What Are The New Guidelines For Alcohol in Canada?

Regulating anything — let alone alcohol — is a tricky task. As Aldous Huxley writes in The Doors of Perception / Heaven and Hell, “The problems raised by alcohol and tobacco cannot, it goes without saying, be solved by prohibition. The universal and ever-present urge to self-transcendence is not to be abolished by slamming the currently popular Doors in the Wall. The only reasonable policy is to open other, better doors in the hope of inducing men and women to exchange their old bad habits for new and less harmful ones.”

While Huxley is actually talking about hallucinogens in this quote, the same goes for alcohol as well: as we learned the hard way from the Prohibition Era, you can’t tell people not to drink, especially if you’re the government.

Instead, modern governments frame their advice as guidelines for safe alcohol use and present them as health initiatives backed by scientific evidence. We are free to choose what we do with that information, and nobody over a certain age (19 in Canada, 21 in the United States) is likely to be prohibited from drinking in North America (as long as they’re not behind the wheel, performing surgery, working on a construction site, or doing anything else where their impairment would pose a risk to others).

However, when it comes to Canada’s new guidelines for safe alcohol consumption, some folks have been left a bit shaken. The guidelines, passed in 2023 after extensive review by the Canadian Centre on Substance Use and Addiction (CCSA), urge Canadians to set a 2- drink weekly limit to avoid potential health risks. Canadian experts argue that the latest evidence proves no amount of alcohol is truly safe.

Global Guidelines for Alcohol Use: A Few Examples From Europe

What are alcohol guidelines in the first place, and what are they based on? Every country is different, but usually guidelines are set by governments according to scientific research and influenced by the cultural traditions of the population.

The World Health Organization reports that Europeans drink the most alcohol of all regions and advises that no amount of alcohol is safe. In light of that position, let’s look at a brief overview of drinking guidelines in Europe according to the 2023 European Commission report:

• The United Kingdom defines a “unit” of alcohol as 8 grams and advises Britons to stick to 14 or fewer drinks per week with some alcohol-free days sprinkled in. This amount is about the same as 6 pints of average-strength beer or 10 small glasses of low-strength wine.
• Germany and Italy consider a “unit” to be 10-12 grams (one glass of wine, a beer, or a shot) and recommend staying at or below 2 drinks per day for men and 1 drink per day for women.
• France advises its citizens to have “not more than 10 standard [10-gram] drinks per week, never more than 2 standard drinks per day, and at least one alcohol-free day per week.”
• Ireland considers as many as 17 standard (10-gram) drinks per week to be okay for men and 11 for women but advises at least 2 booze-free days.
• Sweden has a more conservative stance on alcohol consumption, recommending no more than 10 standard drinks per week for men and no more than 5 standard drinks per week for women, with at least two alcohol-free days to minimize risk.
• The Netherlands stands out from the rest with the recommendation of no booze at all — “or at least not more than one glass per day” for all genders. 

How do these recommendations compare to those in North America?

• The United States isn’t too far off from its European counterparts. Alcohol guidelines in the U.S. are outlined by the 2020–2025 Dietary Guidelines for Americans, which states that adults of legal drinking age can choose not to drink or to drink in moderation by limiting intake to 2 drinks or fewer in a day for men and 1 drink or less in a day for women when alcohol is consumed. Drinking less is better for health than drinking more.
• Canada, on the other hand, has been making headlines with its new regulations. The most current guidelines state that no amount of alcohol is safe and recommends no more than 2 drinks per week for men and women alike. One standard drink there is defined as 17.05 ml (or 13.45 grams) of pure alcohol — the equivalent of a 12-ounce bottle of beer or cider, a 5-ounce glass of wine, or a 1.5-ounce shot of hard liquor. 

Canadian Alcohol Guidelines: The Full Story

The current report is the final result of the guideline review initiative launched in 2020 by the CCSA. The guidelines were developed in 2011, but since then “the evidence on the impact of alcohol on health and its contribution to social harms has advanced considerably.” The update, in turn, addresses these new findings. 

The main message of the report is loud and clear: “We now know that even a small amount of alcohol can be damaging to health.” 

According to CTV News, “While acknowledging that 40 percent of people living in Canada aged 15 and older consume more than six standard drinks per week, the report warns that no amount of alcohol is safe to consume.” Instead, it “recommends a new cap on weekly alcohol consumption that is significantly lower than the previous one” — 2 drinks per week for both men and women — and suggests that those who are breastfeeding or trying to conceive should skip the booze altogether.

A “Continuum of Risk”

The report lays out a “continuum of risk associated with average weekly alcohol consumption” to make it clear what low vs. moderate or high risk really looks like. Here’s the summary of the risks, as outlined in Canada’s Guidance on Alcohol and Health: Final Report: 

• 0 drinks per week poses no risk. “Not drinking has benefits, such as better health and better sleep.”
• 1-2 drinks per week is considered low risk. “You will likely avoid alcohol-related consequences for yourself and others.”
• 3-6 drinks per week represents moderate risk. “Your risk for developing several different types of cancer, including breast and colon cancer, increases.”
• 7 or more drinks per week is considered high risk. “Your risk of heart disease or stroke increases.” Moreover, each additional drink in this category “radically increases the risk of these alcohol-related consequences.”

