Abstinence isn’t for everyone – an introduction to harm reduction

When we talk about harm reduction, safe injection sites or opioid replacement therapy come to mind for many people. But the concept of harm reduction is much broader and can be applied to any substance at any level of severity. You’re  probably familiar with the concept of harm reduction when it comes to food intake, even if you don’t call it by that term. When you choose treats that have less sugar or fat, you are engaging in a harm reduction strategy. When you decide to forgo a second helping of dinner, that is harm reduction. 

Harm reduction is any strategy that reduces the negative consequences of substance use. Some examples include consuming a lower alcohol content beverage, drinking water between drinks, eating while drinking, waiting until a certain age before using substances, or using pain management techniques other than medication, such as yoga or meditation. While some people may be willing to quit substances altogether, most people are not. Harm reduction allows all people to engage with strategies that benefit their lives. The key to harm reduction is that any step in a positive direction is a beneficial step. 

“The key to harm reduction is that any step in a positive direction is beneficial.” 

But shouldn’t some people just stop using substances? Research shows that some people who struggle with substance use benefit from abstinence, particularly if they have found substance use difficult to control over time and have experienced severe consequences such as losing jobs or important relationships. 

That being said, the majority of people do well with harm reduction approaches but do not have that option when seeking treatment. Programs that provide the option of reducing or moderating substance use are rare, and many programs require that you abstain or commit  to abstinence when entering treatment. This all-or-nothing approach prevents seeking help and is not aligned with up-to-date, evidence-based understandings of addiction treatment. 

One of the main barriers to harm reduction approaches — and the reason abstinence is often touted as the gold standard — has been a dominating belief that addiction is a disease. The main premise of the disease model is that people who struggle with substance use have a progressive and irreversible illness that stays with them forever. The research evidence simply does not support this model. 

“The research evidence does not support the model of addiction as a lifelong, irreversible disease.” 

The longest follow-up study in addiction recovery is being conducted at Harvard Medical School, where they have followed the drinking patterns of a group of males since 1940. Results show that many of the participants have continued to use high levels of alcohol for decades without progressing to a more severe state. Similarly, research studies conducted by the National Institute on Alcohol Abuse and Alcoholism have found that about 75% of people who meet the criteria for an Alcohol Use Disorder no longer do so at a later time. We now know that people who struggle with substance use fall along a spectrum of problems from low to high; it is not a matter of having or not having a disease. Most people on this spectrum tend to ebb and flow in and out of struggles with substance use throughout their lifetime. 

What are the benefits of harm reduction?

Abstinence isn’t for everyone:

Many people are not ready or willing to commit to abstinence, especially those on the mild or moderate part of the spectrum who would benefit from harm reduction. Acknowledging that there are numerous pathways to resolution can have implications for drawing more people into treatment. In an analysis of 38 articles with 40 separate samples, Linda Sobell and her colleagues found that 3/4 of the individuals who had recovered from struggles with alcohol use reported that low-risk drinking was part of their recovery. Similar evidence was found for drug use, with nearly half of the combined sample reporting recovery involving some form of continued use. 

It provides early intervention:

A second benefit to harm reduction is that it helps people earlier in the process. A common belief is that recovery from addiction requires hitting “rock bottom” and receiving formal treatment. However, programs that successfully create change in the early stages of an addictive process serve to help people who may not yet have experienced negative consequences of use. 

It’s individualized:

Harm reduction is client-centric, which means techniques are tailored to the individual and meet them where they are. Imagine if you were told today that you had to give up sugar forever? Most people would struggle with this goal, but many are open to reducing their sugar intake over time. The same principles apply to substance use treatment. Allowing people to make choices about how and when they make a change offers the best chances for success. 

It’s the natural process of change:

Referring back to the sugar example, imagine if the only measure of success for good health was to never consume sugar again? What if you had reduced your sugar consumption to only on weekends, or only on holidays? Surely that would be a measure of success? Yet historically, the only measure of success in substance use treatment has been complete abstinence. This outcome does not consider the multitude of ways that someone can change in a positive direction. Most lasting changes happen in small incremental steps over time. 

What are some examples of harm reduction?

Harm reduction can come in many different forms. Here are some ideas of harm reduction you might consider: 

What does harm reduction look like in practice?

Here’s an example of how someone has benefited from a harm reduction approach: 

Jackie likes to relax after work with a few drinks, and sometimes more when she’s feeling stressed out. On the weekends, she often gets together with her girlfriends for nights on the town and boozy brunches. But in the last few years, she feels like these habits have caught  up with her. Her hangovers are getting worse, she’s given up some of her nighttime hobbies, her spending on alcohol has been increasing, and she’s been getting anxiety around all of it. In the last few months, Jackie has been working with a coach to implement harm reduction practices. She now considers the low-risk drinking guidelines by sticking to two drinks a night, except for on special occasions. She’s decided to make Mondays to Wednesdays alcohol free days. On the weekends, she’s determined to forgo any day drinking, and when she does meet up with friends in the evenings, she leaves her car at home, so she’s not tempted to drive home after a few drinks.

