioning (also known as Pavlovian conditioning) is a learning process in which an innate response to a potent stimulus gets associated with a previously neutral stimulus.

A conditioned stimulus (or neutral stimulus) is the one that despite causing a certain response in the studied individual, is neutral to the response that we want to condition. Meanwhile, the innate or unconditioned stimulus is the one that causes the response that we want to condition.

To recap, so far we have:

Conditioned stimulus  – – ->  Neutral response

Unconditioned stimulus  – – ->  Unconditioned response

Now if we simultaneously and systematically present both stimuli (conditioned and unconditioned stimuli) in the presence of the unconditioned response, the conditioned stimulus will eventually trigger both neutral and unconditioned responses. This is phenomenon is called acquisition.

However, if the conditioned stimulus is presented repeatedly in the absence of the unconditioned stimulus, the latter will not trigger the appearance of the conditional response anymore. This phenomenon is known as extinction.

This whole mechanism is easier to understand by using Pavlov’s dog case as an example.

When a dog is presented with food (unconditioned stimulus), it would start salivating (unconditioned response). But if a bell is rang every time that food is presented to the dog (conditioned stimulus), the dog will associate the sound of the bell with the presence of food and every time that it heard the bell ringing, it would salivate, even in the absence of food.

 

Siegel’s experiment

The idea of tolerance and dependence as products of Classical conditioning was first proposed by Ivan Pavlov himself in 1927, although it was not empirically demonstrated until the late 70’s by Professor Shepard Siegel, from McMaster University, in Hamilton (Canada).

When a drug is used (unconditioned stimulus), it affects the structure or a function of a part of the body creating a compensatory response from it in order to restore equilibrium (unconditioned response). However, if that drug is systematically taken alongside the same environmental cues and under the same circumstances, these factors will begin to function as conditioned stimulus which produces the same unconditioned response in the body opposing the effects of the drug.

Most drugs generate a homeostatic disruption of the body in a physiological and psychological level. Siegel found that the body tends to maintain a homeostatic equilibrium in all of its systems, both physiologically and psychologically, by generating a response to the homeostatic disruption produced by the drug. For instance, ethanol has a vasodilator effect and therefore it causes a drop in body temperature. When this happens, the body reacts by trying to restore bodily functions to normal levels and thus it generates a compensatory response, which in the case of ethanol would be increasing body temperature.

This process was also hypothesized by Dr. Richard Solomon in his opponent-process theory (Solomon, 1978). Solomon proved that when an unconditional stimulus that triggers an unconditioned (pleasant or unpleasant) reaction is presented and removed, an opposite state would appear as a result of the compensatory response that the body generates to counteract the initial stimulus. He called this phenomenon ‘’hedonic contrast”. We can find examples of this process in our everyday lives; it’s the pleasure that comes after scratching an itch, the sadness that arises when our ice cream falls off the cone, or the relief that comes when landing safely after a parachute jump.

If the process is repeated systematically, the organism would trigger the compensatory response even in anticipation of the unconditioned stimulus.

This compensatory response can occur before ingestion of the drug. E.g., So when you are planning to go to the bar with friends you may experience a drop in body temp… or someone who has a problem with heroin may begin to go into physiological withdrawal by walking by the corner of their dealer.

According to Siegel’s compensatory response model, the direct effect of a drug on the individual serves as the unconditioned stimulus (UCS), whereas the individual homeostatic regulatory systems attempt to defend itself against the drugs effect and maintain homeostasis is the unconditioned response (UCR). Through repeated drug administration, a stimulus that is often paired with the UCS becomes a conditioned stimulus (CS) and serves as an early warning signal that the homeostatic regulatory system that a UCS is imminent. The regulatory system then prepares itself by eliciting a defensive conditioned response (CR). Through repeated drug administration episodes, the link between the UCS and the CS becomes stronger and eventually the CS can elicit a CR in the absence of the UCS. This CR may then influence the individual’s homeostatic state resulting in the onset of withdrawal symptoms, craving, and likely future drug use (in order to alleviate unwanted withdrawal symptoms).

