The Agenda with Steve Paikin (Audio) - The Pros and Cons of Alcohol Deregulation

Episode Date: June 4, 2024

The Ontario government is moving ahead with plans to liberalize alcohol sales in the province but questions remain about whether the risks will outweigh the benefits, and not just in terms of convenience. A look at how much the provincial economy might be boosted by increased alcohol sales compared to the costs of a potential increase in alcohol-related harms.See omnystudio.com/listener for privacy information.

From epic camping trips to scenic local hikes, spending time outdoors is a great way to create lasting memories to share with friends and family. This summer, TVO is celebrating the natural wonders that inspire unforgettable adventures with great documentaries, articles, and learning resources about beloved parks in Ontario and beyond. Visit tvo.me slash Ontario summer stories for all this and more. And be sure to tell us your stories for a chance to win great prizes. Help TVO create a better world through the power of learning. Visit TVO.org and make a tax-deductible donation today. The Ontario government is moving ahead with plans to liberalize alcohol sales in the province,

but questions remain about whether the risks will outweigh the benefits, and not just in terms of convenience. In fact, across the country, in every province and territory, the statistics say governments pay more to manage the social damage created by alcohol than the revenue they are generating by alcohol sales. Will the Ontario economy be boosted by increased alcohol sales? And what about the costs of a potential increase in alcohol-related harms? Let's get into that with Onandao Sen. He is a professor of economics at the University of Waterloo who has studied the economic benefits of more liberal alcohol

policies in the province. He's done paid research for Spirits Canada, Loblaw, and the Ontario Convenience Stores Association. Joanne Richter is here, co-founder and owner of the Second Wedge Brewing Company. That's in Uxbridge, Ontario. Norman Giesbrecht, adjunct professor at the Dalla Lana School of Public Health at the University of Toronto. His work has been used to create alcohol policy in Canada and is frequently cited in studies on the cost of harms created by alcohol. And Dr. Bjoerg Borgenvog, an emergency health physician with the Sinai Health Network in Toronto

with a research interest in the management of alcohol withdrawal. And it's good to have you four around our table for this timely discussion here. We want to start with a chart, and you can all watch it on the monitors up top or on the wall over there, showing what, in fact, the government takes in in revenue from booze sales compared to what it costs to treat the harms that are caused by alcohol sales. Now, these are 2020 numbers. Sheldon, bring this graphic up if you would. It's detailed. So for those listening on podcast who can't see the numbers, I'm going to go through this a bit. If you take the country as a whole, the country as a whole takes in 13 billion plus from alcohol revenue. But StatsCan says the total societal cost of this is approaching $20 billion.

In other words, a net deficit of 6.3 billion. Let's go province by province. In Quebec, $2.8 billion in revenue, $3.2 billion in the cost of alcohol sales, therefore a $430 million deficit. In Ontario, more than $5 billion in government revenue by selling booze, but $7 billion plus in the costs of dealing with the after effects. That's $2 billion in the whole. billion plus in the costs of dealing with the after effects. That's two billion in the whole. And Saskatchewan, 300 million plus in the whole. Alberta, 1.8 billion plus in the whole. British Columbia, nearly a billion in the whole, dealing with all of these things. Okay, Onondale, let's start with you. Could you explain how, just give us some more detail on whether it makes sense to be as indebted to booze sales, given the costs associated with it.

What's your view? Sure. I think that, you know, this is a great way to start the conversation. I think what we're trying to do is trying to come up with a welfare function for society. The government has to raise revenue. But when we look at costs, it's just not the cost of running the operation, but it's also the social costs. In economics, we call it negative externalities to health and so on and so forth. I think the way to think about it is that it's a layered approach.

Like the first thing is, the first point is that how do we make alcohol available in society, right? And they've made an announcement about that in the last couple of weeks. They're liberalizing sales. They're liberalizing sales, and this is a continuation of policies which began in 2015. Yes.

Right? And so you want to ask yourself that, are we doing that efficiently, right? That's the first point. Because we want to get to a point that when you look at net revenue, that sort of balances the harm. There's always going to be harm with alcohol consumption.

