Addictions
Governments ease alcohol access as evidence of its harms mount
By Alexandra Keeler
From cancer to heart disease to brain damage, the evidence of alcohol’s harms is mounting. So why are governments making it easier to drink?
In May, shortly after Parliament resumed, Quebec Senator Patrick Brazeau introduced Bill S-202, a private member’s bill to require nearly all alcoholic beverages to carry health warning labels.
“As a former alcohol consumer, I was once in the 75 per cent of Canadians who are not aware that there is a causal link between alcohol consumption and seven cancers,” Brazeau told the House of Commons on June 3.
“I personally battled colon cancer several years ago, so much so that when I received treatment, I felt I was being killed inside.”
Brazeau is something of an outlier in government. Public health experts say Canadian governments are not doing enough to address alcohol’s known health risks — and that the alcohol industry is a big part of the problem.
“We’ve known about the carcinogenic effects of alcohol since the 80s,” said Peter Butt, a University of Saskatchewan researcher and co-chair of Canada’s latest drinking guidelines. “But there are no warning labels, so the consumer is given false confidence.
“Some of this falls at the doorstep of the government, because they regulate the labeling.”
Alcohol harms
Today, the World Health Organization warns that alcohol harms nearly every system in the body.
The International Agency for Research on Cancer classifies alcohol as a cause of six cancers.
Chronic alcohol use raises the risks of liver and heart disease, brain damage, mental health issues, injuries and fetal alcohol spectrum disorders.
In Canada, the federal government oversees labeling and public health messaging rules, while the provinces control liquor sales and drinking ages.
In January 2023, Health Canada released updated national alcohol guidelines in response to the growing evidence of alcohol-related harms. This new guidance marked a major departure from its 2011 recommendations, which had suggested women not exceed 10 drinks per week and men not exceed 15.
The new guidelines have a sober message: no amount of alcohol is risk-free, and risk rises significantly with more than two drinks a week.
“We didn’t say you shouldn’t drink more than two standard drinks a week. We said you should reduce the amount that you drink,” said Butt, who co-chaired the team that updated the guidelines.
“The consumer had a right to know.”
Mixed messages
Aside from tightening its guidelines, Canadian governments have done little to better protect the public.
Public health experts say one major flashpoint has been warning labels. In general, drinks with greater than 0.5 per cent alcohol content are exempt from standard food and beverage labeling requirements.
“Even bottled water or non-alcoholic beer has to have the nutrition facts because it doesn’t have enough alcohol in it to get the exemption,” said Adam Sherk, a research scientist at the Canadian Centre for Substance Use and Addiction who also advised on Canada’s updated alcohol guidelines.
The Canadian Cancer Society has been advocating for labels on alcohol products since 2017. The Canadian Institute for Substance Use Research has done the same since 2023. But Health Canada has not initiated any regulatory process to mandate warning labels for alcohol products.
Some research indicates such labels could reduce sales.
A 2020 study by the Yukon government and the Canadian Institute for Substance Use Research tested how warning labels affect consumer behaviour. It found labels did increase awareness and reduce sales.
Yukon pulled its label requirements after the alcohol industry threatened to sue the government.
Convenient
Labelling is just one of many measures governments could take to reduce alcohol-related harm.
In addition to labels, the Canadian Alcohol Policy Evaluation project recommends minimum unit pricing, marketing and advertising controls, and public education campaigns. No province or territory has fully implemented all of these measures.
“[T]he Canadian federal government has not adopted or only partially adopted many evidence based alcohol policies,” the project’s report reads.
Meanwhile, some provinces are moving in the opposite direction.
Nova Scotia is considering expanding retail options. In April, Quebec rejected a recommendation to lower its blood alcohol limit for drivers, despite repeated coroner warnings.
Ontario has gone the furthest.
The province plans to invest $175 million over five years to grow its alcohol sector. It has begun permitting alcohol sales in convenience stores for the first time — with up to 8,500 new retailers expected to carry alcohol by 2026. It has also scrapped previous limits on pack sizes and discount pricing.
In April 2024, the province’s chief medical officer, Dr. Kieran Moore, recommended raising the legal drinking age from 19 to 21. Premier Doug Ford rejected the idea, arguing that if 18-year-olds can enlist in the military, they should be allowed to drink.
