Health, Disease, & Injury

Alcohol-related deaths

In KFL&A area from 2000-2007, an estimated 105 chronic disease deaths attributable to alcohol consumption occurred among men and women between the ages of 15 and 69 years. This represents 3.3% of all deaths in KFL&A area for this age group. Digestive diseases, a category almost entirely made up of liver cirrhosis, contribute 36.2% (38 deaths) of the overall alcohol-related chronic disease deaths, followed by cancer at 33.3% (35 deaths). Males died of such causes 2.5 times more frequently than women over this eight-year period.^{36, 37}

Alcohol-Related Hospitalizations

In KFL&A area from 2002 to 2010, an estimated 1306 chronic disease hospitalizations attributable to alcohol consumption occurred among men and women between the ages of 15 and 69 years. The most common chronic disease hospitalizations attributed to alcohol were neuropsychiatric conditions, including alcohol dependence syndrome and alcoholic psychosis. Males were twice as likely as females to be hospitalized from all causes over this eight-year time frame.^37, 38

The data presented in Figure 2 is pulled from the Discharge Abstract Database - which represents inpatient discharges in acute care hospitals. Another source of hospital admissions for neuropsychiatric conditions due to alcohol use is the Ontario Mental Health Reporting System (OMHRS) which captures acute mental health admissions. From 2006 to 2010, there were 377 mental health hospitalizations due to alcohol-related neuro- psychiatric conditions, including alcohol dependence syndrome and depression.³⁹

Figure 3 displays  the  top  ten  causes of chronic disease hospitalizations attributable to alcohol for males and females in the KFL&A area. For all chronic diseases with the exception of breast cancer and 'other cancers', there are more males than females. Alcohol dependence syndrome and cardiac arrhythmias are in the top three causes for both males and females. ⁽¹⁷⁾

Alcohol Dependence, Addiction and Access for Treatment

During the years 2004-2008, the number of open admissions (carry-over and new) for substance abuse in the South East Local Health Integration Network (LHIN) increased from over 7,600 in 2004 to 8,200 in 2006 before dropping to 7,400 in 2008. Although the majority were for individuals aged 35-54 years (43%-46%) considerable service was also needed for the younger population including those aged 25-34 (23%-25%), 16-24 (19%-21%), and even youths younger than 15 years (3%-5%). The main drug for which treatment was required was alcohol at 69%.⁴⁰ In 2009 to 2010 this trend continued with almost 70% of substance abuse admissions required for alcohol.⁴¹

Although data specific to the incidence of substance abuse in the KFL&A area is lacking, the number of caseloads for substance abuse admissions for treatment could be used as an indirect indicator of problematic substance use in the area. Figure 4 below shows a 7.4% increase in the number of caseloads between 2005/06 to 2009/10. It is important to note that the highest number of caseloads for substance abuse admissions for treatment was in 2007/08.⁴¹

The Options for Change Addictions Team at Frontenac Community Mental Health and Addictions Services sees on average 15 - 18 new clients weekly. sixty-three percent of unique individuals admitted are males, with the majority of admissions for individuals between 25-44 years of age.⁴²

Kairos substance use and addictions is a program of Youth Diversion in Kingston that specializes in treatment for youth and young adults with alcohol and other drug problems. The program serves youth ages 12-25 years. According to Darren Dougall, Executive Director, the program sees on average 10-15 new clients per week. Four percent of clients are under 14 years of age, 60% are between 14 and 17, 15% are between 18 and 24, and 21% are more than 24 years of age. Of the clients seen, 70% are male.⁴³

Alcohol and Mental Health

The relationship between alcohol problems and mental health is multi-faceted. Close to half of all those who misuse alcohol or other drugs will develop a mental illness at some time in their lives.⁴⁴ And three out of every ten people who have a mental illness will develop a dependency on alcohol or other drugs.⁴⁵ According to a newly released Ontario report on the burden of mental health and addictions, alcohol use disorders are among the top five conditions which account for the highest burden. "Alcohol use disorders account for 88% of all deaths attributed to mental illness and addictions and 91% of years lost due to early death."⁴⁶

One in ten students in grades  7-12 reported both hazardous drinking and elevated levels of psychological distress e.g. symptoms of depression, and anxiety.

Ontario Student Drug Use and Health Survey (OSDUHS), Centre for Addiction & Mental Health, 2011.

• According to the Ontario Ministry of Transportation, 10.2% of all motor vehicle fatalities involved a driver who had consumed alcohol, and 80% of the drivers involved in those fatal collisions were considered legally impaired by alcohol.⁵¹
• The Canadian Institute of Health Information reports that of all the major trauma cases in Ontario in 2011, more than half (53%, n = 2,265) were tested for blood alcohol concentration (BAC). Thirty percent of those tested had a BAC > zero and 24% had a BAC ≥0.08%, or above the legal limit for driving.⁵²

Alcohol-related Injury Deaths

From 2000 to 2007 in the KFL&A area, an estimated 74 injury-related deaths attributable to alcohol consumption occurred among 15 to 69 year olds. Figure 5 describes the estimated injury-related deaths (%), attributable to alcohol consumption in KFL&A from 2000 to 2007. About a quarter are related to each of motor vehicle collisions and self-inflicted harm.^{37, 38}

Alcohol-related Injury Hospitalizations

The percentage of injury-related hospitalizations attributable to alcohol in the KFL&A area is shown in Figure 6. From 2002 to 2010 in KFL&A area, an estimated 1145 injury-related hospitalizations attributable to alcohol consumption occurred among 15 to 69 year olds. Falls account for nearly a third of all alcohol- related injury hospitalizations, while motor vehicle collisions account for 12.2%.^38, 39

Alcohol-related Emergency Department Visits

KFL&A Public Health is able to track the number of alcohol- related emergency department visits to local hospitals through the Emergency Department Syndromic Surveillance (EDSS) system. The EDSS system was launched in 2004 with the goal of monitoring changes in the incidence of endemic disease and also to detect new and emerging disease threats.

ED visits are collected in near real-time from Kingston General Hospital, Hotel Dieu hospital and Lennox and Addington County General Hospital. The following graph illustrates yearly counts of alcohol-related chief complaints from patients presenting to Kingston area hospitals that were collected from the EDSS system between 2006 and 2011.⁵³

A large proportion of these visits fall into the 17-25 age group. While the numbers of intoxicated individuals in this age group has fluctuated over the last few years, there are concerns surrounding the impact on emergency services.

"Individuals who present intoxicated usually require close observation in case they become unconscious and are unable to protect their airway. If a patient becomes unconscious they are usually situated in our resuscitation area which is normally reserved for the most urgent cases, routinely referred to as life and limb cases. Having even a handful of intoxicated patients in the emergency department's resuscitation area can impede our ability to deal with life-threatening issues in a timely manner." (Karen Smith, Public Affairs, KGH, Nov 2011)