And what I've studied in my research is the differences across provinces. So when you look at Alberta, on a per capita basis, they make much more in alcohol sales than Ontario and other provinces. And the reason is, is that because they don't have administrative expenses. It's about $30 million, $67 million or something. And the reason is, is that because they don't have administrative expenses. It's about $30 million, $67 million or something. And the reason is that because they don't manage their outlets, unlike what we have in Ontario. In Ontario... It's a privatized system out there. It's a privatized system.

In Ontario, we have the government running the LCBO and the outlets, and that's about $1.9 or $2 billion. Yep. So we're ending up with a net income of $2.5 billion. So that's more than the net income we have in Alberta. But on a per capita basis, Alberta is much more. So the point being, what I'm trying to get at is that this perception among the population that if you have deregulation, it actually results in lower net income. That's not true. That's not necessarily true. All right. Let me go to Norman with a follow-up here.

And that is, can you give us a little bit more detail? When we say, when those numbers say that it actually costs society more to sell booze than the taxation revenue realized by selling booze, what does that refer to? That refers to, excuse me, a number of things. It refers to a whole range of health costs, both emergency room and inpatient treatment, doctors' costs and staff costs. It also refers to law enforcement costs, justice system costs, policing costs. It refers to workplace disruptions and costs related to that. There's about a list of 20 or 30 categories that the team has examined

with regard to the provinces and the territories. That many categories? Yeah, a lot of categories. And the other thing I would like to mention is that there's been recent research published this year indicating that the gap between the revenue and the costs is getting bigger. So it is since 2007, I believe, it went from, it's gone up by 122% to 2020. 2020 is the last year they did the calculation. Okay, let's ask our director, Sheldon Osmond. I'm in the middle of page two.

Can we bring up that next chart as well? This is a chart, rather, breaking down how much alcohol costs Canadian society when compared to other substances. So, Sheldon, let's bring that up. And if you look at the comparisons between what it costs us in health care, lost productivity, criminal justice, others, you've got alcohol

versus tobacco versus opioids versus cocaine versus cannabis. And again, for those listening on podcast, I will describe the tallest bar on that bar graph belongs to alcohol nearly 20 billion dollars that it costs us Compared to tobacco which is about half that opioids less cocaine less and cannabis the least You'd let me get you in on this now. What are the most common alcohol related injuries that you would see in emerge at Sinai? Alcohol is ubiquitous substance and problems related to alcohol, pardon me, are extremely common in emergency departments everywhere, not just at our hospital and not just in big cities. And the range of problems are people

who are suffering from extensive alcohol use disorder, people who are homeless, people who have lost their jobs, lost their families, lost their homes, people who've gotten intoxicated and got in fights, people who've gotten intoxicated and fell down and hurt themselves. It's a thread that's woven between the fabric of emergency medicine thoroughly, and it's an extraordinarily common issue that we deal with. Okay, Joanne, you're in the business. I am in the business.

How do you react to all these numbers? There's no doubt, absolutely, there's a societal cost. All I can say from my perspective as the owner of a small craft brewery is that we sit on the front lines of responsible alcohol sales. All of us small breweries have our retail stores, and most of us have our tap rooms where we are wholly invested in making sure that we don't over-serve or serve to minors. We are the caretakers at our very local level.

And to be honest, I think I'm just happy that we are able to play that small part. And you'd find that many, many, most of our craft breweries are taking the laws very, very seriously. You're a responsible player in the field. We are. We try to follow the rules

and we understand how dangerous it can be. And that's why we, you know, we focus on flavor. We focus on quality over quantity. That is just what we're all about. So what is your view on the announcement that Premier Ford made a couple of weeks ago saying he wants to liberalize beer sales in the province? What does that represent in terms of your sector, your slice of the pie? Right. It gives us so many more doors to knock on. So for us, it's great news. I fully understand all of the pie. Right. It gives us so many more doors to knock on. So for us, it's great news. I fully understand all of the cautions. But as far as us as a small business, it allows us to literally go door to door. We compete. We're a small brewery. We're located in a small town.