Jackie never saw abstinence as a realistic option or something she needed. But making these changes in her life has given her a sense of accomplishment and improved her health and mood. As a way to continue to motivate herself, she’s been socking away the money she saves on alcohol and putting it towards monthly massages and pedicures, as well as saving for a vacation she’s wanted to take for a long time. 

How can I change my substance use? 

If you or a loved one has been thinking about changing your substance use, think about one small change you can make today that would move you in a positive direction. This change could include reducing the amount of substance you use or reducing the harmful consequences of use. 

ALAViDA provides a range of support options for anyone wanting to change their relationship with substances, whether that’s through harm reduction or abstinence. Support is accessed through the TRAiL platform, and includes iCBT modules, daily notifications and tracking tools, coach-assisted support, live classes, and facilitated care groups. Access the ALAViDA TRAiL.

 

 

 

The Gut-Brain Connection

The Role of Nutrition in Mental Health

The brain influences the body and vice versa. We hope by now that’s a no-brainer. But when we look at how nutrition works, we see that the connection to brain health is tighter than imagined. You are what you eat, after all! 

Cutting-edge research is emerging on the microbiome, and one thing is for sure: there is a robust relationship between gut health and mental health. If your nutrients are imbalanced, you’re not alone. Studies have shown that 40% of the population has been found to have inadequate intakes of vitamin A, C, D, and E, calcium, and magnesium. Research developments show that it’s no longer a question about if nutrition plays a role in mental health but how?

If you’re looking to boost your nutrients, here are 13 powerhouse mental health snacks:

Nutrition experts recommend behavioural strategies to combat food cravings and substance use, too:

Nutrition can also be a causal component of a substance use challenge and a critical aspect of resetting when you’re making a change. Why?

Because researchers have found that we use substances to make up for nutrient deficits. Our substance of choice provides clues about those nutritional deficits. 

For example, let’s say you’ve boosted your nutrients and decide to make a change. You reduce your consumption, and suddenly, you’re overwhelmed by an unrelenting sweet tooth. It can feel as if the universe is conspiring against you. Luckily, it’s temporary, and you’re not alone; there is solid evidence that explains the alcohol-sugar swap.

Why do you crave sugar?

Many of us crave alcohol, caffeine, drugs, or sugar and all of these substances have something in common. They trigger the release of feel-good chemicals (serotonin and dopamine) in the brain, making you feel happy, relaxed, and wanting more. When you remove or reduce your consumption, your brain panics. Your brain is clever and persistent; it looks for another substance that will offer the same relief, and that’s when you find yourself digging into the ice cream tub late at night. Scientists refer to this as addiction transfer.

It’s not just that your brain feels better with the support of a substance that promotes dopamine and serotonin release; its absence can make you feel unwell. Some common signs of low blood sugar are irritability, anxiety, shakiness, energy crashes, mood changes, and in some cases, panic. On top of that, heavy drinking can make you prone to hypoglycemia, another term for low blood sugar. So, it’s no wonder that you reach for sweets. It’s important to remember that your body is trying to fill a biological need, so shame and blame don’t belong. Your desire for sugar is not an indication of reduced willpower, and with time, your body will re-balance. Be gentle with yourself.

Here are some tricks to help you through sugar cravings:

The gut and the brain are interdependent, and that’s where the name second brain comes from. The digestive system plays a crucial role in controlling the complex network of nerves and chemicals (over 100 million!) that send messages to our central nervous system. The second brain is responsible for neurotransmitters and the bacteria that regulate brain function. There is an undeniable connection between the brain, nutrients, and the body.

Access the ALAViDA TRAiL.

 

 

 

 

Free up your finances – how cutting back on consumption makes sense

The most powerful indicator of a person’s potential to change their substance use habit is their reason for the change. This comes down to the why. Why do you want to change your substance use pattern?

You might feel like you have to align your change with social norms. For instance, if you cut back on weekday wine to relieve your partner’s stresses, you will feel that you’re pleasing them. And the same goes if you change to avoid a tough conversation with your doctor at your next annual check-up. But changing is hard work, and to get to the goal line and make your change stick, it’s crucial that you pick a meaningful reason for you. It doesn’t have to be the same motivation as a leading organization or a news headline; it just has to inspire you and have personal value. Substance use can indeed increase the risk of developing certain health conditions, including many cancers, but that might be a secondary reason. Find the thing that makes you tick.

