Lagacé on the alcohol guidelines
Patrick Lagacé has written about the new alcohol guidelines: La drogue la plus dangereuse, La drogue la plus dangereuse 2, and Thursday’s followup. Lagacé is only saying here that he’s happy to have access to the facts so he can decide how to proceed, after an outcry from his readers (Et vous avez hurlé, mon Dieu que vous avez hurlé !).
Joey 14:40 on 2023-01-19 Permalink
It’s interesting that the government that has been extremely unwillig to allow its cannabis store to sell anything that might remotely appeal to a young person (e.g., gummies, chocolates) if they have a small amount of THC in them also oversees an alcohol store (and alcohol sales framework) that seems to sell nothing but high-alcohol soda, seltzer, etc. Lagace, not for the first time, raises the immense contradiction between how governments in Canada treat cannabis vs. alocohol, pointing out that the various costs associated with alcohol (healthcare, justice, lost productivity, etc.) are both individuall and cumulatively much higher than the corresponding costs associated with cannabis (also opioids, cocaine, tobacco aside from healthcare costs, which are about even, etc.). On one level this is perfectly understandable – if alcohol had only come out of prohibition in 2019 it would be sold very differently than it is now – but on another it reeks of hypocrisy and very narrow puritanism.
Our attitude to alcohol is carte blanche (how many fatal accidents involving alcohol include a driver who has previous DUIs?), as is our approach to gambling – just tune in to any sporting event now, it’s all about making best. We treat weed with extreme kid gloves and we are thisclose to leaving opioid addicts all on their own.
shawn 14:49 on 2023-01-19 Permalink
As a cannabis user I’m somewhat sympathetic to the government position in this one case. There are too many instances of accidental cannabis ingestion by kids with candy-like edibles. You simply can’t have that with alcohol, which has a distinctive (and unpleasant) taste.
Blork 15:20 on 2023-01-19 Permalink
In the previous thread, MarcG helped put some concrete numbers on the risks by digging into the report and coming up with this: “Risk Associated with Weekly Levels of Alcohol Use” section: 2 drinks per week = 1 in 1,000 risk of premature death, 3 to 6 drinks per week = 1 in 100 risk of premature death.
This got me thinking about what that “1 in 100 risk of premature death” means, or at least how it can be interpreted. “1 in 100” sounds like a lot (especially after the jump from “1 in 1000”) but stated another way — 1% — it doesn’t sound so dire. (“Drinking 3 to six drinks per week gives you a 1% chance of premature death.”) Also, what does “premature” mean? It’s not like “you have a 1% chance of dying from this surgery” in which case if you hit that 1% you die right away. This means that with 3-6 drinks per week you have a 1% chance of dying at some point before your average life expectancy. So maybe 75? 80? 82?
Here’s the thought experiment I ran on myself: Imagine you love Thai food. You eat it several times a week, and it’s always a convivial thing that you share with friends and it makes up a big part of your social life. You love to eat it, to talk about it, etc. and it forms a big part of your identity because it’s something that your parents did, and their parents, etc.
Then one day you develop an ulcer that makes eating Thai food dangerous and unbearably painful. You can no longer eat Thai food. You can still go to the restaurant and whatnot, but you have to sit there eating toast while your friends enjoy themselves eating the fantastic Thai food that you love.
One day a doctor tells you they can perform a surgery that will cure the ulcer, after which you can go back to eating Thai food. BUT! There is a 1% chance that at some point in the next 30 years a complication will develop that will cause you to die.
What do you do? Do you play it safe and avoid the Thai food that you love for the rest of your life? Do you give up on some or all of those convivial meals with friends? Or do you get the surgery so you can continue to enjoy something that has been an important and pleasureable part of your entire adult life, takiing the 1% chance that it might one day prove fatal? (There is no right or wrong answer: this is about re-contextualizing that 1% risk. Only you can decide what’s right for you.)
