B.C. No. 1 province for hospitalization caused solely by alcohol abuse: federal report

B.C. had nearly 15,000 hospital admissions in 2015-16 due to alcohol abuse, making it No. 1 among the provinces in that category, according to a new federal report.

High volumes of alcohol sales and heavy drinking are related to high hospitalization rates. While the national age-standardized rate for hospital admissions entirely caused by alcohol was 239 per 100,000 population, in B.C. it was 349. (The three territories had higher rates than the provinces.) Although the opioid addiction crisis has garnered all the attention, hospitalizations caused entirely by alcohol are 16 times greater than those for opioids, the report shows.

Alcohol abuse is a leading risk factor for death and disability, not to mention the cause of many social harms like accidents. The report by the Canadian Institute for Health Information (CIHI) shows that on average, provinces spend $8,100 every time someone is hospitalized for an average of 11 days because of the ravages of heavy drinking. That’s longer and costlier than the $5,800 spent on most other hospital stays. The number of admissions would be even higher but short visits to the emergency department for problems like alcohol poisoning were not included in the data, only admissions to medical wards for several nights.

Across Canada, hospitalizations entirely caused by alcohol (77,000) exceeded those caused by heart attacks (75,000). Most hospital admissions caused by alcohol related to mental health and behavioural disorders including chronic use disorder, withdrawal, alcohol poisoning or delirium, liver disease, pancreatitis and hepatitis.

Within provinces, there are regional variations such that rural and remote areas had higher hospitalization rates than urban areas. In B.C., the Northern Health region has a hospitalization rate of 532 per 100,000 compared to Vancouver Coastal Health’s rate of 262 per 100,000. The explanation for high hospital admission rates in rural and remote areas is poor access to alternatives for treatment outside of hospitals.

Hospitalizations caused by alcohol are more common in low-income neighbourhoods than high-income neighbourhoods, yet the study points out there is a known “alcohol harm paradox” since previous research has shown that low-income groups typically drink less than wealthy individuals. The paradox relates to greater susceptibility to the consequences associated with living on a lower income: More stress, fewer social supports, less resources to cope, more binge drinking and poor diets.

Geoff Hynes, manager of population health at CIHI, said the B.C. data showing hospitalizations being significantly higher here than the Canadian average are indeed surprising.  “B.C. was average in terms of (Statistics Canada) self reports of heavy drinking, but B.C. had higher sales than the Canadian average and higher per capita consumption (8.7 litres) compared to the Canadian average of 8.1 litres per capita,” he said.

The report shows B.C. residents may be in denial about the extent of their drinking habits and potential harms. When polled, only 15.8 per cent reported heavy drinking (more than five drinks per day at least once per month) yet per capita consumption of alcohol is, as Hynes points out, among the highest of the provinces (slightly behind Newfoundland and Alberta).

Dr. Perry Kendall, provincial health officer, said B.C.’s high per capita alcohol consumption levels are related to hospitalizations and other deleterious effects.  “The consultation led by John Yap on modernizing B.C.’s liquor laws and regulations ended up making alcohol more accessible,” said Kendall. “More is being consumed as there are now more opportunities to do so.  “As consumption goes up, however, so do harms,” he added, noting he’s in the midst of preparing an evaluation of recent changes made by the provincial government to alcohol policies.

Kendall said public health and law enforcement experts issued warnings about the negative consequences of increasing access to alcohol and he published two reports on alcohol policy and its impact. He also made recommendations on access and pricing.  Asked if he felt his recommendations fell on deaf ears, Kendall said: “I wouldn’t say that. The renewal of the alcohol policy framework did include a number of public health supported initiatives and recommendations. However as it turns out, these did not offset the impact of increasing access and consumption.”

Hynes said just as raising tobacco prices has been effective at reducing smoking rates, raising liquor prices has been proven to curtail alcohol consumption and is a policy B.C. could consider pursuing, especially for liquor with the highest alcohol content.

Tim Stockwell, a University of Victoria professor and director of the Centre for Addictions Research of B.C., said the evidence shows that price increases of at least 10 per cent cause reductions in hospitalizations for chronic alcohol-related diseases.  “Consumption of alcohol in B.C. has been increasing about three times faster than in the rest of Canada in recent years, coinciding with liquor reforms,” said Stockwell.

“Alcohol-related hospitalizations now surpass hospitalizations caused by tobacco in most parts of the province and are substantially higher than hospitalizations caused by illicit drugs. But deaths from opioids get more attention because they appear to be more visible and more dramatic.”

Full article