So, in Pavlovian terms:

Drinking alcohol (unconditioned stimulus) – – -> Increase in body temperature (unconditioned response)

 

In Siegel’s experiment (Crowel, Hinson, & Siegel, 1981), the researchers administered ethanol injections to a group of rats while a particular stimulus was being presented to them (white noise). These injections were alternated with saline injections and a different environment. Rats’ body temperature was continuously monitored in order to check if a compensatory response was being generated.

The first time that rats received ethanol injections in the presence of white noise, a reduction in body temperature was observed. However, the intensity of that temperature drop decreased with subsequent trials despite receiving the same amount of ethanol. Rats were developing a tolerance to the injections of ethanol in the presence of white noise.

In order to determine if a compensatory response was being produced by the environmental cues, saline solution was injected in the presence of white noise, while a control group received saline solution injections in the absence of those environmental cues. The results showed that rats that received saline solution injections in the presence of white noise experienced an increase in body temperature while the rats in the control group did not experience such change. Additionally, Siegel found that the tolerance to ethanol that rats had acquired decreased if rats were injected with ethanol in a different environment. Meaning that if rats received a similar dose of ethanol to that they were used to, but in a different environment, they experienced a drop in body temperature again.

Siegel found that this same effect would occur with opiates, barbiturates and benzodiazepines (Hinson & Siegel, 1983), suggesting that this mechanism was not exclusive to alcohol.

The results of these experiments may seem meaningless, but the implications of Siegel’s discoveries are very important for the understanding and treatment of substance dependence. Siegel’s theories suggest that both dependence and tolerance could have a strong psychological component and therefore, operant drug treatment approaches should incorporate aspects of Classical conditioning in order to address the effect that environmental cues have in the process of acquisition of tolerance and dependence.

 

Siegel also found that tolerance would increase when the user was exposed to the usual drug associated environmental cues, but not when the user was exposed to different conditions. This process was termed “situational specificity of tolerance” (Siegel, Baptista, Kim, McDonald, & Weise-Kelly, 2000).

It is believed that this situational specificity of tolerance could be the cause of the high incidence of opioid overdose among long-term dependent heroin users. To prove his point, Siegel reported the case of a cancer patient who was receiving morphine injection by prescription at home and died of an overdose (Shepard & Ellsworth, 1986). The patient received morphine injections in his bedroom for four weeks, with a gradual increase in dosage level as the patient developed tolerance to the drug. One day, the patient received his scheduled morphine injection in the living room instead of in his bedroom and he suffered a fatal overdose of morphine. Siegel explanation suggested that the bedroom was acting as a form of conditioned stimulus generating a compensatory response on the patient to the effects of morphine. However, when that stimulus was removed, that compensatory response disappeared, producing the fatal overdose.

 

The applications of these theories reach further than just dependence to so called “hard drugs”. Having a coffee after lunch or a cigarette after having sex could become habits hard to change if done systematically under the same environment and under the same circumstances.

Like Aldous Huxley said, “Habit converts luxurious enjoyments into dull and daily necessities”.

 

References:

Crowel, C., Hinson, R., & Siegel, S. (1981). The Role of Conditional Drug Responses in Tolerance to the Hypothermic Effects of Ethanol. Psychopharmacology, 51-54.

Hinson, R., & Siegel, S. (1983). Anticipatory Hyperexcitability and Tolerance to the Narcotizing Effect of Morphine in the Rat. Behavioral Neuroscience, 759-767.

Pavlov, I. P. (1927). Conditioned Reflexes. London: Oxford University Press.

Shepard, S., & Ellsworth, D. W. (1986). Pavlovian Conditioning and Death from Apparent Overdose of Medically Prescribed Morphine: A Case Report. Bulletin of the Psychonomic Society, 278-280.

Siegel, S., Baptista, M. A., Kim, J., McDonald, R. V., & Weise-Kelly, L. (2000). Pavlovian Psychopharmacology: The Association Basis of Tolerance. Experimental and Clinical Psychopharmacology, 276-293.

