The History, Current Prevalence, and Consequences of Drinking Problems in Canada

Abstract

Given its ubiquitous use over time and across many cultures, and its multitude of desirable effects for the user, alcohol has been described as "the world's number one psychoactive substance" (Ray & Ksir 1990). Although moderate drinking is a normative and accepted activity at social gatherings in Canadian culture, we also ironically view alcohol as an agent of disease and destruction. As in Scandinavian countries, there is has long been a preoccupation in Canada with drinking as a social problem (Smart 1985). As a result, Canada has been a world-leader in alcohol research for several decades (Smart 1985). Examining the history of alcohol use in Western civilization in general, and in Canadian culture in particular, can help clarify how we have come develop our ambivalent attitudes about this drug. History. For most of the past 10,000 years, alcoholic beverages were the most popular and common daily drink among people in Western civilization. However, according to Vallee (1998), Distinguished Senior Professor at Harvard Medical School, until the availability of sufficient clean, pure water supplies in the 19 th century, the health advantages of consuming alcohol far outweighed its dangers. In fact, alcohol was likely a very important source of fluids to meet the human need for physiological hydration in a world of contaminated water supplies. Alcohol was also very likely a crucial source of calories in meeting human energy requirements when groups faced food shortages. These health advantages earned alcohol the label "aqua vitae" or "the water of life" in the Middle Ages (Vallee 1998). By 6400 B.C., berry wines were being produced. The discovery of wine-making led to the domestication of particularly sweet grapes and the development of viniculture in what is now Armenia (Firestone & Korneluk 2003; Vallee 1998). Before the third millennium B.C., Egyptians and Babylonians were drinking beers that they made from barley and wheat (Vallee 1998). According to Vallee (1998), the alcohol content of these early wines and beers was very low by today's standards. It wasn't until around 700 A.D. (after about 9,000 years of use of low concentration alcohol in Western society) that the procedures involved in the distillation of spirits were discovered by Arabian alchemists (Firestone & Korneluk 2003; Vallee 1998). The advent of distillation led to the introduction of alcohol in much more concentrated form. This in turn led to the proliferation of beverages with sufficient alcohol content to contribute to widespread social and health problems that are directly related to alcohol use (Vallee 1998). The excessive use of alcohol has been reported throughout the ages (Firestone & Korneluk 2003; Vallee 1998). Alcohol was not a problem for Native Canadians until the French brought brandy and the British brought rum soon after immigrations from Europe began (Smart, 1985). Reports of the early missionaries contain many descriptions of intoxication among the natives and early settlers (e.g., Daily 1968); government control activities and anti-drinking movements quickly followed (Smart 1985). However, all 2 attempts to regulate alcohol use throughout the centuries have largely failed (Firestone & Korneluk 2003). In the 19 th century, the physician and American political figure Benjamin Rush began clinical research on the effects of prolonged consumption of hard liquor. Although his research was fuelled by his religious beliefs (i.e., Methodism), his research and publications provided an early description of symptoms associated with alcohol use disorders and the recognition of alcoholism as a chronic, life-threatening disease (Vallee 1998). Ideas such as these fuelled the Temperance Movement which allowed for the benefits of moderate drinking while morally condemning the heavy use of spirits (Vallee 1998). The Women's Christian Temperance Union tried to have alcohol education courses introduced into schools and was successful in several Canadian provinces (Smart 1985). The work of individuals such as Rush and the viewpoints expressed by proponents of the Temperance Movement paved the way for the American Prohibition (1919-1933). Although prohibition did reduce overall levels of use in the United States, it had some unintended side-effects such as increases in organized crime and bootlegging, some of which originated in Canada (Firestone & Korneluk 2003). These problems led to the repeal of Prohibition near the beginning of the Depression. Alcohol use steadily increased in the United States following Prohibition until it peaked in the 1980s. Canadian's per capita use of alcohol followed a comparable pattern (Firestone & Korneluk 2003). A longitudinal study by Mäkelä et al. (1981) compared alcohol use in Ontario, Canada to that in six other cultures (Switzerland, the United States, the Netherlands, Poland, Ireland, and Finland) from the years 1950 to 1980. Over the study period, alcohol consumption rose greatly in each culture studied. Variations between countries decreased over this time period, although great differences still existed by 1980. Throughout this time period, alcohol use in Ontario, Canada was on the upper end of the distribution of consumption of the seven countries studied, but remained lower than per capita consumption in Switzerland and the United States. Current Prevalence. An examination of Canadian liquor sales data shows a declining trend in alcohol sales through the 1980s and 1990s (see Canadian Profile 1999; Canadian Centre for Substance Abuse (CCSA)). Interestingly, however, this trend did not continue in most recent statistics. Liquor sales increased from 7.4 litres per person to 7.6 litres per person from 1995-96 to 1996-97. This is the first increase in per capita alcohol sales since the early 1980's (CCSA 1999). In 1996-97, the average Canadian spent almost $500 on alcohol. A 1993 survey of over 10,000 Canadians collected data on people's drinking habits (the General Social Survey, conducted by Statistics Canada; as cited in Firestone & Korneluk 2003). About three-quarters of those surveyed indicated that they had consumed some alcohol in the previous year. Another 18% were categorized as former drinkers and about 8% reported never having used alcohol. The rate of those drinking in the 12 months prior to the survey represented a significant reduction from rates in 1978 where 84% of those surveyed reported having consumed alcohol in the year prior to the survey. This significant decrease may be due to an increased awareness among Canadians about the risks associated with alcohol consumption and/or to the fact that during this time period, a larger proportion of the Canadian population moved into the 60+ age range where drinking rates decrease relative to rates of alcohol use in younger people (Firestone & Korneluk 2003).