While it may not seem life-saving at face value, saving money is a powerful motivator for change. While you save, you’ll be transforming your well-being in many other ways:

Let’s break down your substance-related spending:

Like any practiced and repeated behaviour, substance use becomes a habit. It changes the hardwiring of the brain. When you drink or use, your brain gets rewarded with dopamine (a feel-good neurotransmitter), which paves a shortcut in your brain pathways that makes you more likely to use substances to celebrate good emotions or avoid negative ones. Purchasing a substance becomes less like a choice and more like stocking up on your morning coffee or cereal. It meets an essential need, and it dictates your spending. This habit loop is strengthened by society’s emphasis on using substances to feel happy, manage stress, or just numb out. It may be subconscious , but you take in a lot of messaging about vaping, drinking, and cannabis in a single day, whether on social media, a billboard, or a television commercial.

Here are some of the ways you might be regularly spending on substances (absentmindedly):

An excellent place to start is to evaluate the costs of your habit. Take a moment to jot your regular spending on paper and use this calculator.

Ready to find out how much you’ll save? Input your regular substance spending into our cost calculator. It can add up, right? There’s no reason to feel shame about your spending. Instead, celebrate the potential reward for a change in your habits.

Here are some potential wins:

It can be hard to think about a birthday party or wedding without the fizz of champagne or an ice-cold beer. Your brain has been conditioned to use substances as an outlet or release valve. Alcohol-free days are a good way to cut down. If it makes you feel dread, you may need an incentive, so set a goal and line up a treat. Maybe you want to take an alcohol-free Friday and go for a celebratory brunch on Sunday. Fit in one per week this month and use those savings for a massage.

Here is a guide for cutting back:

  1. How many alcohol-free days do you want each week?

  2. What’s the maximum number of drinks you want to have per day?

  3. Think about your common triggers and plan coping activities like calling a friend, turning on a podcast, taking a walk, or having a bath.

  4. How will you track your consumption?

  5. Do you have off-limit drinks?

  6. Will you keep alcohol in the house? Or, use a trick like getting into your p.js to make it harder to go to the liquor store?

  7. What is your fixed budget? Put it on paper!

  8. Who will you connect with for accountability?

Do you know that fable about the turtle and the hare? In the end, the turtle won the race.? It is true: slow turtle steps make a big difference when they add up. Take your first action toward change today. Remember, it doesn’t have to happen all at once. Keep an eye on your growing savings to measure your commitment to reducing your consumption.

Access the ALAViDA TRAiL app.

 

Beating Holiday Cravings

Planning for the Holidays

When the days get shorter and the temperature drops, many combat the gloom with Christmas lights, holiday baking, and festive lattés. The calendar fills up. But despite the excitement, the holidays can come with a lot of pressures and expectations. It’s easy to feel grief over lost loved ones, a sense of nostalgia for the way things used to be, or feelings of comparison to friends with good circumstances.

When everyone around you seems joyous, it’s hard to admit that you feel lonely, low, or out of place. The focus on family and relationships during the season can create a lot of pressure. And maybe once the days shorten and it becomes harder to convince yourself to go out for a walk, which impacts your mood and puts a grey lens over all of the festive spark.

Interested to read more about how to cope during the holiday season, read more here. 

As families change and children develop traditions separate from their parents, it can cause painful feelings.

Whether it’s a Naughty but Nice Christmas Cocktail, mulled wine, eggnog, or a peppermint espresso martini, alcohol tends to go hand-in-hand with the holidays. If you’re feeling triggered around the season and by memories, get-togethers, or expectations, your cravings might become more intense. Since alcohol can be an automatic pairing for many at this time of year, you might have to work harder to change your pattern and disrupt the association. So what are some things you can do to stay on track with your goals over the holiday season?

Cravings are normal. The urge to drink is no different than the challenge someone faces when they’re trying to stay on track with their weight-loss app and are tempted by the shortbread tray. Whether your soft spot is beer or the cheese board, planning, visualization, and accountability are a good place to start.

  1. Write down your plan:

It’s easy to get overwhelmed by strong emotions or anxiety, and it makes it harder to clearly articulate what part of a situation or relationship makes you more vulnerable to cravings. Writing helps because when your thoughts are down on paper, they’re concrete. You can assess them, challenge the logic, and often it is easier to identify the root of the problem.

2. Set boundaries:

It’s ok to protect yourself from triggers, even if it means going against the crowd or saying no. You can adjust plans to reduce stimulus, shorten your window of activity, or to make it easier to achieve your change goals.