We don't have big buckets of money to compete. But what we do have is we compete on our quality and on the quality of our relationships as well as our beer. So many more small players for us to work with means we have more opportunities to compete for shelf space. Norman, how would, here's the thing. People have demonstrated in public opinion polling over the years that they actually want more liberalized beer and wine sales in the province. And obviously, Premier Ford is spending potentially anywhere from $225 million to as high as a billion dollars to end that master framework agreement with the brewers in order to bring this forward by just a year. He thinks it's that much of a vote winner. So how do you balance all of that with the harms

that have been described in the charts that we've seen? Well, I think the public doesn't really know some of the harms from alcohol. And people around this table do. But I wonder how many, what percentage know about alcohol as a carcinogen, heart disease and other problems. cause of carcinogen, heart disease, and other problems. So I think that if the public is not fully informed of the harms, then I'm not sure if they can, you know, make the right decision with regard to how much they should drink and how little they should drink. The other thing is, I'm wondering if the system couldn't be fixed to address the things that Joanne raised without having a 300% increase in the number of outlets. What do you mean a fix? What fix?

Well, I mean, maybe there's a way they could make more space for craft brewers on the shelves. Maybe they could, other changes. I'm not in the business, so I'd be interested to hear, you know, what's possible. A 300% increase in number of outlets is the biggest change in alcohol policy in decades in Canada. And it's putting Ontario ahead of the other provinces, with the exception of Newfoundland, on a per capita basis.

What do you think the impact of that much liberalizing of booze sales in the province will have? To be honest, Steve, I'm not 100% sure. I'm not convinced it's really going to have much of an impact at all. I think people who consume beverage alcohol are going to continue to do so, and the majority of people who do are going to, you know, maintain control over that. The problem is there's a small portion of people who drink regularly who develop problems. It's hard to predict how that number will grow, but I would say that people who are going to buy alcohol are going to go and buy it at the corner store

or they're going to go to the beer store, they're going to go to the liquor store. I think it's just going to be more convenient to me. That was my question, Joanne. I mean, the fact is, whatever our population is now, 15, 16 million people can only drink collectively so much. Exactly. And they may have more places to buy it, but are they necessarily going to drink more because there are more places that they can buy it?

Yeah, I don't honestly think so. We've had grocery stores opened up, quite a few more retail locations in the last several years. I mean, sales of craft beer boomed in like 10 years ago. They were booming, you know, up until before the pandemic. And then things have gone fairly flat. I don't know that we're going to see the market expand. I think it just gives, you know, smaller players a little bit more opportunity to compete within the space. I don't know that the extra availability is just more stores. That

doesn't necessarily mean a great big huge increase in alcohol consumption. What does your research show? I agree with that opinion. I published a paper in the Canadian Journal of Criminology and Criminal Justice and I looked at differences in provinces and tried to correlate that with increases in per capita alcohol sales, and there wasn't any statistically significant relationship. I think that the key point out here is not just access, but the cost, right? Cost of what? The cost of alcohol. So there are two layers to cost.

The cost of actually driving and accessing the product, and also the cost of paying for the product. And sure, with more expansion, the cost of traveling to get your product goes down. But the key point is, what are the prices post this experiment we're going for. If the prices don't drop significantly and we retain the minimum price regulations, you're not going to see a significant drop in prices. So I don't see, there's going to be switching around from one store to another.

But will there be a significant increase in sales? I'm not sure. Well, yeah, go ahead. In fact, the price ceiling, there will now apparently be an opportunity for the individual retailers to set their own pricing, which they have not been able to do to date. It's been LCBO, grocery and brewery retail stores have uniform pricing. So I believe the idea behind the convenience stores having that opportunity is that they can set the prices higher. It is a convenience to be able to go somewhere a little closer by. So those prices might actually go higher in those stores

than consumers are used to, which again can help control overconsumption, hopefully. Norman. A couple of points. The World Health Organization has indicated that two best buys to control harm from alcohol are pricing and physical availability, number of outlets. In Ontario, pardon me, in three provinces, there's research on what happened when you make alcohol more available. In British Columbia, there's an increase in morbidity and mortality. In Alberta, increase in suicides. In Ontario, when the corner stores, pardon me, when the supermarkets were allowed to sell alcohol, there was an increase in ER admissions for alcohol, 24,000 more admissions in the two years following the change.