Solomon, R. L. (1978). The Opponent-Process Theory of Acquired Motivation: The Cost of Pleasure and the Beneficts of Pain. Eastern Psychological Association. American Psychologist.

Siegel, S., Krank, M.D. & Hinson, R. E.  (1987)  Anticipation of pharmacological and nonpharmacological events.  Journal of Drug Issues, 1:83-110. 0.38 Impact Factor

Siegel, S., Hinson, R. E., Krank, M.D. & McCully, J.  (1982) Heroin “overdose” death: The contribution of drug-associated environmental cues.  Science, 216:436-7.  31.48 Impact Factor

 

Michelle Theissen

Michelle Theissen

Treasurer

An Honours graduate with a Psychology B.A. from the University of British Columbia, Michelle will begin her Masters in Clinical Psychology in fall 2016, continuing her research examining the motivations and outcomes of recreational and therapeutic use of cannabis and psychedelics. Find out more.

Antonio Cillero

Antonio Cillero

A Queen's University graduate with a Master’s degree in Chemical Engineering, Antonio helped translate Alexander Shulgin’s PIHKAL and TIHKAL to Spanish and is head translator at infocannabis.org. Find out more.

Listen to youth when developing youth drug policy

Listen to youth when developing youth drug policy

The following article was initially presented as a discussion paper at First, Do Less Harm: The Future of Drug Policy in Canada on January 31st, 2017, a panel sponsored by The Canadian Harm Reduction Network and The University of Toronto Centre for Community Partnerships.

First, Do Less Harm: Protecting the Youth

Canadian Students for Sensible Drug Policy (CSSDP) is always working to reduce the potential harms of bad policy on young people by including youth voices and input in some of the bigger decisions happening in Canada. Under the guise of “protecting the youth,” we often create policies that do more harm and does little to actively protect young people. When looking at doing less harm, we have to consult the evidence.

Listening to Youth

In September, CSSDP organized a youth roundtable that focused on elements of the legalization task force discussion paper to show how we can do less harm, starting with cannabis.

CSSDP noticed that youth were not being consulted outside of the general public consultation and that stakeholder meetings focused more on organizations that work with youth, rather than youth themselves. To give youth a clear voice on upcoming cannabis legalization, CSSDP, with support from Lift and the International Centre for Science in Drug Policy, hosted a youth roundtable in September called Youth Speak: Cannabis Policy in the 21st Century, which was attended by Task Force member Catherine Zahn, a representative from the legalization secretariat, MP Vaughan, and MP Erskine-Smith. We reviewed the discussions and produced a report based on feedback from 21 diverse youth voices in Toronto, including peer youth workers who work with at-risk youth, medical cannabis patients, students, and those who work in the illegal and legal cannabis industries. The young people who participated were aged 18-29.

The Ontario Student Drug Use and Health Survey shows that in 2015, self-reported alcohol use amongst grades 7-12 was over 45%, tobacco use was 34%, cannabis was at 22%, and each figure increase with age. The highest use of cannabis was among those between 20-24—with 26% using in the last year. These numbers could be even higher, as they don’t capture the many at-risk or homeless youth who may fall outside of what’s reported in the survey.

Criminalizing Young People

Prohibition has been constructed as a way to protect youth, but it really hasn’t done much to keep young people away from illegal drugs like cannabis; instead they have become one of the most criminalized populations for cannabis-related charges. The criminalization of youth has effects on their future in many ways, such as getting loans, housing, financial aid, and even employment. And we have found that a criminal approach to cannabis possession, production, and distribution causes more harm than the actions themselves. In fact, some youth describe criminal records as, “a gateway to longer prison sentences and the cycle of imprisonment.” Of course, this relates not just to cannabis, but to all drugs.

For example, youth talked about how age restrictions are not about when it’s safe to initiate use, but when we think young people can make reasonable choices. Setting age limits too high means one of our largest cannabis using populations is now outside the regulated system. High rates of use among young people are a key reason why youth felt the age limit should not be too high, and this recommendation was reflected in the Task Force recommendations.