3. Get enough light:

Try to time your walks for mid-day. Take a lunch break, a walking meeting, or a thinking break. Get some Vitamin D and enjoy the day while it’s bright outside! Even as the weather gets colder, try to stay active outdoors. You might integrate a walk with a friend after work once a week. Try to keep your blinds open, as well, to let the light in. It can help your sleep-wake schedule to wake with the morning light.

4. Step outside:

There’s a time in almost every family gathering where things feel a bit tense. The holidays can make you feel trapped, and a good strategy is to step outside. Not only will the fresh air clear your mind, but movement will help you relax and change your mindset. It could be a few deep breaths on the porch to cool your body temperature, or you can offer to take the family pet out for a walk around the block. If you can tap into your breathing and take deeper, slower breaths or even tune into a short walking meditation, it can help you re-set.

5. Plan time before or after the holidays when triggers are less activating:

All of your social interactions don’t have to happen in one month! You can explain to friends that the holidays are more challenging for you and arrange something more intimate in the New Year. It can feel less daunting to see a friend one-on-one for a walk with a cup of tea or hot chocolate. Pace yourself, and remember there is no one way to approach the holiday season. Additionally, talking to your friends about how you feel can normalize challenging emotions. You might find one or two of your friends have similar feelings or that their sensitivity and awareness of your experience increases after an open conversation.

6. Sleep, eat, exercise – repeat:

When we get out of our routine, the first thing to slip is our eating and sleeping schedule. The holidays are a time when exercise tends to go by the wayside too! But those are the things that stabilize our mood, energy and help us maintain a balanced outlook in a more triggering time. Naturally, parts of your schedule might change. You may be staying up later and sleeping in, and that will throw off your meal times but try to set the alarm clock for 7-8 hours from the time you go to bed and eat regular meals during the daytime. The holidays may disrupt your regular workout routine, but a brisk walk or virtual yoga while the turkey cooks goes a long way!

7. Try one of these alcohol alternatives:

If a part of your plan is to make a mocktail for a family dinner or bring one for friends, here are a couple of great mocktail suggestions for those long winter evenings. 

Christmas Punch:

Serves: 10

Step 1: Place cranberries and club soda into an ice tray and set aside to freeze

Step 2: Mix pomegranate juice, cranberry juice, and club soda

Step 3: Add in lemon juice, fresh from the lemon if you like and simple syrup

Step 4: Mix together and add your ice cubes. Enjoy!

Cherry Bombs

Serves: 6 (adults and kids alike)

Step 1: Place two cups of water in a medium saucepan and bring to high heat. Add grenadine and stir to combine. Pour mixture into two ice-cube trays. Freeze until solid.

Step 2: Fill six glasses with grenadine ice cubes. Add soda and garnish with maraschino cherries. Serve!

Mulled Cranberry Mocktail

Serves: 1 quart

Directions:

Step 1: In a medium saucepan, combine the juice, cinnamon stick, and cloves and bring to a boil. Reduce the heat and simmer.

Step 2: In a small saucepan, combine the cranberries, sugar, ground cinnamon, 2 tablespoons of water and heat over medium-low heat gently stirring, until the cranberries pop and are well coated with the sugar mixture.

Step 3: When cool, thread three or four berries onto toothpicks and pour the mulled cranberry juice into four mugs.

Chocolate Martini Mocktail

Serves: 2 servings

Directions: 

Step 1: Combine the milk, ¼ cup chocolate syrup, corn syrup, and crushed ice in a blender and blend until smooth.

Step 2: On two small plates, pour chocolate syrup and chocolate sprinkles. Dip the rim of each glass on both plates.

Step 3: Fill the glass with chocolate milk mixture. Enjoy!

Mock Apple Cider Sour

Serves: 1 drink

Step 1: Add the sugar cube, lemon juice, apple cider and seltzer to a 6-8 ounce old fashion glass.

Step 2: Stir to dissolve the sugar

Step 3: Add the ice cube and apple chip

Step 4: Add the orange peel to the rim of the glass. Serve and enjoy!

Drinks courtesy of Martha Stewart and Food Network.

It might seem simple but planning is a powerful evidence-based strategy that can help you manage your cravings and reach your goals around reduced substance use. The great thing about planning is that it’s in your control. You can deconstruct your triggers and the challenging emotional aspects of holiday parties, family gatherings, or gift-giving rituals and make changes to support your mental health and wellbeing. Try one or two of these strategies this season. Get some sunshine, step outside, or do an online kickboxing class. And remember, the holidays may seem inflexible but any tradition can be tweaked if it means protecting your wellbeing.

Happy Holidays and make sure to connect with us if you need some support. 

Looking for more strategies to manage during the holidays? Read more here.