“We believe in treating people like adults,” he told media at the time.
In late June, the province also approved alcohol consumption on so-called “pedal pubs” — large, multi-person bicycles equipped with a U-shaped bar, often used for tours or bachelor parties.
“There’s never been such a large increase in availability all at once,” said Sherk, calling Ontario’s expansion “unprecedented.”
False profits
Tim Stockwell, a University of Victoria professor and former director of the Canadian Institute for Substance Use Research, says corporate influence helps explain why governments are failing to address alcohol’s health risks.
“Evidence for harms from alcohol has been with us for decades and has only strengthened,” said Stockwell. “Commercial vested interests have always dominated the policy sphere.”
Federal lobbying records show Beer Canada has routinely targeted Health Canada and more than two dozen federal agencies to influence policy on labeling, taxation and public health messaging. This includes closed-door meetings with MPs and senior officials from the Department of Finance and Agriculture Canada.
Beer Canada did not respond to multiple requests for comment by press time. Spirits Canada and Molson Coors Beverage Company also did not respond to multiple requests for comment.
Butt, of the University of Saskatchewan, says the money governments generate from alcohol sales creates a conflict with their public health mandate.
Federal and provincial governments generate revenue from alcohol through a range of mechanisms, including excise taxes, provincial markups, sales taxes and licensing fees. In some provinces, governments also earn profits from government-run liquor stores.
“[Governments] look at it from a lost revenue perspective, rather than from a public health perspective,” said Butt.
Ian Culbert, of Public Health Canada, puts it more bluntly. “Governments have a substance sales issue, as opposed to a substance use issue,” he said. “But it’s short-term gain for long-term pain.”
“Public Health wants to reduce consumption, because all consumption contributes to harm,” said Stockwell, of the Canadian Institute for Substance Use Research. “Commerce wants to … expand the consumption.”
A familiar playbook
Every expert interviewed for this story said the alcohol industry is following the tobacco industry’s playbook.
“They’re using the same sort of rear-guard action policies: denial, heavy government lobbying, government revenue,” said Butt.
“I don’t trust either the industry nor the government to do the right thing based upon past action. I think it’s important that consumers are educated.”
Adam Sherk agrees. “If I was [the industry], I would also be scared about consumers knowing this link [to cancer] better,” he said.
“The strategy is to obfuscate the link — point to studies that might be older or found no link, or put a lot of things in the water so it seems less clear than it is.”
But alcohol, experts say, is harder to regulate than tobacco. “Nobody liked to be in an airplane with smokers eating dinner next to smokers, so it was really easy to demonize smoking,” said Culbert.
“Alcohol is so ingrained in everything: we drink when we’re happy, we drink when we’re sad, we drink when we’re bored — we drink.”
Still, the normalization does not make the risks any less real. “There’s a mortality rate attached to this,” said Butt.
“And that’s the thing that is tragic — this is a modifiable risk factor.”
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
Our content is always free – but if you want to help us commission more high-quality journalism, consider getting a voluntary paid subscription.
Addictions
Canadian gov’t not stopping drug injection sites from being set up near schools, daycares
From LifeSiteNews
Canada’s health department told MPs there is not a minimum distance requirement between safe consumption sites and schools, daycares or playgrounds.
So-called “safe” drug injection sites do not require a minimum distance from schools, daycares, or even playgrounds, Health Canada has stated, and that has puzzled some MPs.
Canadian Health Minister Marjorie Michel recently told MPs that it was not up to the federal government to make rules around where drug use sites could be located.
“Health Canada does not set a minimum distance requirement between safe consumption sites and nearby locations such as schools, daycares or playgrounds,” the health department wrote in a submission to the House of Commons health committee.
“Nor does the department collect or maintain a comprehensive list of addresses for these facilities in Canada.”
Records show that there are 31 such “safe” injection sites allowed under the Controlled Drugs And Substances Act in six Canadian provinces. There are 13 are in Ontario, five each in Alberta, Quebec, and British Columbia, and two in Saskatchewan and one in Nova Scotia.
The department noted, as per Blacklock’s Reporter, that it considers the location of each site before approving it, including “expressions of community support or opposition.”
