Convenient access to alcohol is going to cost us

Purchasing beer, wine, cider and ready-to-drink cocktails is about to get a lot easier in Ontario. What’s now limited to 1,100 LCBOs and Beer Stores will balloon to 8,500 retail outlets by November. This includes grocery, convenience and big box stores. Without a doubt, this vast array of new options will add convenience, but it comes at a steep cost to healthcare and government coffers.

Making alcohol more accessible will increase use and the injuries and violence that come with it. It will profoundly affect people already struggling emotionally, and because of its highly addictive nature and because it deepens depression and exacerbates anxiety while increasing suicide risk. It also raises blood pressure, worsens diabetes and increases the risk of having—and dying from—a heart attack, stroke, or several cancers, including cancers of the breast, colorectal, liver, stomach, and pancreas.

Expanding alcohol’s availability to retail stores will make enforcing its safe sale far more difficult. According to its website, the LCBO challenged 12 million purchases last year from people thought to be under 25 or who appeared to be intoxicated. Such challenges will be tougher when many thousands of retailers, operating under less oversight, are asked to balance profits against the interests of public health. This could prove especially damaging to those under 19, and be detrimental to the mental health of Ontario’s 1-in-5 children and youth already struggling with their psychological well being, not to mention their caregivers and loved ones.

The U.S. offers cool comfort in expanding alcohol’s availability. Alcohol has been widely available for years in retail outlets and even in pharmacies. But unlike our neighbors to the south, Canada has a binding social contract to provide universal healthcare, an agreement that the added shopping convenience for alcohol threatens.

All this comes at a time when diagnoses and treatments are being delayed in the face of unprecedented widespread healthcare staffing shortages. 1-in-6 Ontarians currently lack a family doctor, a number that’s expected to rise to 1-in-4 by 2026. ER waits in Ontario average 22 hours before being admitted, nearly three times the recommended provincial target. Even worse, several Ontario ERs have limited their hours due to insufficient healthcare staff.

These many inevitable, foreseeable and catastrophic harms have prompted immediate calls-to-action from Ontario’s top medical associations. Public outcries have come from Ontario’s Chief Medical Officer of Health, Dr. Kieran Moore, the Canadian Mental Health Association, the Centre for Addiction and Mental Health and the Registered Nurses’ Association, to name a few.

Yet these well-founded concerns have fallen on deaf ears. How the added demands on healthcare will be met has yet to be addressed. The only solution on offer by Ontario’s government so far is a paltry $10 million that’s doled out over five years, a figure that doesn’t begin to move the needle on an annual mental health budget that exceeds $3.8 billion.

Some may believe that revenues generated from alcohol will offset its costs. Not so, according to a rigorous breakdown by the Canadian Centre on Substance Use and Addiction. An extensive review showed that while alcohol sales in 2020 put $3.2 billion into Ontario’s coffers, they came at a cost of $7.1 billion. That left the province with an alcohol deficit of $3.9 billion. Healthcare accounted for $2.3 billion. The rest went to servicing alcohol-related criminal justice and lost production costs. These figures reflect a deficit capped by the limited number of LCBO and Beer Stores, a limit that will soon cease to exist.

Having the convenience to purchase alcohol comes at grave costs that cannot be blithely ignored or dismissed. It’s a severe blow to Canada’s already fraying promise to provide timely access to healthcare as well as a burden to Ontario’s already massive debt. Turning a blind eye to its profound price tag will erode Canada’s social contract and is an affront to public health and fiscal management.


^{Iris Gorfinkel is a family physician, clinical researcher and medical contributor to CBC radio.}