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Care that fits into your life

You’ve heard it before, maybe you’ve thought it yourself:

In-person appointments are more effective.

Seeing my therapist online won’t offer the same support.

I might as well hold off on appointments until I can see my therapist face-to-face again.

Many individuals are skeptical about virtual appointments. It’s common to feel that something will be missing from a phone or video interaction, or that without an in-person connection, the clinician won’t see their experience. At ALAViDA, we have been offering virtual care to clients struggling with substance use challenges for five years. We’ve found that this form of treatment empowers clients to stay engaged with their lives while developing meaningful therapeutic relationships to support sustainable change. 

Virtual care isn’t a downgraded option; it’s a clinical model defined to increase the quality and accessibility of care. It is designed to produce positive outcomes and to give individuals the option to stay engaged in their work and home life without disruption while receiving the support they need. Virtual care has become popularized but it’s not a new concept. The U.S. is a leader in this model with cutting-edge services modelled by the Kaiser Permanente systems. 12 million health plan members had access to the healthcare services offered by Kaiser Permanente by 2020—80% of which was virtual. Despite these advances, access to virtual treatment is not uniformly distributed across the globe. 

Of the 85.5 million virtual contacts: 

But in Canada, the growth of telehealth and virtual care is slower moving. While COVID-19 has accelerated the emphasis on virtual care as a part of Canadian healthcare, integration lags. 

Canada is no stranger, however, to adaptive methods of care delivery. In the 70s, Dr. Maxwell House introduced telehealth to extend the reach of care to isolated communities across the province of Newfoundland. The World Health Organization (WHO) has identified that in under a decade, the world will face a global shortage of 18 million health workers. This burning problem can be circumvented through digital health. A global survey that included 27 countries showed that 10% of individuals had tried virtual care but nearly half of the population was interested in trying it. Virtual care has the potential to change the burden of chronic illnesses, according to WHO, 80% of which can be eliminated with early prevention.

Virtual care removes barriers to access including common roadblocks such as accessibility, affordability, geographical distance, travel burden, and out-of-pocket expenses. For people who live in rural areas or wish to consult with specialists at a distance, it offers unique opportunities for more specialized care. It is also useful in emergencies and as a mediator for emergency room visits. When it comes to substance use and mental health, virtual care enables the patient to seek support without the stigma of leaving work and taking big chunks of time out of their schedule which leaves them feeling vulnerable to judgment from management. It’s important to consider the anxieties and challenges that the older population may experience with this format and to consider approaches to reduce barriers to access. 

The evidence is robust that virtual care has an important place in healthcare delivery and can make a powerful difference. Still, only 1 in 10 companies have adopted virtual care technologies into their benefits plans. These choices do not represent the 71% of employees who state that they would access virtual care if it was available. It has the potential to change the workplace and put a dent in the downstream effects of absenteeism, presenteeism, and disability. It saves thousands, per employee, in absenteeism alone. Virtual care gives patients the opportunity to fit care into their schedule in a more flexible range of hours, to avoid long wait times, prevent interruption to work, less stress, convenience, and more regular touchpoints. Prevention and early intervention are the gold standards and with easy access and minimal compromise, employees can bypass delay to treatment and avoid more serious health consequences. 

Tips for your virtual care appointment:

Virtual care gives you the opportunity to stay on top of your health and connect with specialists from anywhere. Prevention can make the difference in your substance use and connecting with ALAViDA is a great place to start.

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Metabolizing Alcohol

How is Alcohol Absorbed in the Body?

The feeling of having a drink is familiar: warm belly, light head, calm nerves, and relaxed muscles. Your past sensations while drinking give you a sense of how long the drink has been in your bloodstream and how long it will remain. You can likely discern how long you should wait before driving and what time you’re likely to fall asleep. You know roughly how many drinks it takes before it’s harder to walk in a straight line or to put together a coherent sentence. But what about the science of how alcohol is metabolized in the body? 

Alcohol is classified as a depressant; it is referred to in this way because it depresses the nervous system. This mechanism of action leads to slurred speech, wobbly movements, altered perceptions, and changes in the ability to think, judge and react. Alcohol directly affects the front part of the brain – the cerebral cortex – inhibiting our ability to use judgment, as well as the hippocampus where memories are formed. That is why you might forget parts of the evening when you engage in heavy drinking. Additionally, alcohol affects the amygdala which is responsible for social behaviour, the cerebellum which is in charge of balance and coordination, and the hypothalamus which keeps appetite, temperature, pain and emotions in balance. 

