There has been a significant rise in alcohol-related emergency department visits among women and young adults in Ontario, according to a new study published on Monday in the Canadian Medical Association Journal.
The findings were consistent with provincial and national data that show a rise in binge drinking and average weekly alcohol consumption. It’s the latest in a growing number of studies around the world that has found an increase in alcohol-related deaths and ER visits over the last 20 years or so, and highlighted the costly burden on the health-care system.
Dr. Daniel Myran, the lead author of the study, said researchers had expected to see increases. “But the extent of the increases that we saw were quite surprising,” said Myran, a family doctor and resident with University of Ottawa’s School of Epidemiology and Public Health.
“I find these increases alarming, and I think that policy-makers should find these increases alarming.”
The study by researchers in Ottawa looked at data over a 14-year period involving more than 15 million people in Ontario between the ages of 10 and 105, and examined trends over time based on sex, age and socioeconomic status.
The authors of the study said the findings suggested a potential need for the medical community to screen for unhealthy drinking and for services targeting demographics at higher risk. The findings also serve as a possible warning that younger Ontario residents may be falling into harmful drinking patterns, with potential long-term health care consequences in the future.
According to the Canadian Substance Use Costs and Harms, the economic impact in Ontario in 2014 from alcohol abuse was $5.34 billion, or $390.66 per person. This included health-care costs, lost productivity, and legal costs. Canada-wide, the cost surged to $14.64 billion for the same period, the website said.
The latest study looked at data involving 767,346 emergency visits “entirely caused by alcohol” in Ontario between 2003 and 2016 and found that visits by those between the ages of 25 and 29 rose 175 per cent. Within that age group, trips to the ER by women jumped 240 per cent and rose 145 per cent for men.
While men still made up the bulk of alcohol-related hospital visits, the rate of visits among women increased by more than 86 per cent, compared to a 53 per cent rise among men.
Middle-aged men made the most emergency room visits due to alcohol, but visits by girls and young women aged 15 to 24 were also growing, with more females under Ontario’s legal drinking age of 19 ending up in the ER than males.
Moreover, the number of ER visits due to alcohol was 4.4 times greater than the rise in ER visits for all other reasons combined, with 71.7 per cent of alcohol-related codes listed as the primary reason for hospital visits in 2016.
Intoxication was the most common diagnostic code, followed by harmful use, withdrawal and alcohol dependence.
Those living in low-income neighbourhoods visited the emergency department for alcohol-linked reasons at twice the rate of those living in areas with the highest income, according to the data, though only modest increases were observed over the 14-year study period, compared to U.S. trends.
The study did not focus on the underlying causes for the rise in alcohol-related ER visits. Much of the data predated recent changes to alcohol sales in Ontario, and was collected during a time when provincial regulations around pricing and where it can be purchased were stricter.
“This makes you concerned that the causes that led to these increases are unknown and could be ongoing,” Myran said in a phone interview, adding that there is a lot of evidence and research that suggests regulating the price of alcohol, putting restrictions on the hours it can be sold and where it can be sold, and controlling who advertisers target, are effective in limiting dangerous alcohol consumption.
The study noted that advertising rules around alcohol are less tightly regulated in both Ontario and Canada, and pointed to anecdotal evidence that marketing directed at women has been on the rise.
Myran said coolers, and other pre-mixed, sugary and fruity alcoholic beverages targeted at youth and especially young women - known as “alcohol pops” in the medical community - could “certainly be a contributor” to the increase in harmful drinking.
Last year, the Ontario government introduced “buck-a-beer,” decreasing the minimum price of a bottle or a can of beer to $1. Earlier this year, the province began loosening rules around when alcohol can be served and where it can be consumed as part of a broader campaign promise by Premier Doug Ford to make alcoholic drinks more widely available.
“I would be worried that any reversal or removal of policy could lead to more harmful drinking in the future,” said Myran, adding that he hopes the study will spur more conversation among Canadians around their relationship with drinking, and also prompt governments at all levels to look at implementing policies that will reduce alcohol abuse.
Despite the regulatory changes, the Ontario government said it was committed to supporting responsible drinking, addiction prevention, and helping those requiring treatment, through educational programs and funding ConnexOntario, which provides live 24/7 assistance and referrals to addiction treatment services.
“The government is committed to developing and implementing a comprehensive and connected mental health and addictions strategy in Ontario, with a historic new investment of $3.8 billion that will support those struggling with addiction and provide them with the help they need,” said David Jensen, a spokesman with the Ontario Ministry of Health, in a statement.