And you would draw a straight line between those two things. There's no question that that's the reason for it? Well, the researcher Daniel Myron looked at the admissions prior to the change, and then he looked at the admissions two years after the change, and he found a big increase. The international research is very strong on this, that if you increase the availability of alcohol, you're likely to have increased in hospital admissions, violence, and many other problems from alcohol. Buick, is that your experience? It's hard to say. I can say that the problems related to alcohol have gone up. They've gone up, it feels like, a lot since the pandemic started. They've gone up over the almost 30 years that

I've been practicing emergency medicine. Let me jump in on that. I guess what I need to know is, have the problems gone up because we can buy booze at more places or because we needed to drown our sorrows during COVID and therefore it went up for that reason? I think it's because people were stuck at home and people didn't have to go anywhere and having a beer on an afternoon seemed like a good idea, or a drink or a glass of wine. I don't want to pick on the beer brewers. But truthfully, at my place in the picture, it's hard for me to say what may be factors that are affecting that. I guess, I mean, Ontario is one place that has extremely good provincial health data through ICE, the Institute of Clinical and Value of Sciences.

So I think we'll get the answer soon enough what happens. On and down. Norman's correct in the research he cited, absolutely. But there is a paper by Schwartz in the Journal of Studies on Drugs and Alcohol. What they did is that they exploited the Ontario experiment. They basically got survey data which looked at drinking patterns in the population and correlated it to whether there was a grocery store which suddenly started stocking a beer after 2015

over a couple of years, and they didn't find any significant correlation out there. No significant correlation? No, in intensity of alcohol consumption, no. Norman, you want to come back on that yeah i would because i i know that paper and i think that's an excellent point but uh there's another paper that has just been published uh which which which found that there was an increase in uh in um alcohol related hospital admissions following following the access through the

supermarkets although we got an er doc right here who says he can't be sure that the reason is liberalized sales. I'm looking at the population level and you're looking at your individual experience. I'm looking in an emergency department waiting room, not a whole province. It's hard to say. And therefore, whose word do we take here? They're both relevant. They're both relevant. Okay, well, that was very diplomatically put.

That's nice. All right, let's, again, Sheldon, I'm going to ask you to bring up this graphic here, bottom of page three, because we asked, okay, here's what we did. We asked Ontario's chief medical officer of health whether or not he was consulted either before or during the government's plan to deregulate booze sales in the province, and they didn't really want to give us an answer. They referred us to the provincial ministry of health, who I guess gets to speak for the government now, as opposed to the medical officer of health.

And here is what the ministry of health had to say. Let's bring these comments up. They say alcohol is one of Canada's most regulated products, and there are a number of provincial regulations and programs already in place to ensure the safe and responsible sale and consumption of alcohol, including, and here's their list, standard hours of sale, minimum drinking age, minimum retail pricing requirements, requirements for warning signs, mandatory staff training that would be required for all new retailers, rigorous standards for licensing and enforcement through the Alcohol and Gaming Commission of Ontario, and their concluding

comment is, our government is also investing an additional $10 million to support social responsibility and public health efforts to ensure alcohol continues to be sold and consumed safely in the expanded marketplace. That funding is on top of the additional nearly $400 million announced in this year's budget, building on the existing historic investment of $3.8 billion over 10 years for mental health and addiction services. Okay, so Norman, in your experience, how much consultation goes on between governments and professionals such as yourself or the Medical officer of health or others before policy is in fact made? An excellent question and I don't know the answer. I'll tell you why. Because the consultation that the Premier referred to was consultation

with the industry. His statements have made no reference to consultation with public health experts. Do you think there should have been if there wasn't? Yes. I think there always should be. But you don't know that there wasn't? I can't say what there was. But I do know that he was very dismissive about the recommendations by the chief medical officer. Who's the he?