Michel had earlier told the committee that it was not her job to decide where such sites are located, saying, “This does not fall directly under my responsibility.”
Conservative MP Dan Mazier had asked for limits on where such “safe” injection drug sites would be placed, asking Michel in a recent committee meeting, “Do you personally review the applications before they’re approved?”
Michel said that “(a)pplications are reviewed by the department.”
Mazier stated, “Are you aware your department is approving supervised consumption sites next to daycares, schools and playgrounds?”
Michel said, “Supervised consumption sites were created to prevent overdose deaths.”
Mazier continued to press Michel, asking her how many “supervised consumption sites approved by your department are next to daycares.”
“I couldn’t tell you exactly how many,” Michel replied.
Mazier was mum on whether or not her department would commit to not approving such sites near schools, playgrounds, or daycares.
An injection site in Montreal, which opened in 2024, is located close to a kindergarten playground.
Conservative Party leader Pierre Poilievre has called such sites “drug dens” and has blasted them as not being “safe” and “disasters.”
Records show that the Liberal government has spent approximately $820 million from 2017 to 2022 on its Canadian Drugs and Substances Strategy. However, even Canada’s own Department of Health admitted in a 2023 report that the Liberals’ drug program only had “minimal” results.
Recently, LifeSiteNews reported that the British Columbia government decided to stop a so-called “safe supply” free drug program in light of a report revealing many of the hard drugs distributed via pharmacies were resold on the black market.
British Columbia Premier David Eby recently admitted that allowing the decriminalization of hard drugs in British Columbia via a federal pilot program was a mistake.
Former Prime Minister Justin Trudeau’s loose drug initiatives were deemed such a disaster in British Columbia that Eby’s government asked Trudeau to re-criminalize narcotic use in public spaces, a request that was granted.
Official figures show that overdoses went up during the decriminalization trial, with 3,313 deaths over 15 months, compared with 2,843 in the same time frame before drugs were temporarily legalized.
When it comes to addressing the national overdose crisis, the Canadian public seems ideologically split: some groups prioritize recovery and abstinence, while others lean heavily into “harm reduction” and destigmatization. In most cases, we would defer to the experts—but they are similarly divided here.
This factionalism was evident at the Canadian Society of Addiction Medicine’s (CSAM) annual scientific conference this year, which is the country’s largest gathering of addiction medicine practitioners (e.g., physicians, nurses, psychiatrists). Throughout the event, speakers alluded to the field’s disunity and the need to bridge political gaps through collaborative, not adversarial, dialogue.
This was a major shift from previous conferences, which largely ignored the long-brewing battles among addiction experts, and reflected a wider societal rethink of the harm reduction movement, which was politically hegemonic until very recently.
Recovery-oriented care versus harm reductionism
For decades, most Canadian addiction experts focused on shepherding patients towards recovery and encouraging drug abstinence. However, in the 2000s, this began to shift with the rise of harm reductionism, which took a more tolerant view of drug use.
On the surface, harm reductionists advocated for pragmatically minimizing the negative consequences of risky use—for example, through needle exchanges and supervised consumption sites. Additionally, though, many of them also claimed that drug consumption is not inherently wrong or shameful, and that associated harms are primarily caused not by drugs themselves but by the stigmatization and criminalization of their use. In their view, if all hard drugs were legalized and destigmatized, then they would eventually become as banal as alcohol and tobacco.
The harm reductionists gained significant traction in the 2010s thanks to the popularization of street fentanyl. The drug’s incredible potency caused an explosion of deaths and left users with formidable opioid tolerances that rendered traditional addiction medications, such as methadone, less effective. Amid this crisis, policymakers embraced harm reduction out of an immediate need to make drug use slightly less lethal. This typically meant supervising consumption, providing sterile drug paraphernalia, and offering “cleaner” substances for addicts to use.
Many abstinence-oriented addiction experts supported some aspects of harm reduction. They valued interventions that could demonstrably save lives without significant tradeoffs, and saw them as both transitional and as part of a larger public health toolkit. Distributing clean needles and Naloxone, an overdose-reversal medication, proved particularly popular. “People can’t recover if they’re dead,” went a popular mantra from the time.
Saving lives or enabling addiction?
