On average, in Quebec, there were 54 emergency room visits per day with a primary diagnosis related to alcohol last year, according to figures obtained by The DutyAlthough less talked about, it is almost twice as many as drug-related visits.
“Drinking alcohol is less stigmatized and more commonplace than taking drugs in society,” says Dr.r Guillaume Lacombe, vice-president of the Association of Emergency Medicine Specialists of Quebec.
In 2023-2024, the number of emergency room visits with a primary diagnosis related to alcohol was 19,815, according to data provided by the Ministry of Health and Social Services (MSSS). More than half of these visits were made by people aged 30 to 54.
While the figures for pandemic years should be taken with caution, as COVID-19 may have had an impact on the number of emergency room consultations, those for 2019-2020, preceding the health crisis, are relatively stable (21,063) compared to 2023-2024.
The number of these consultations “still seems high,” says Dr.r Lacombe, who is an emergency physician at the Lanaudière Regional Hospital Center. “A significant portion of these visits are potentially avoidable,” says the toxicologist.
As for emergency room visits attributable to narcotics, there were 10,025 in 2023-2024, according to data provided by the ministry. However, these have increased slightly, as there were 9,747 in 2019-2020.
Powerful drugs and/or drugs contaminated with other substances in circulation are particularly to blame, says the DD Marie-Ève Goyer, medical head of homelessness and addiction services at the Integrated University Health and Social Services Centre (CIUSSS) of South-Central Montreal. “Several reports show us that fentanyl is found in cocaine. So, even someone who doesn’t think they’re using opioids can be using them without knowing it.”
The MSSS emphasizes that it is, however, difficult to accurately quantify the gap between emergency room visits attributable to alcohol and those related to drugs. “In many cases, a person may present to the hospital having consumed both alcohol and drugs. It can therefore be difficult for healthcare personnel to determine precisely which exact substance is linked to the patient’s condition.”
More accessible, still risky
According to the Dr Lacombe, the difference between the number of visits related to alcohol and those related to drugs could be explained in particular by the fact that alcoholic beverages are more accessible than narcotics.
However, alcohol consumption can have serious consequences, he continues. “In the short term, there can be poisoning, but also falls down stairs, for example. [Parfois]it can go as far as alcoholic comas.”
The figures provided by the ministry regarding this type of emergency room consultations would only be the “tip of the iceberg”, according to Dr.r Guillaume Lacombe. According to him, many more people are showing up at the hospital for a reason related to these substances.
The toxicologist gives the example of a patient who injures himself with glass because he is drunk. “He may not mention having been drinking before coming to the hospital. He will be in the waiting room for three, four or five hours and, by the time I see him, he will have sobered up,” he illustrates.
The ministry’s data on narcotics also does not include poisonings treated directly at supervised consumption sites, points out Martin Pagé, general director of the Montreal organization Dopamine.
More prevention
According to the website of the Institut national de santé publique du Québec, Quebec’s per capita alcohol consumption has remained relatively stable since 2013-2014. However, it has “remained higher than the Canadian average over the past sixteen years.”
More prevention is needed to ensure better knowledge of the risks and reduce alcohol-related emergency room visits, says Kim Brière-Charest, director of projects on psychoactive substances at the Association pour la santé publique du Québec.
The trivialization of alcohol is an important issue, stresses Mme Brière-Charest. According to her, one of the problems is that because of its legal nature, alcohol is rarely perceived as a psychoactive substance. However, it is indeed, she says. “Without demonizing alcohol, we still have to review the information that is accessible and put forward to be certain, ultimately, that people consume it while being aware of its effects on health.”
There is an “inconsistency” in the way alcohol and drugs are treated in society, notes Jean-Sébastien Fallu, associate professor at the School of Psychoeducation at the University of Montreal. “On the one hand, we trivialize, even glorify alcohol consumption, which means that people consume more or perhaps do not pay enough attention, and on the other hand, we stigmatize those who take drugs.”
“The different substances are not necessarily the same and cannot be treated in the same way in public policies. However, there needs to be a framework and a much more coherent vision between the substances,” adds the specialist in addictions.
Joined by The Dutythe office of the Minister of Health, Christian Dubé, emphasizes that the MSSS “is continuing information and awareness campaigns on the risks of alcohol consumption targeting young people.” “Alcohol consumption, like various other risk factors, is part of the ongoing discussions to improve prevention in Quebec,” writes Julie Drolet, communications advisor for the MSSS.