Alcohol kills nine Canadians daily in hospitals, yet treatment remains hard to access

Alcohol causes more harm overall than any other drug in Canada — more than non-prescription opioids or tobacco — according to a national study from the Centre for Addiction and Mental Health published earlier this year in the Journal of Psychopharmacology.

Yet Canadians struggling with alcohol-use disorder face a system that fails them. Around nine people die in Canadian hospitals each day from alcohol-related harm. Another 280 are hospitalized daily. Nearly 18 per cent of Canadians aged 15 and older will meet clinical criteria for alcohol-use disorder in their lifetime. The disorder costs Canadian society around $20 billion a year in health care, lost productivity and criminal justice costs.

Dr. Evan Ailon, who runs the only dedicated practice for alcohol-use disorder on Vancouver Island, says the barrier is not medical — it is knowledge and stigma. "The challenges that I have are with colleagues whose lack of information, lack of knowledge about this really gets in the way of the treatment of these patients," he said. Patients often face marginalization seeking help. Family doctors have ignored patients' alcohol use or advised them to cut down. Some have simply told patients to go to Alcoholics Anonymous.

Support groups like AA work for some people but should not be the only option offered. Some of the most effective medications ever invented in medicine are for alcohol-use disorder, Ailon said: "That is not something that's known by most providers and certainly not known by the average person."

Naltrexone, approved by Health Canada in 1997, affects the brain's opioid reward centre and decreases cravings. It helps people reduce consumption and, for those in recovery, reduces the chance of relapse. Yet most doctors do not prescribe it, and most patients do not know it exists.

Jordan Kawchuk, 54, a writer and former TV producer, has been through his fifth in-patient program during decades-long struggle with the disorder. His second time at the Vancouver Island Therapeutic Community in Nanaimo, B.C., earlier this year lasted six months. Alcohol cost him countless jobs, his marriage, money, and trust — and the chance to live full time with his daughters.