The premier. Premier Ford. Yes. Was dismissive of, yes, when the two drinks per week came out. No, I'm talking about the recommendations by the report by the chief medical officer of health in April. There are recommendations, I think there are recommendations referring to different strategies. And you're saying the premier was dismissive of those health care concerns.

That's my personal interpretation. You're nodding, but do you agree? I can't comment. I haven't studied that aspect. Okay. of those healthcare concerns. That's my personal interpretation. You're nodding, but do you agree? I can comment. I haven't studied that aspect. Okay. But I would say that this list is only half the list. They didn't talk about mitigation strategies they could put into place once this change happens.

Such as what? There's a whole list of what they could do. They could put warning labels on alcohol containers. They could give the municipalities a chance to decide. Municipalities could say, we've got seven liquor stores and four beer stores and eight wine shops. Thank you, we're good. We don't need to have more outlets. Let me put that issue of labels. Would you want labels on your product saying, you drink in excess and it's bad for your health? I mean, for us, beer is, you know, an object that you're supposed to enjoy with a meal. It's supposed to be pleasurable.

You're supposed to enjoy it in moderation. So it's a downer. It's a bit of a downer. But, you know, if somebody says you're going to have to slap those labels on, you know, fine. We'll do it. Whatever helps keep our industry afloat, basically. But it is a bit of a downer when you think of it.

I mean, the idea of it is small amounts of very flavorful, creatively crafted liquid. Do you have a view on whether warning labels on booze is a good idea? We see people who regularly drink hand sanitizer and non-beverage alcohol. It's not clear to me that it's going to make a big difference. I don't know. I'm not an expert, and I would defer to Norm on specifics about whether warning labels really has an impact on these kinds of things. There there were there was a very excellent

study done in yukon a few years ago and they compared yukon to northwest territories and they they had warning labels on the bottles in yukon that refer to alcohol as a carcinogen and other problems very large labels very colorful labels and they also had information on the number of standard drinks in the in the bottle and that had an impact on the number of standard drinks in the bottle. And that had an impact on people's awareness of risks, awareness of alcohol problems, awareness of good policies, and impact on drinking.

So this is the best study that I know of internationally, and it was very well done, and it does have an impact. Now, the U.S. warning label is not a good example, and it's often used by the industry to say that warning labels don't work well. The U.S. warning label was made to fail. I mean, they had very dense text on the same sort of background, and so. Okay. Let me, I want to circle back to something here,

and I'll start with you on this because you know i can't remember i think maybe norman you said it i mean we're seeing the most significant changes in the way booze is marketed in this province maybe since the end of prohibition this is a huge change in the way things are going and how it's all going to shake out is really anybody's guest right now. You know, the brewers, what we used to call brewers retail, now the beer store. The beer store have been doing it the way they've been doing it for a very long time. And it's been simple in terms of distribution because they've only had to take their product to the beer store and that's where you had to go to get it, in the main. Now it's going to be in, I mean, hundreds if not thousands of different locations. So what's going to happen to the beer store?

I've studied the beer store quite a bit. And I think that there's not much of a sense for them to retain their outlets. Because from an economic perspective, why did the beer store or the brewers fight so long to retain the beer store? Why did the beer store or the brewers fight so long to retain the beer store? I mean, it's really ridiculous to think that we are probably the only country in the world where the government outsourced, gave the brewers a private retail monopoly. Right. And that's an artifact of successful lobbying, very successful lobbying. So my point being is that when you have the beer store, it is a really good mechanism in order to control prices, in order to make sure that there was an intense price competition, right? Also to make sure that your products are the ones which gain prominence, not the craft beers, right? But if the major multinational breweries, I'm going to leave you out of the equation for a second here. If the folks who are responsible for shipping the most,

I don't know, tonnage, gallonage, however you describe it. Yeah, liters. Yeah, liters. Now have to deliver to many, many, many more locations, not just their own beer stores. Does it stand to reason that that's going to increase the cost of distribution and therefore the product? Well, not necessarily because that's what happens in Quebec, right?