Alcohol has a short stay in the body. Once it enters your bloodstream, your body metabolizes alcohol at a rate of 20mg per deciliter (mg/dL). To put that into perspective, if your blood alcohol level was 40mg/dL, it would take two hours to metabolize the alcohol consumed. The rate at which alcohol is felt or metabolized depends upon individual factors. This comes down to blood alcohol concentration or (BAC), which is a measure of the amount of alcohol in your blood in relation to the amount of water in your blood. Some of the factors that impact your BAC and how you respond to drinking alcohol are:

What happens when alcohol enters the body?

Alcohol first travels to the digestive system. Unlike food, 20% of alcohol from a drink goes to the blood vessels, meaning that it is carried to your brain. The remaining 80% goes to your small intestine and into your bloodstream. The last step is that alcohol is taken out of the body through the liver and any deficit in your liver may slow this process down. 

Another key factor in determining how long it will take to metabolize alcohol is to know how much alcohol is in your drink. Generally, it takes one hour for one serving of alcohol to be metabolized, which is the equivalent of 5 oz of wine, 12 oz of beer, or 1.5 oz of liquor. 

 

How can you reduce the effects of alcohol?

It’s important to take into account all of the factors that affect your body’s absorption of alcohol. Safety and moderation are the best approach.

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Alcohol-Related Cancer Risk

The Connection Between Alcohol and Cancer

Nearly 1 in 2 Canadians is expected to develop cancer in their lifetime and the effects can be devastating. If you’ve watched a family member battle cancer, maybe you’ve wondered about whether you share their genetic predisposition. This fear can lead you to examine whether external factors like diet, exercise, and environment might play a role in your chance of developing cancer. But how often do you think about alcohol consumption in relation to cancer? Science shows that alcohol can be a contributing factor in the development of certain kinds of cancer, including cancers of the mouth, throat (pharynx), voice box (larynx), esophagus, liver, colon and rectum, and breast. If you haven’t thought about the connection between alcohol and cancer before, you’re not alone; 7 out of 10 North Americans are unaware of this link because alcohol is so intertwined in our social lives that we don’t think twice about it. 

Alcohol is a part of our culture. It’s ingrained in the way we connect and it helps us to feel comfortable and confident in social interactions. Many people don’t realize the long-term effects of alcohol and often the short-term gain is not worth the health risks. Instead, we might take a reactive approach to our problems, including our health, but with a proactive approach, you can prevent alcohol-related cancers. To drive this home, another perspective you can consider is your dental health. While it can be a pain to brush and floss regularly, or to visit the dentist several times a year, it pays off in comparison to having to get a cavity filled. Checking in with your substance use can be similar to flossing your teeth, you may want to floss twice a day, or you may want to do so several times a week but your preventative and mindful approach will pay off in the long run. 

So what are the stats on alcohol and cancer?

The more you drink, the greater the likelihood that you will develop cancer and the more serious the cancer diagnosis will be. Those who drink two to three drinks or more per day are most at risk. Even if you don’t drink much, say, a few drinks a week, your risks are higher than for non-drinkers. Alcohol increases your risk to develop cancer in seven parts of your body and the most common type of cancer that alcohol causes are called squamous cell carcinoma, which lives in the lining of your esophagus. Colon and rectum cancer is also common and people who engage in heavy drinking have a 44% higher probability of getting colon or rectal cancer than those who choose not to drink. The risk of getting breast cancer is also increased in proportion with the amount of alcohol consumed weekly. 

So why is alcohol harmful? 

  1. DNA mutation: Alcohol has inflammatory properties and particularly, it has this effect on your organs and tissues. In defence, your body responds by trying to repair itself and this can lead to mistakes in your DNA which cause cancerous cells to grow. 
  2. Hormones: In women, alcohol can increase estrogen levels, which is a risk factor that can lead to the growth of cancer cells. 
  3. Toxic Chemicals: When your body processes the ethanol in alcohol, it makes a compound. Researchers believe that this compound causes cancer. 
  4. Nutrients: Alcohol compromises your immune system and it makes it more challenging for your body to absorb key vitamins which pose a cancer risk. These vitamins include B vitamins and folate, among others. 
  5. Weight Gain: Alcohol has sugars and carbohydrates that can lead you to put on weight and being overweight is a risk for developing cancer. 

As evidence and research continues to develop when it comes to alcohol and its role as a risk factor for cancer, one thing is for sure: the less alcohol you drink, the less risk you have of alcohol-related cancer. Studies have confirmed that the most serious risks come from drinking four or more drinks per day. It’s important to remember that many of us drink more than a 1.5 ounce shot of liquor, 5 ounces of wine or 12 ounces of beer. So, it’s possible that you’re drinking outside of the limits that you set for yourself. Change doesn’t need to happen all at once but becoming mindful of the impact that alcohol can have on your body is an integral step to taking charge of your health. When it comes to cancer and alcohol, knowledge is power. 