However, many of these addiction experts were also uncomfortable with the broader political ideologies animating the movement and did not believe that drug use should be normalized. Many felt that some experimental harm reduction interventions in Canada were either conceptually flawed or that their implementation had deviated from what had originally been promised.
Some argued, not unreasonably, that the country’s supervised consumption sites are being mismanaged and failing to connect vulnerable addicts to recovery-oriented care. Most of their ire, however, was directed at “safer supply”—a novel strategy wherein addicts are given free drugs, predominantly hydromorphone (a heroin-strength opioid), without any real supervision.
While safer supply was meant to dissuade recipients from using riskier street drugs, addiction physicians widely reported that patients were selling their free hydromorphone to buy stronger illicit fentanyl, thereby flooding communities with diverted opioids and exacerbating the addiction crisis. They also noted that the “evidence base” behind safer supply was exceptionally poor and would not meet normal health-care standards.
Yet, critics of safer supply, and harm reduction radicalism more broadly, were often afraid to voice their opinions. The harm reductionists were institutionally and culturally dominant in the late 2010s and early 2020s, and opponents often faced activist harassment, aggressive gaslighting, and professional marginalization. A culture of self-censorship formed, giving both the public and influential policymakers a false impression of scientific consensus where none actually existed.
The resurgence in recovery-oriented strategies
Things changed in the mid-2020s. British Columbia’s failed drug decriminalization experiment eroded public trust in harm reductionism, and the scandalous failures of safer supply—and supervised consumption sites, too—were widely publicized in the national media.1
Whereas harm reductionism was once so powerful that opponents were dismissed as anti-scientific, there is now a resurgent interest in alternative, recovery-oriented strategies.
These cultural shifts have fuelled a more fractious, but intellectually honest, national debate about how to tackle the overdose crisis. This has ruptured the institutional dominance enjoyed by harm reductionists in the addiction medicine world and allowed their previously silenced opponents to speak up.
When I first attended CSAM’s annual scientific conference two years ago, recovery-oriented critics of radical harm reductionism were not given any platforms, with the exception of one minor presentation on safer supply diversion. Their beliefs seemed clandestine and iconoclastic, despite seemingly having wide buy-in from the addiction medicine community.
While vigorous criticism of harm reductionism was not a major feature of this year’s conference, there was open recognition that legitimate opposition to the movement existed. One major presentation, given by Dr. Didier Jutras-Aswad, explicitly cited safer supply and involuntary treatment as two foci of contention, and encouraged harm reductionists and recovery-oriented experts to grab coffee with one another so that they might foster some sense of mutual understanding.2
Is this change enough?
While CSAM should be commended for encouraging cross-ideological dialogue, its efforts, in this respect, were also superficial and vague. They chose to play it safe, and much was left unsaid and unexplored.
Two addiction medicine doctors I spoke with at the conference—both of whom were critics of safer supply and asked for anonymity—were nonplussed. “You can feel the tension in the air,” said one, who likened the conference to an awkward family dinner where everyone has tacitly agreed to ignore a recent feud. “Reconciliation requires truth,” said the other.
One could also argue that the organization has taken an inconsistent approach to encouraging respectful dialogue. When recovery-oriented experts were being bullied for their views a few years ago, they were largely left on their own. Now that their side is ascendant, and harm reductionists are politically vulnerable, mutual respect is in fashion again.
When I asked to interview the organization about navigating dissension, they sent a short, unspecific statement that emphasized “evidence-based practices” and the “benefits of exploring a variety of viewpoints, and the need to constantly challenge or re-evaluate our own positions based on the available science.”
But one cannot simply appeal to “evidence-based practices” when research is contentious and vulnerable to ideological meddling or misrepresentation.
Compared to other medical disciplines, addiction medicine is highly political. Grappling with larger, non-empirical questions about the role of drug use in society has always necessitated taking a philosophical stance on social norms, and this has been especially true since harm reductionists began emphasizing the structural forces that shape and fuel drug use.
Until Canada’s addiction medicine community facilitates a more robust and open conversation about the politicization of research, and the divided—and inescapably political—nature of their work, the national debate on the overdose crisis will be shambolic. This will have negative downstream impacts on policymaking and, ultimately, people’s lives.
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