So if you strip away, and this is part of my research, if you strip away the taxes and you're left with the prices, the net prices, back a few years ago when I did my research on pre-COVID prices, the prices in Quebec of major products, the Coors Molson, were still lower in Quebec relative to the LCBO, despite the brewers having to incur all these transportation and logistical costs. So they're sensitive to the marketplace still. Absolutely. They are. Okay. Do you have a view on what may happen to the beer store now that this liberalization is coming into effect? Well, it's a great question. I mean, they have options that I'm obviously not sitting in their meetings, but I know that they have a distribution network of their own. So, you know, they handle logistics for other breweries delivering across Ontario. So perhaps they would invest there, but I don't, I can't really say. Were you ever allowed to sell your stuff in the beer store? We were allowed but we did not. How come? It's owned by

conglomerates that have a vested interest in well they have a vested interest against the success of craft breweries so we just chose you know wonderful people working there across this province. I love the recycling program, but we just didn't want to collaborate with these conglomerate breweries that have all the power. What about the notion of getting your product into the LCBO or into corner stores or supermarkets? Well, we do have our products in the LCBO and grocery,

and we sell to LCBO convenience outlets up in our area. We're in our northeast of Toronto. In Uxbridge. In Uxbridge, yes. So up in our area, we have already, you know, what they used to call outlet stores. So we're used to going to, you know, selling to individual stores,

driving up with our own van and pulling up our dolly to the back door and unloading our own product. So that's something that we already have going. And we are in the LCBO. The LCBO is a much more controlled retail environment, and it often really benefits the companies with the most money. It is great for craft beer. It's been a great place for us to sell, but it does limit what we can do because the shelf space is often purchased and there's a very long seven-month process to get one product listed. It's a rather large and weighty process. weighty process. My understanding is that now with the individual convenience stores, we will be able to sell any of our products as long as they meet all of the requirements. Then, you know, when we're

ready, we have a beer that's available, we can go sell it now. Like that is ideal for us. How many locations you got? Right now? Yeah. We're in 50 to 75 LCBO stores. So we're still a fairly small distribution, but a lot of it is because you just have to be on the phone and you have to be visiting all the stores and everything. And you make it all in the one place in Uxbridge? We do. You don't have a second location for manufacturing?

No, we don't. Okay. Can you do that now, or would you want to do that now? We, hey, never say never. At the moment, we're a very community-focused place, and we have enough room to do a little bit more expansion on our own property that we rent in Uxbridge. We'd love to grow to the point where we could, you know,

potentially open a second location. We're growing in a fairly modest way. But again, because things have been fairly flat since COVID times in the market, you know, growth is kind of how you sustain at this point. Like the only way to actually survive is to be able to kind of expand our market a little bit. Well, let me ask Anandal about that. Again, based on your research, your experience, when this kind of liberalization takes place in other provinces, for example, is it a boon for the craft business?

Absolutely. You look at the experience of Alberta, you look at the experience of British Columbia, there's just so much, I mean, essentially it comes down to shelf space, right? And reaching the products, sorry, consumers efficiently. And so therefore I expect there to be possibly significant economic benefits to the province in terms of small distilleries and small manufacturers, craft brewers. She's still got to be good at what she does, though. She's got to fight for a piece of the action. That's the market. Yeah, exactly. As you well know. Yeah. And, you know, I would like to think that our beer can just stand on its own. And like I said, the quality of our beer and the

quality of our relationships, we still, you know, without big money bags, we can only do so much with the opportunity. We're going to do our very best. But so it's a freer market. But I'm really happy that Ontario Craft Brewers, of which we're a member, has pushed hard for 20% shelf space of the beer on the convenience store shelves has to be Ontario craft beer. That favours you? It does favour us. And, you know, I think we could stand on our own, but just having, you know, the big breweries have had an advantage for so many years.

It's nice to have finally a little bit of an advantage for the little guys. All right. Again, going to circle back to where we started here. All right. Again, going to circle back to where we started here. I appreciate that some of you here believe that the cost of liberalizing beer sales isn't worth it because the downside is so much more significant. If that's the case, what should we do about it? I mean, we're not going to ban the sale of alcohol in the province of Ontario in order to avoid all of the potential negative consequences. So what do we do? Hugh. Well, I think one thing that would be helpful to do would be to increase education around treatment for alcohol use disorders. So, you know, people are going to continue to drink, as you say, and some people are going to get into trouble with that.