It’s so easy to lose sight of what counts as one drink. Canada’s low-risk guidelines simplify the process of defining your limits. 

A drink means: 

Taking care of your limits reduces your long-term health risks. For women that means:

For men, the limits are:

It is useful to:

Sometimes zero is the limit: 

Safe drinking tips: 

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Alcohol & Diabetes Risk

The Effect of Alcohol on Diabetes

13% of North American adults have diabetes, and that’s not including those who are pre-diabetic or at risk. It takes concerted effort, planning, and grit to manage your sugars. While many of us go through stages of wanting to reduce our sugars, there’s added pressure, temptation, and stress when there are no choice around-consuming sugars. Still, you might decide to cut out cake and chocolate – apparent candidates – but forget that you also consume sugars while drinking. Drinks often slip under the radar when it comes to maintaining balanced glucose levels, and for those who struggle to keep theirs under control, drinking can be a way to relax. This oversight can be costly to health. Not only are there substantial calories in alcohol, but there is a lot of sugar. 

Alcohol is made from natural sugars and starch, and the number of calories depends on the fermentation process specific to the kind of alcohol you are consuming. The calories in alcohol are empty calories, meaning they don’t have any nutritional value. It’s easy to write off drinks and focus your successes on how you abstain from unhealthy food choices but drink calories add up. For instance, one gram of alcohol contains seven calories, and one gram of fat contains nine calories. Remember that when you’re drinking hard liquor, it’s common to add in other sodas and drinks with added sugars. 

Let’s break down the calories and sugar content in common alcoholic beverages. 

You might drink a cider each evening to wind down while talking to a friend on the phone, and you probably don’t even think about it. 

You might not even put that much in the picture of lemonade. So, if your sugars are off-kilter and you feel foggy and low energy the morning after drinking, you know the culprit. If you choose to drink, your best bet for an option with the lowest sugar content is a glass of red wine or a beer.

Alcohol starts to affect your body the moment you take your first sip. While it may feel as if the occasional drink isn’t a concern, the cumulative effects of drinking wine, beer, or spirits over a prolonged period can negatively affect your health. It’s not just about putting that extra sugar in your body but instead about the way that alcohol affects your body’s ability to process sugar. Drinking alcohol affects your pancreas and liver, and your pancreas is responsible for keeping balanced sugar levels in the body. Drinking too much can take its toll on the pancreas, which can cause an imbalance in your blood sugars and lead to increased diabetes-related complications.  

Aside from the direct impact on blood glucose levels, consuming less sugar can make you feel better. It can be hard to find a compelling enough reason to reduce sugar, but at ALAViDA, we get an inside look at how members feel at the start of their program and when they leave the program. At that point, most have reduced their drinking and sugars, and it shows. Many members feel increased energy and desire to exercise, as well as experiencing weight loss. When you know the sugar content of alcohol, it empowers you to make choices about how you consume your sugars, and you might find that you prefer the occasional piece of cake to a bottle of wine. 

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The Hidden Benefits of Drinking Less

The effect less alcohol has on our bodies is, quite honestly, amazing.

All of the time and energy our body spends breaking down and digesting alcohol moves toward increasing the efficiency of other functions, and wildly improves other aspects of our health. This leads to a variety of improvements in your mental and physical well-being. But in what ways does consuming less alcohol help us?

You have more energy, and feel better in general.

On the mental side, drinking can help individuals feel calmer and relaxed, but the brain quickly adjusts to those positive effects as it tries to maintain balance. Because of this, when the buzz wears off, people can feel more restless and anxious than before they drank. 

Physically, continuous alcohol-use is tough on the brain and body, as it works overtime to metabolize the alcohol, adjust to the neurological stimulation caused by it, and simply regulate one’s heartbeat and breathing pattern. Without alcohol, the mind and body are able to function at higher levels, because it is not focused on regulating the body’s response to alcohol, as well as processing it. 

Better relationships.

Alcohol can release emotions we were holding back or make feelings of anger and frustration feel more intense, which can affect our health, friendships, family and work. Heavy drinking patterns may also change the way we make decisions and react to diverse stimuli and stressors, which can lead to possible disagreements and arguments, as we’re less likely to be diplomatic or refrain ourselves from showing frustrations when we’re intoxicated.

When we are aware of our thoughts and actions, there is a higher chance of feeling our frustration and letting it pass, instead of acting on it in the moment. Because of your ability to better control your behaviour, you may find yourself with more time to be patient, understanding, and to put effort into your relationships with others. 

