Most people in Canada who are at risk from alcohol use are not alcoholics (alcohol dependent), nor will the large majority of them ever be.

Moreover, what they are primarily at risk for is not alcoholism, but much more so for illness and early death from such preventable diseases as cancer, stroke, and diabetes.

Those risks go up significantly for every drink individuals regularly have over the upper thresholds of Canada's Lower Risk Drinking Guidelines (LRDG): only 10 standard drinks per week for women, 15 for men. A standard drink is the alcohol content equivalent of a 5oz glass of wine.

Furthermore, according to the LRDG, individuals are at risk for immanent injury after 4 or so drinks in a sitting (or for alcohol poisoning if they consume well over that amount). This heavy episodic drinking pattern is common among young adults and may involve as many as a third of postsecondary students.

Taken together, this is why at the population level alcohol's overall burden of disease (and system costs) is associated largely with non-dependent risky drinkers, rather than with the much smaller group who are dependent (alcoholics).

Policy, prevention and early intervention efforts need to reflect this reality.