One of the most predominant and recurring themes centered on the criminalization of young people: we must ensure we do not thinly veil restrictions that actually do more harm as “protecting youth.” When it comes to criminalizing youth, the key recommendation focused on youth offences that occur outside the regulated system. Like we see with underage alcohol access, cannabis access will happen outside of the regulated system even if it mirrors the drinking ages. For youth that use cannabis, it should not come with a criminal record. Youth recommended some kind of decriminalized/low penalty system like ticketing or community service, although there were some disagreements on what appropriate alternatives to criminal sanctions there could be. For example, ticketing could further disenfranchise the most vulnerable young people who can’t afford to pay, while community service may take at-risk youth away from jobs and school. The Task Force recommendations also reflected that simple possession of cannabis by youth should not be a criminal offence. Many also noted that although outside the scope of the task force, past non-violent criminal records should be expunged, particularly underscored by youth who worked with other at-risk and homeless youth, where the consequences are magnified.

Cannabis Education

Young people also expressed the need to have access to evidence-based but non-judgemental education about cannabis and other drug use. A good example is iMinds learning resources from BC, which focuses on increasing youth drug literacy. Most of the youth at the roundtable didn’t remember anything but abstinence-only education or anything specific about cannabis use in particular. Youth felt this may be because educators worry about being seen as “pro-drug” should they provide realistic drug education. Cannabis and other drug education needs to include harm reduction, and “protecting the youth” must include protecting those young people who do choose to use drugs. This should include information about things like driving under the influence without stigmatizing use itself. For example, we’ve done a good job changing the public opinion on drinking and driving, without stigmatizing alcohol use itself.

Although cannabis education is a big positive step towards harm reduction in a legalized framework, it is only the first of many topics to cover in the wider conversation on the future of drug use and drug education in Canada.

Education Models and Tool kits

CSSDP has been looking at education models from within Canada and other jurisdictions, such as ‘Cannabis Conversations’ from Washington State, as well at the Canadian Centre for Substance Abuse’s Cannabis Education Toolkit. While these are a good starting point, we feel that the lack of inclusion of youth voices in both developing and testing these tool kits is problematic. For example, we found that often these tool kits overlook the nuances of cannabis use and overstate the scientific evidence, which could undermine the effectiveness of prevention efforts among youth, particularly those who are older, as they might have personal experiences that don’t align with these descriptors, resulting in fostering distrust. Some strengths might include the acknowledgment of medical use and pleasure as reasons people use cannabis, as well as different talking points for different age groups. Youth at the roundtable stressed the importance of education being developed with the input of youth and young people, including those who do and those who do not use cannabis, in order to test the curriculum and provide feedback.

Upcoming Cannabis Education and Research Campaign

Moving forward, CSSDP is beginning an education and research campaign that prioritizes youth input. We hope to stress the need for harm reduction in cannabis education and recognize that this is the first step in a much wider conversation around youth education and cannabis access. Access to age-appropriate materials that start in elementary school will be beneficial to youth, but these materials should be developed with the input of young people to really unpack what it means to ‘protect young people’ in this context. For the young people we worked with, this meant keeping the criminalization of youth, which arguably does the most harm, at the forefront of these conversations.

Collaboration Opportunities for Researchers and Educators

We’re seeking collaborators on this cannabis education campaign and hope that we can help develop meaningful tools to give young people access to the education they deserve. If you have questions or are interested in contributing, connect with us.


Below is the video from the First, Do Less Harm panel, moderated by Joe Fiorito and featuring panelists Patricia Erickson, Raffi Balian, Trevor Stratton, Eugene Oscapella, as well as CSSDP representative, Dessy Pavlova.

Dessy Pavlova

Dessy Pavlova

Chair

A professional writing and English graduate, aspiring project manager and sensible drug policy advocate, Dessy works for Lift and does research, outreach, writing and web development.
Find out more.

