Any number of people are lobbying the provincial government's liquor policy review with ideas to liberalize B.C.'s liquor laws.
The politician conducting it - Liberal MLA John Yap - is getting peppered with ideas such as allowing drinking on beaches, happy hours, price cuts and looser restrictions.
But the temperance movement, as represented by various medical experts, is also making a play. The Vancouver Coastal Health Authority pleaded this week for higher prices, stricter warnings and a continued moratorium on private liquor store expansion.
The health authority grudgingly conceded there are some arcane and unnecessary rules that could be changed. But it stressed that policy changes must decrease the harm from alcohol, not increase it.
It presented some startling numbers to back up the perceived need for continued vigilance over booze.
Hospital emergency departments are the ideal place to monitor emerging trends in alcohol use, the authority said. A great proportion of trauma is found in emergency departments where alcohol and other drugs are a major risk factor for injury.
A health-surveillance system at four Metro Vancouver emergency departments shows a marked increase in intoxication/overdoses over the past few years.
"Compared to 2008, the number of ER visits due to alcohol/overdoses in 2012 increased 81 per cent in men and 75 per cent in women," the authority said. "We see a serious and worsening impact on youth and young adults."
The authority said there were 886 visits for acute alcohol intoxication in 2006-7 and 1,646 in 2011-12.
"That is a 100 per cent increase in five years, while overall emergency department visits have increased only 20 per cent over the same time."
It also challenged common assumptions, by estimating that binge-drinking young people are more of a problem for hospitals than chronic alcoholics.
About 2,500 of St. Paul's Hospital's 72,000 patient-visits a year are acute intoxication, and most of them are young weekend drinkers.
More than a quarter of the top 100 most frequent visitors had an alcohol-related diagnosis.
But the brief said: "Compared to the youthful, binge-drinking population, these seemingly recalcitrant alcoholics are probably less of a burden."
The chronics visit more frequently, but the younger population is four or five times more likely to visit the emergency department.
Some selected anecdotes also brought the message home.
Vancouver trauma surgeon Dr. David Evans wrote that the negative impact of alcohol is "brutally evident" day after day.
He said that in August, out of 30 major admissions for serious injuries, between eight and 10 were alcohol-related. Three young people - aged 17, 19 and 22 - fell from heights while intoxicated. One was seriously injured and one died.
The health authority recommends continuing the moratorium on private liquor store expansion, indexing liquor prices to cost of living increases and putting more health warnings on labels.
Island Health took the same tack in its brief to Yap last month.
Chief medical health officer Dr. Richard Stanwick argued for indexed pricing and also pricing by alcohol content, an idea long advocated by the University of Victoria's addiction-research centre.
He also urged the government to consider raising the drinking age to 21, or at least maintaining it at 19. Stanwick suggested that spending on social-responsibility advertising should equal or exceed spending on product promotion.
That would involve a huge increase in "drink responsibly" messages, all of it funded by alcohol-derived revenues.
The two health authorities' views contrast with other submissions urging relaxation of many restrictions in B.C.'s liquor policy.
Yap's job is to "modernize" the volumes of rules and regulations. Many people take modernize to mean rationalize and reduce, which would amount to liberalizing.
Making social drinking more convenient is often cited as a reason, but there's also a straight economic driver. The same day the Vancouver health authority was citing its concerns, the restaurant industry told the review that its business is a $10-billion-a-year part of the economy, employing 170,000 people.
Balancing social drinkers against problem drinkers is always the problem. Tinkering with that balance is going to take a fine touch.
Born in Rivers, Man., Les Leyne was raised in Qualicum Beach. He writes four days a week on provincial affairs for the 'Victoria Times Colonist'.
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