risk – Page 3 – Matters of Substance

It is now timely to consider how liquor laws can promote the health and safety of all British Columbians as BC has decided to review its liquor policies for the first time since 1999. Drinking patterns change over time and often new products emerge. One such emerging issue is the growing practice of mixing energy drinks with alcohol.

The consumption of energy drinks has gained in popularity and the practice of mixing them with alcohol has become commonly adopted by young adults in Canada. Energy drinks are widely available in liquor outlets and at drinking events where they are also often heavily promoted. When cocktails which mix energy drinks with alcohol are ordered at drinking establishments, sometimes a pre-mixed cocktail is served and sometimes the customer has to mix the cocktail themselves.

Despite the regular practice of mixing alcohol with energy drinks (which may occur for several reasons), the labels of energy drinks warn against their consumption with alcohol. Mixing them with alcohol is not approved by Health Canada and is advised against. As reported by the media and in scientific research, multiple hospitalizations, deaths, and other adverse consequences have been associated with the consumption of alcohol and energy drinks. Researchers have found that the consumption of alcohol and energy drinks, compared to alcohol use alone, is associated with an increased risk of heavy alcohol use, requiring medical treatment, being hurt or injured, drinking and driving, and engaging in high-risk sexual behaviours.

In response to more general concerns regarding the safety of energy drinks, Canadian policy makers have considered implementing regulations on energy drinks, although these regulations appear to have fallen short in terms of addressing the mixing of energy drinks with alcohol (see policy report for more details). Other countries (e.g., U.S.) have addressed safety issues with energy drinks and alcohol by banning the production and sale of high-risk alcoholic energy drinks (high alcohol content cocktails marketed as energy drinks). In Canada, some provinces have limited the amount of caffeine which can be permitted in an alcoholic beverage to 30mg/beverage. This regulation is a step forward in protecting the health and safety of Canadian consumers, although it fails to address the hand-mixing of alcohol and energy drinks which is more common. It also does not address the availability of energy drinks in establishments where alcohol is sold.

Although the research in this field has its limitations, risks associated with combining alcohol and energy drinks has been identified. In these circumstances, liquor laws need to be adapted. Should alcohol establishments be permitted to sell energy drinks mixed with alcohol? Should energy drinks be sold in drinking establishments? Should energy drinks be heavily marketed in these establishments? A transparent discussion of this emerging public health issue is surely warranted in the context of the current policy review.

Should a modern BC liquor policy include regulations on selling high caffeine content energy drinks in risky environments like bars and clubs?

Author: Kristina Brache

While we know that there are individual risks associated with consuming alcohol, such as acute injuries or chronic diseases such as liver cirrhosis, how often do we think about the impact that our own alcohol use has on those around us? Alcohol use has many potential negative secondhand effects including stress to relationships, impacts on other’s health and safety (e.g. on the roads, in the streets late at night, in the workplace), violence and property crime, developmental problems in children and substantial economic costs. For example, in 2012 alone there were 17,888 alcohol-related violent crimes committed in BC.

Looking at the overall impact of all these second-hand effects of alcohol has been an important focus of research in recent years. When smoking was linked with cancer and people became aware of the effects of second hand smoke, we began to see major developments in tobacco policy designed to protect those affected by other people’s smoking. The same is true of changes to drinking and driving policies and to some degree initiatives to prevent Fetal Alcohol Spectrum Disorder (FASD)—when innocent people are harmed it gets people’s attention and this can pave the way for change.

While there is limited data on this specific to Canada, three Canadian studies conducted between 2004 and 2008 found that nearly one in three adults reported experiencing one or more types of harm resulting from someone else’s drinking in the past 12 months. In contrast, according to the Canadian Alcohol and Drug Use Monitoring Survey results for 2010, of those who drank alcohol in the past year fewer than one in ten reported experiencing any harm to self, showing that individuals are much more likely to be affected my others drinking than their own drinking.

Do we need to use a wider-lens when we think about the impact of alcohol use? Would social norms around alcohol use change significantly if we started taking harms to others more seriously? Many individuals are ‘responsible’ drinkers, but others are often not. Moreover, our level of responsibility declines as our level of consumption increases. Liquor laws help protect everyone, drinkers and non-drinkers and we need to carefully consider how access to cheap alcohol affects drinkers and non-drinkers alike.

Now probably the most important question is what can we do about harm to others? There are many specific measures to reduce these harms that can be applied in different contexts e.g. policing late-night drinking venues, deterring impaired driving and also more general measures which target hazardous drinking in the whole population. CARBC research shows that while BC leads in some areas of alcohol policy it also lags well behind in others and, overall is only achieving half its potential for alcohol harm reduction – both for drinkers and those around them.

How important is it that we implement evidence-based policies that can reduce harm for everyone?

Authors: Kate Vallance (pictured), Kara Thompson, Ashley Wettlaufer

Tag: risk

A “modern” drinking practice: Alcohol and energy drinks

Harm to others: Is alcohol just a private matter?