In contrast, if you realize that most arguments sparked with a loved one occur when one or both of you had been drinking, this might be a red flag about the impact of alcohol consumption on your relationship. 

Better sleep.

Drinking before bed may make us sleepy, but it actually worsens the quality of sleep one gets because it activates a part of the brain that is usually inactive during regular sleep. This activity disable our ability to enter REM (Rapid Eye Movement) sleep, where we get our deepest sleep. 

You look younger.

Alcohol tends to make people look older than they are. It’s a diuretic, which means that it dehydrates the body, and because the skin dries out, it has less elasticity.

It also causes inflammation. This is why we see some people get red cheeks when they drink. The redness usually goes away once they alcohol leaves their system, but over time, constant inflammation does cause skin damage. Reducing alcohol consumption can help rehydrate your skin and improve its elasticity. 

You may even lose weight.

Alcohol contains “empty calories”, meaning it doesn’t necessarily keep you full or provide nutritional value. When alcohol is metabolized in the liver, it is converted into a substance that is consumed in priority to usual fuels such as fat and sugar, which may be the reason why workouts and diets may not have the desired effects when drinking heavily, even on an occasional basis.

A common alcohol-related activity is eating out as well, where the chances of getting something both healthy and nutritious are slim compared to a home-cooked meal,  making it easier to gain weight. Many of our clients have lost significant weight on their journey to drinking less, including dropping 50 lbs and going down 4 dress sizes because they no longer consume as many empty calories.  

Of course, there are other benefits to drinking less that we haven’t mentioned here, such as saving money, improving liver and heart health, and many more.

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Sleeping with the Enemy

By Kristen Hydes

The evening routine; as a young child it often involved a bedtime story and a warm bath with scents of lavender and the soft voice of a loved one helping us transition into bedtime.  There is an entire market dedicated to soothing “fussy babies” with lotions, music and sound machines.

As a young adult or first year University student, the evening ritual often included late night cramming and fast food runs. There may have been occasional parties and binge drinking on the weekends, however, an evening nightcap of a “hard day” at school was not always routine on a weeknight (save that one for the ‘Weekend Warrior’ to emerge). And then after, as we embark on our career paths with longer hours and stressful days, we begin to introduce alcohol as a part of the evening routine.

It often begins with having a glass of wine while cooking dinner for your partner, or a gin and tonic on the patio with colleagues after a long day at work. You can overhear other groups of people collecting over the mantra of “we deserve this” and “work hard, play harder”.

The drinks progress over the evening at home and you feel that you have arrived to a sensation of “calm”; things feel less intense and your pervasive thoughts over the next day seem to have softened.  You feel that you are able to find a sense of peace that lends you to falling asleep on the couch (with the TV still on) or slipping into slumber as soon as you hit the pillow of your bed.

It may appear that this routine of “winding down” in the evening is helpful to your sleep, and reduces your experience of stress. Unfortunately, the effects of continuous exposure to alcohol in large volumes on a daily basis impacts our nervous system and our overall ability to regulate and self-soothe.  There is a known correlation between the dependency of alcohol and symptoms of anxiety. When we no longer know how to “cope” with everyday stressors without the aid of alcohol, we create a very attached relationship to alcohol as a means to settle.

As the pattern of using alcohol for a means to sleep consists over time, removing alcohol from the evening routine will often result in feelings of anxiousness, insomnia and discomfort. Therefore, it may be helpful to start challenging the evening beer after dinner, or third glass of wine at the dinner table.

Challenging your ‘night-cap’:

In order to challenge the relationship between our alcohol dependencies for sleep, we must introduce evening rituals that allow for similar effects to comfort the nervous system, without depending on the effects of alcohol for slumber.

  1. Try reducing your alcohol content 4 hours before your estimated “bedtime”. This will allow for your body to begin metabolizing the alcohol and reduce the impact that alcohol has on our REM sleep – crucial for us to feel ‘rested’.
  2.  Create “clean” bedtime habits; such as reducing screen time before bed and ensuring the bedroom is a haven for rest.
  3. Introduce a new evening “ritual” such as finding an enjoyable non-caffeinated tea before bedtime or rubbing hands and feet with lavender oil.
  4. While in bed, allow for reflection at the end of the day by keeping a journal near your bedside table to identify what might be causing the issues and impacting your sleep. If a journal does not appeal to you, you may be interested in reflecting three things you are grateful for at the end of each day as a practice of mindfulness.

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Kristen Hydes is the Clinical Program Manager at ALAViDA. She’s a registered social worker and holds a Master in Counselling Psychology, and has over 10 years of experience counselling individuals and families. Kristen holds a passion for working with clients and families who are impacted by addiction, and pulls from evidence based methods of counselling to ensure the highest standard of care.