What most people don't know, what most doctors, I think, are unaware of, certainly most emergency physicians, is there's very effective treatment for alcohol use disorder. We just published last month some national, actually international guidelines called GRACE-4, the Guidelines for Reasonable Appropriate Care in Emergency Departments, outlining specific treatment that we think emergency physicians should be offering people who have alcohol use disorder. Anti-craving medications is what they're called. They've been available for decades. Probably fewer than one percent of people with alcohol use disorder are ever actually prescribed those medications. They're incredibly effective. The number needed to treat in order to get to a good outcome, however you might measure that

outcome, whether it's reduced heavy alcohol consumption, abstinence or something in between, is somewhere in the neighborhood of three to twelve patients. So in Ontario this is paid for by Ontario Health. It's readily available. We are trying very hard to get emergency physicians to want to participate in looking after people with alcohol use disorder in a nonjudgmental way, offering treatment for people who are willing to explore the harms that have happened to them,

likely as a result of their alcohol use disorder. How do you get more uptake on that? It's been hard. I think doctors, or emergency physicians anyways, are pretty action-oriented. They want to do something. And I think one of the problems with problematic alcohol use is people don't feel they can do anything. They feel there's a high degree of stigma associated with alcohol use disorder. Many people feel it's a moral failing. Why can't these people just drink less? From a provider's point of view, just giving somebody the telephone number for the local detox is not very satisfying.

At our hospital and at other places, we've created a list, a toolkit of pre-printed prescriptions that have the correct dose with the limited use codes that will be paid for by Ontario Health. We've created sheets outlining for the patient what medication they're taking. We've created referral pathways to the rapid access addiction medicine clinics that have proliferated in the province of Ontario over the last 10 years.

We've even come up with guidance for family doctors if a patient chooses to go back and see their family doctor because family doctors don't prescribe this medication otherwise. Norman, let me get you in here too. We're not going to ban booze sales, but what could we do to make it less expensive? I think, first of all, the government should stop, pause, wait till January 2026.

They can save the taxpayer $225 million, if not more. They're not going to do that, Norman. They've already announced that they're in fact going to do the exact opposite of that. But that's illogical. Okay. Secondly, and I agree with what you said, Joanne, earlier on, I think they really need to beef up the server training to make sure that there's no sales or minimum sales to youth and people who are intoxicated.

Countries that have looked at this, including in Alberta and British Columbia, the private outlets do not do as good a job as the government outlets in terms of selling, preventing sales to miners or to intoxicator patrons. I think they should also give municipalities a chance to decide whether they want this or not, have the municipal decision. And thirdly, I think they could put a cap on number of outlets per municipalities. Instead of 8,500, it may be somewhat less, but they could still have a few outlets. And last but not least, I think picking up what it was just said, to have a screening, a brief intervention, brief intervention used more widely so that people who are at the early stage of problem drinking have a way of stopping or reducing their drinking. And rather than wait until they're really into the alcohol

and are going to be going into hospital for a long-term stay, which is much more expensive. So I think there's some things that could be done to mitigate some of the harms that are likely result from this change. But waiting a year would be a great idea because I could think about the options and plan the mitigation strategies and so on. Understood. I want 20 more seconds control room to ask Bug about the fact that the last time

he was on this program, he mentioned that his daughter was unemployed and she gave him HE double hockey sticks for doing that. Would you care to give us an update on how your daughter's doing these days? My lovely daughter, Natalie, is gainfully employed after losing her job in the pandemic, and she'll be very happy to hear me say on television that she's not unemployed. Thank you for that operation. Excellent. Happy to do that. We're a full service operation here. Anand Dowsen and Norman Giesbrecht on the right-hand side of the table. Joanne Richter

and Björg Borgenvog on the other side of the table. Good to have all four of you here tonight to help us with this conversation. Appreciate it. Thank you. Thanks very much for the invitation, Steve. The Agenda with Steve Paikin is made possible through generous philanthropic contributions from viewers like you. Thank you for supporting TVO's journalism.