Disclaimer: the above thought experiement only really applies to middle-aged people who drink socially because they like it and it has long been an important part of their social lives and thus their sense of themselves. Does not apply to young people who have never really established that. ALSO: the goal is not to dismiss the risk, it’s to put it in a different context and see if it still stands with the same sense of urgency or gravitas.
Blork 15:20 on 2023-01-19 Permalink
And with that, I promise no more long comments for at least a week! 🙂
MarcG 16:31 on 2023-01-19 Permalink
@Blork: There’s another table in the report that shows years of life lost per 1000 people. If you add up all the cancers and divide by 1000 you get 0.1407 for men who have 2 drinks a day. Not sure if my math is right, but that seems to me like about a month and a half of life lost compared to 6 days for someone who has the low-risk 2 drinks a week.
MarcG 16:33 on 2023-01-19 Permalink
The biggest life-shorteners seems to be “Intentional injuries” (self-harm and suicide?) and liver cirrhosis which dramatically increase when you get into 2+ drinks per day.
MarcG 16:44 on 2023-01-19 Permalink
If you add up all of the Bad Things in the table (for men who have 2 drinks per day) the average years of life lost per person is 8.5 months. Smoking cigarettes is ~10 years.
Ephraim 16:45 on 2023-01-19 Permalink
Reminds me of the statistic that no one talks about… drinking and driving is less dangerous than drinking and walking. The difference is that with drinking and driving the likelihood is that others may die. In drinking and walking, it’s YOU that are more likely to die. You are 8 times more likely to die from drunk walking than drunk driving… per km or mile. See https://freakonomics.com/podcast/the-perils-of-drunk-walking/ for a discussion of impaired walking (and an explanation as to why New Year’s is the deadliest day for pedestrians… weird, isn’t it?
Blork 17:04 on 2023-01-19 Permalink
OMG, Ephraim, I can just imagine the conversation between a couple of drunks stumbling out of a bar.
DRUNK FRED: Come on ya smelly bastard, we’re too drunk to drive. We’re walking home.
DRUNK BOB: G’wan ya lit bastard. We’re driving home because it’s safer. I read it in “Freakonomics.”
DRUNK FRED: Game on! Fire up the Chevy!
Kevin 18:21 on 2023-01-19 Permalink
Blork
It’s not just the shorter life — it’s how poor health degrades the quality of your life for several years.
For example, you can live 5 or 10 years with emphysema — but you’ll feel it. COPD and nerve damage from smoking? You can live for decades with that and be aware of it all day long.
I’m not afraid of growing old. I’m afraid of being frail and sickly.
GC 19:42 on 2023-01-19 Permalink
Yeah, “your life might be two months shorter unless you stop doing this thing you like” is not that compelling when you’re middle-aged or younger. BUT, if it means not spending your last ten years highly ill…that’s a bit more convincing.
carswelll 20:23 on 2023-01-19 Permalink
A conseiller at an SAQ Sélection store just wrote me saying “One out of two customers has mentioned this in the last two days.” Will be interesting to see if the public health announcement/scare tactics (depending on your point of view) has an immediate and lasting effect on beverage alcohol sales.
MarcG 20:28 on 2023-01-19 Permalink
Good points about quality vs. length of days.
Ephraim 22:10 on 2023-01-19 Permalink
@Blork – Problem is that people usually drive further than they walk. And that the statistic refers to those who walking/driving, not the people that they hit with their car (or even the occupant who hits them… remember René Lévesque and Edgar Trottier… he dragged the body over 30m and they never tested Lévesque for his blood alcohol level… but they did test the body of Edgar Trottier)
Blork 10:23 on 2023-01-20 Permalink
True enough about not wanting to be ill in your old age. Which leads to another thought experiment: imagine what you want your life to be like in 20 years time. Now figure out what you need to do in order for your life to be like that when the time comes. If “being very healthy and vivacious” is a top priority then that 1% looms much larger than in the previous thought experiment.