With or without the blessing

With or without the blessing

Harm reduction workers celebrating their temporary agreement with local law enforcement. (John Lesavage/CBC)

Toronto opened the 1st pop-up safe injection site.

The city of Toronto has not ‘blessed’ the project. However, activists for the site are excited about it, and “hope authorities won’t shut them down” (Nasser, 2017).

For one of the underserved sectors of the Toronto community, the Toronto Harm Reduction Alliance will open on Saturday. Harm reduction workers and activists, and advocates, have been making calls for something like this for some time (Rieti, 2017).
Three people have died, recently, due to overdoses (Glover, 2017). This is seen as a wakeup call by many (The Canadian Press, 2017). With these deaths, and with the ongoing protestations of harm reduction activists, they are taking these issues on for the community on their own.
These are unregulated pop-up safe injection sites. The exact site, was not given by harm reduction worker Matt Johnson in conversation with CBC News, to protect users and organizers (Nasser, 2017).
Johnson said, “We just can’t wait any longer.… With this many deaths we just can’t afford to.” The advocates for harm reduction consider the harm reduction sites sanctioned, or ‘blessed,’ by the city of Toronto.
Advocates for harm reduction have been making calls for the declaration of a public health emergency alongside immediate funding for the 24-hour care for substance users.

Many have praised the city sites. However, these are considered insufficient by the harm reduction advocates. “They were opened to deal with the overdose problem that we had — not the increase that we’re dealing with. So they can’t handle the overflow that we’re seeing now,” Johnson said, citing a rash of drug overdose deaths in the past month that prompted police to issue a public alert.”
Mayor John Tory met with John and other harm reduction advocates for reassurance that the city’s staff and police will not attempt to take down the pop-up harm reduction site and would permit the harm reduction group to stay there.
The assurance was not given to the activists. Chair of the board of health, Joe Mihevc, told CBC News that the city of Toronto has been working to develop more city-sanctioned sites, but that this takes time.
Harm reduction activists appear to have been opening up these in the light of the delays.

 

References

Glover, C. (2017, August 11). 3 dead in Durham region from drug overdoses, fentanyl suspected. Retrieved from http://www.cbc.ca/news/canada/toronto/three-dead-durham-overdoses-1.4243468.

Nasser, S. (2017, August 11). Toronto’s 1st pop-up safe-injection site set to open without city’s blessing. Retrieved from http://www.cbc.ca/news/canada/toronto/toronto-overdose-prevention-pop-up-site-1.4244301.

Rieti, J. (2017, August 11). Toronto harm reduction advocates pushing for pop-up safe-injection sites. Retrieved from http://www.cbc.ca/news/canada/toronto/push-for-pop-up-injection-sites-1.4243020.

The Canadian Press. (2017, July 31). Spate of drug overdoses in Toronto wakeup call, experts say. Retrieved from http://www.cbc.ca/news/canada/toronto/toronto-ovedose-alert-1.4228660.  

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Scott Jacobsen

Scott Jacobsen

Member-at-large

Scott Douglas Jacobsen researches and presents independent panels, papers, and posters, and with varied research labs and groups, and part-time in landscaping (lifting, mowing, and raking) and gardening (digging, planting, and weeding). He founded In-Sight: Independent Interview-Based Journal and In-Sight Publishing. He is a Tobis Fellow (2016) at the University of California, Irvine’s (UCI) Interdisciplinary Center for the Scientific Study of Ethics and Morality (Ethics Center). He researches in the Learning Analytics Research Group, works as the Gordon Neighbourhood House Community Journalist/Blogger, researches and writes for the Marijuana Party of Canada, and is a contributor for The Voice Magazine. UCI Ethics Center awarded him with the distinction of Francisco Ayala Scholar (2014) for mentoring, presenting, researching, and writing. If you want to contact Scott, you may inquire or comment through e-mail: Scott.D.Jacobsen@Gmail.com.

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The New Alcohol Sales Policies will Increase Harm in Ontario

The New Alcohol Sales Policies will Increase Harm in Ontario

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.

Kyle Lumsden

Kyle Lumsden

Secretary

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.