Applications of Canada’s Guidance on Alcohol and Health in Primary Care

Abstract

Key Points

• Given that alcohol is a leading preventable cause of death and social problems in Canada, it is important that primary care clinicians are empowered to provide the best advice to patients on alcohol use and health.

• For long-term health, when it comes to consuming alcohol, the core message primary care clinicians should communicate to patients is “less is better.”

• The health and safety risks associated with alcohol use are determined by the number of standard alcoholic drinks consumed per week and per occasion. A standard alcoholic drink contains approximately 13.5 grams of alcohol.

• To foster supportive conversations or potentially screen for and treat alcohol use disorder when necessary, it is crucial for primary care clinicians to take a non-judgmental, equitable approach to advising patients about alcohol and health.

• Anchor conversations about alcohol to the risk zones in Canada’s Guidance on Alcohol and Health: consuming 1–2 standard drinks per week is low risk, 3–6 standard drinks per week is moderate risk, and seven or more standard drinks per week is increasingly high risk. For drinks per occasion, more than two standard drinks increases short-term health risks.

• Take into account special considerations about alcohol for young people under the legal drinking age, people who are pregnant, planning to become pregnant, or breastfeeding, as well as older adults.

• Best practices for treating high-risk drinking and alcohol use disorder include prescribing anti-craving medications such as naltrexone and acamprosate, providing psychosocial counselling, and maintaining ongoing follow-up with patients.