Here’s how Taryn Grieder, a professor of psychology at the University of Toronto, sums it up: 

“Alcohol is a psychoactive drug. Occasional use isn’t going to have really significant effects. Even if you occasionally use something like heroin, you probably wouldn’t see significant effects on your life. But that’s the thing: people aren’t using alcohol occasionally — they’re using it every day … The hope is that people will moderate their usage and not drink every day, because we’ve seen research that has shown that alcohol is a carcinogen.”

Reasons Behind the New Canadian Alcohol Guidelines

So what type of risk are we talking about exactly? The report goes into detail about the most recent research regarding the health issues caused by alcohol.

• Alcohol and cancer. The report points to alcohol as a major carcinogen that’s often overlooked (especially when compared to substances such as nicotine). And yet, alcohol is responsible for roughly 7,000 cancer deaths in Canada every year! The authors go on to cite the Canadian Cancer Society, which suggests that cutting back on drinking is one of the top 10 ways people can reduce their cancer risk.
• Alcohol and heart disease. Heart disease follows cancer as the second leading cause of death in Canada. While popular science has touted alcohol (especially red wine) as a way to help prevent heart disease when used in moderation, recent research has exposed many flaws in previous studies and suggests that the link is a lot less clear. What is clear, however, is that excessive alcohol use can lead to heart problems such as hypertension, heart failure, high blood pressure, atrial fibrillation, and hemorrhagic stroke.
• Alcohol and liver disease. Last but not least, alcohol is the main culprit behind liver disease in Canada and globally. Drinking too much (even for a few days) can cause fat buildup in the liver, which is a precursor to more serious types of liver conditions, such as cirrhosis.

The Full Picture

The report goes on to describe the many other public health consequences of alcohol consumption beyond the risks to personal health.

• Binge drinking. The report explains that binge drinking — having 5 or more drinks in a single drinking session — is especially dangerous. Even doing so once in a while poses significant risks of injury and possible alcohol poisoning.
• Risks for men. The writers mention that men, in general, tend to drink more and are “more likely to drink in excess.” Unsurprisingly, this means that men are more likely to end up in alcohol-related accidents and face a higher risk of health problems and injuries associated with drinking.
• Risks for women. Pregnancy and breastfeeding are times when drinking is an absolute no-go according to the report. While men might be more likely to face alcohol-related consequences simply due to the fact that they tend to drink more, it takes less booze for women to develop the same problems. The difference has to do with fat distribution patterns associated with female hormones (you can read more in our blog about alcohol and women). The report mentions that there are several other factors at play, including body size, enzymes, and differences in genetics and metabolism that add up to higher risk of disease, such as breast cancer and liver damage.
• Alcohol and violence. The report also talks about aggression and violence as a fallout of excessive drinking. Intimate partner abuse, as well as gender-based violence, tends to be especially common and is a major concern.

Implications of the New Canadian Alcohol Guidelines

Needless to say, the report hasn’t gone unnoticed in Canada (or outside its borders) — and many people are up in arms about it. Some disagree outright, some say the report is greatly exaggerated and borders on fear mongering, while others say it’s simply talking about risk assessment and shouldn’t be taken at face value.

A CBC article focuses on the fact that the report is based on risk analysis: “It outlines exactly how many years of life — averaged over the lives of 1,000 males and 1,000 females — would be lost, depending on how many drinks they ingested per week and what disease they had.” The article goes on to suggest that these calculations of risk don’t translate all that well into realistic advice for actual (not hypothetical or “average”) people, and should therefore be taken with a grain of salt.

The “Right To Know”

Still, the science is pretty clear when it comes to what alcohol does to our bodies and minds, so it makes sense to revisit this subject now that more information is available. It also goes without saying that this information should be accessible to everyone. There have been many myths about alcohol and even scientific studies that have been quietly debunked. For example, there’s the idea that moderate drinkers supposedly have a lower risk of mortality than nondrinkers — an idea that was based on studies with serious flaws.

Ultimately, Canada’s new guidelines come down to providing the public with all of the information necessary for each person to make the decision that’s best for them. Professor of family medicine at the University of Saskatchewan Peter Butt told The Guardian, “We wanted to [simply present] the evidence to the Canadian public, so they could reflect on their drinking and make informed decisions … It’s fundamentally based on the right to know.”

Tips for Staying Safe

The report also provides some tips for safety around alcohol, which can be useful for anyone trying to watch their intake:

1. Set limits. Set limits before you go out and keep yourself accountable (better yet, use an app such as Reframe to help!).

2. Take it slow. There’s no rush — drinking slowly can help you stay within your limits.

3. Drink water and alternate between drinks. For every alcoholic drink, have a non-alcoholic one (or better yet, a glass of water to keep yourself hydrated!).

4. Eat before you drink. Having food in your stomach will help absorb the alcohol, reducing the rate at which it hits your system and mitigating the effects.

5. Take breaks and get sober-curious. There’s a whole world out there to explore! Make it a habit to try booze-free activities on a regular basis.

Summing Up

In the end, alcohol guidelines in any country are just that — guidelines. It’s up to us to make decisions based on the knowledge we gather from various sources, our own life experience, and knowledge of ourselves. When it comes to deciding what role we would like alcohol to play in our lives, it’s best to keep an open mind and approach the question in the spirit of exploration and curiosity. After all, there is so much to discover in sobriety. Letting our views of alcohol evolve as we learn more about alcohol and how it affects our bodies and minds can only make our lives better.