Guideline supports people living with alcohol addiction

published on December 17, 2019

British Columbians dealing with high-risk drinking or alcohol use disorder will be connected to services that better suit their needs.

A new made-in B.C. guideline helps fill a crucial gap in the province’s system of care for people with addictions.

The Provincial Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder has been announced by Judy Darcy, Minister of Mental Health and Addictions, and representatives from the BC Centre on Substance Use (BCCSU) in Vancouver.

“The rise of problematic drinking in British Columbia, especially among our young people, is of deep concern to our government,”said Darcy. “The impacts are far reaching and can be devastating for youth, for families and for communities across B.C. These new guidelines are the first of their kind in B.C. They will significantly improve care for people who struggle with alcohol use, and better connect them to the supports and services they need.”

The guideline helps bridge the gap between research and practice and will be used by clinicians to manage and treat high-risk drinking and alcohol-use disorder, resulting in more people accessing better, quality care.

The guideline also includes recommendations to improve early screening and intervention in primary care settings for youth aged 12 to 25 and adults, as well as new tools for withdrawal management and guidance for continuing care.

“Alcohol addiction is the most common substance-use disorder and can be devastating in terms of both health impacts and the costs to our health system, as well as the harms caused to individuals, families and our communities,” said Cheyenne Johnson, co-interim executive director, BCCSU. “Traditionally, evidence-based treatment and recovery have not been well integrated and implemented into routine clinical care. We’re hopeful these new guidelines will support the development of a substance use continuum of care that identifies signs of alcohol addiction early and provides evidence-based treatment and referral to recovery services.”

The guideline was created by a committee of 43 clinicians, researchers, scientists and policy experts from regional health authorities and the Ministry of Health, as well as people with lived experience. The committee intends to update the guideline every three years to ensure it is based on the most current research available.

The BCCSU will work with health-care partners to bring the guideline into practice through a number of initiatives, including:

• a series of in-person seminars throughout the province;
• new training and specialist supports for primary care teams in collaboration with Doctors of B.C. that will be implemented early next year; and
• a free, self-paced course offered in partnership with the University of British Columbia.

In addition, the BCCSU is working on two supplements to the guideline: one in partnership with the First Nations Health Authority, which will give clinicians the tools to provide culturally safe care to Indigenous peoples; and a second to support the management of alcohol-use disorder for women who are pregnant.

Improving addictions care throughout the province is an integral part of A Pathway to Hope, B.C.’s roadmap for improving mental health and addictions care for everyone. Implementing the roadmap is a shared priority with the BC Green Party caucus, and is part of the Confidence and Supply Agreement.

Quick Facts:

• Alcohol addiction is the most common substance-use disorder in B.C.
• Over 20% of British Columbians over the age of 12 are currently taking part in heavy drinking.
• Nearly 200 health conditions are associated with long-term high alcohol consumption.
• Average consumption levels as low as one or two standard drinks per day are directly or indirectly linked to increased risk of at least eight different types of cancer, as well as numerous other serious medical conditions.

Learn More:

Read the guideline: www.bccsu.ca/aud-guideline

Read a summary of the guideline recommendations: www.bccsu.ca/aud-recommendations

Canada’s Low Risk Alcohol Drinking Guidelines (Canadian Centre on Substance Use and
Addiction): https://www.ccsa.ca/sites/default/files/2019-09/2012-Canada-Low-Risk-Alcohol-Drinking-Guidelines-Brochure-en.pdf

Alcohol Consumption in BC (Canadian Institute for Substance Use Research): https://www.uvic.ca/research/centres/cisur/stats/alcohol/index.php

A Pathway to Hope:

What people are saying about B.C.’s guidelines for dealing with alcohol addiction

Russell Purdy, individual in recovery from alcohol addiction:
“My alcohol use went unchecked for years. At first, it was something I did with my friends to loosen up and have fun. Over time I came to depend on it until it took over my life. I started using stimulants along with my near daily drinking. My work could no longer support my addiction and I did whatever was necessary to feed my substance use. I pushed everyone close to me away. I had the same family doctor since childhood and we never talked about my drinking, so it wasn’t until I reached out to my family for help that I was finally connected to the treatment I needed. I wonder if I didn’t have that support from my family if I’d be three years in recovery today.”

Jennifer Cottell, member, Family and Caregivers Committee, BC Centre on Substance Use:
“I’ve lived the devastation that is untreated alcohol addiction. It tore my family apart. My ex-husband started with a couple of drinks. Gradually, the behaviour changed as his drinking increased. We talked to our doctor, but he never got treatment. He lost his job because of his drinking and I started to fear for the safety of my children. He was in denial and lied about his use. He got sicker and sicker, and eventually was hospitalized because he’d poisoned his body. The treatment he needed came too late to save our family and probably too late to save him.”

Dr. Keith Ahamad, clinician researcher, BC Centre on Substance Use, and co-chair, guidelines writing committee:
“The health system has generally failed people who use alcohol. The result is our hospitals and emergency rooms are filled with individuals suffering a range of consequences of alcohol addiction. We’re left managing the devastating effects rather than preventing and treating the addiction itself. We have a responsibility to provide easy access to upstream evidence-based treatment and to look to guide people earlier toward treatment and recovery. These guidelines provide the tools to empower primary care in doing just that.”

Dr. Karen Urbanoski, Canada research chair in substance use, addictions and health services, scientist and associate director, Canadian Institute for Substance Use Research:
“Alcohol is a major cause of harms and disease in B.C., costing just shy of $2 billion per year according to recent estimates. These new guidelines fill an important gap by providing an up-to-date summary of evidence on clinical interventions for high-risk drinking and alcohol use disorders, recommending a range of options for health providers across the system. Alongside a strong public health framework for alcohol regulation and distribution, effective clinical management of high-risk drinking and alcohol-use disorders, based on tailored interventions and multidisciplinary collaboration, will contribute to a reduced burden of illness and better population health.”

Dr. Matthew Chow, president-elect, Doctors of BC:
“Doctors of BC looks forward to working with the provincial government and the BC Centre on Substance Use to facilitate training for family doctors around the province on the new guidelines. Family doctors are the first point of contact for most patients seeking medical help for their alcohol concerns, so these guidelines will support them in providing evidence-based care and better patient outcomes.”

Dr. Nel Wieman, senior medical officer, mental health and wellness, First Nations Health Authority:
“The provincial guideline will increase knowledge and options for people with alcohol-use disorder. The upcoming Indigenous supplement to the guideline will address cultural safety and humility in providing holistic health care to people with AUD. It will also bravely expand the conversation about alcohol use in First Nations communities.”

Dr. Bonnie Henry, provincial health officer:
“Too many people have lost their lives to the overdose crisis in B.C. If we’re going to turn the corner on this complex crisis, we must understand its connection to addiction and substance use challenges as well. Almost half of people who have died in the overdose crisis have also had alcohol in their system, which is why alcohol addiction and its impact on British Columbians cannot be overstated. It is the most common substance-use disorder in the province and has the most widespread negative impact of families and communities compared to other substances.”

Contacts:

Ministry of Mental Health and Addictions
Communications
250 883-2941

BC Centre on Substance Use
Kevin Hollett
[email protected]
778 918-1537