安省饮酒新趋势：狂饮现象调查
主持人: “精神卫生中心”（Centre for Addiction and Mental Health）的一项研究发现，与疫情前相比，现在选择不饮酒的安大略省居民更多了，但“狂饮”（指一次场合饮用五杯或更多酒）的比例却并未下降。那么，是什么导致了这种脱节呢？Dominique Moreno 医生是一位临床心理学家，也是多伦多大学的兼职教授。Moreno 医生，很高兴您来到节目。根据 KM 报告，去年安大略省饮酒的成年人比疫情前少。然而，“狂饮”现象依然普遍。请解释一下。这中间的脱节是什么？
Original English
>>: A study from the centre for Addiction and Mental Health finds that fewer Ontarians are drinking than before the pandemic, but rates of binge drinking defined as having five or more drinks on a single occasion, haven't gone down. So what's driving the disconnect? Doctor Dominique Moreno is a clinical psychologist and an adjunct professor at the University of Toronto. Doctor Moreno. Great to have you on the show. According to the KM report, fewer adults in Ontario drank in the past year compared to before the pandemic. However, binge drinking still remains high. Help us understand that. What's the disconnect there?
Dominique Moreno 医生: 嗯，我认为原因有很多。这是“多因素”（multi factorial）的。而且，我觉得，虽然总的来说可能喝酒的人少了，而且我们注意到很多趋势，比如“一月戒酒”（dry January）之类的，感觉越来越多的人在追求“清醒好奇”（sober curious），但那些还在喝酒的人，当他们喝酒时，他们是为了“喝醉”（get drunk）。我认为，比如我们看到的“经济困难”（increased economic difficulties）普遍增加，以及“压力”（stress）、“抑郁”（depression）和“焦虑”（anxiety）的增加，都导致了“狂饮”（binge drinking）率的升高。
Original English
>>: Well, I think that, you know, there are a number of reasons for this. It's, you know, multi factorial. And, you know, I think while fewer people may be drinking overall and, you know, we've noticed a lot of trends with, you know, dry January and things like that, it feels like more people are sober, curious, but the people that are drinking when they are drinking, they're drinking to get drunk. And I think that, you know, increased economic difficulties, which we've seen, you know, across the province, increases in stress, depression and anxiety have all been contributing factors to higher binge drinking rates.
狂饮者与酒精依赖者
主持人: “狂饮者”（binge drinker）和“酒精依赖者”（alcoholic）之间有区别吗？
Original English
>>: Is there a distinction between a binge drinker and an alcoholic?
Dominique Moreno 医生: 是的，“狂饮者”和“酒精依赖者”之间有重大区别。事实上，总的来说，我尽量不使用用一个人的“问题”来定义他们的词语。所以，你知道，那些“狂饮”的人，我们远不止于此，对吧？就像我们日常生活中做的任何事情一样。但是，当人们患有“酒精使用障碍”（alcohol use disorder），有些人称之为“酒精中毒”（alcoholism），这是一种“慢性病”（chronic condition），它迫使人们需要“规律性地”（on the regular）饮酒，对吧？每天，也许一天多次。而“狂饮”更像是一种“行为模式”（behaviour pattern），你是在……对女性来说，是任何一次饮酒四杯或更多；对男性来说，是任何一次饮酒五杯或更多。
Original English
>>: Yeah, there's a major difference between a binge drinker and an alcoholic. And in fact, like in general, I try not to use terms that define people by a problem that they have. So, you know, people who binge drink, you know, because we're so much more than that in general, right? Whatever we may be doing in our, in our daily life. But you know, when people have alcohol use disorder, which some people call alcoholism, it's a chronic condition that requires that really moves people to have to drink on the regular, right? Daily, maybe multiple times during the day. And binge drinking is more of a behaviour pattern where you're. For women, it's drinking four or more drinks at any given time, and for men, it's drinking five or more drinks at any given time.
标准饮品与“狂饮”定义
主持人: 我认为观众和听众可能会对“五杯或四杯”就被定义为“狂饮者”（binge drinker）感到惊讶。这对许多人来说是不是个冲击？
Original English
>>: I think viewers and listeners might be surprised that when we hear sort of the definition of, of five drinks or four drinks, that that would be, you know, classified as someone who, who would be a binge drinker. Is that is that is that a shock to many people?
Dominique Moreno 医生: 我不知道，我不知道。我认为每个人都有不同的“临界点”（tipping points），这就是我和我的患者谈论的那一点，一个人会失去对饮酒量的“控制”（loses control）。他们可能没有做出好的决定。也许他们的“抑制力”（inhibitions）完全被消除了。但另一件事是，人们不一定知道什么是“标准饮品”（standard drink）。人们常常惊讶于，在安大略省，一杯“品脱”（pint）（大约 20 盎司）不算一杯酒。那更像是“一杯半”的量。一个 12 盎司的啤酒才算一杯标准饮品，或者 1.5 盎司烈酒，或者 5 盎司葡萄酒。你知道，他们有时甚至有大杯葡萄酒。所以，真正让人们思考的是：“我到底在喝多少？”对女性来说是四份标准饮品，对男性来说是五份标准饮品。
Original English
>>: I don't know, I don't know, I, you know, I think everybody has different, you know, what I call tipping points and that's that, you know, point where I talk about with my patients where someone loses, loses control over the amount that they're drinking. They're not maybe making good decisions. Maybe their inhibitions are fully, you know, dismantled. But the other thing is that people don't necessarily know what a standard drink is. And people are often surprised that, you know, a full pint in Ontario, which is about, you know, 20oz is not a drink. That's more like a drink and a half that a 12 ounce beer is a standard drink, or like a 1.5oz of hard alcohol or, you know, five ounces of wine. You know, sometimes they even have big glasses of wine. So really getting people to think about, what am I actually drinking? It's four standard drinks for women, for five standard drinks for men.
狂饮的诱因与风险
主持人: 是的。你刚才谈到了一些“因素”（factors）。请进一步解释是什么让人容易“狂饮”（binge drink）？
Original English
>>: Yeah. You talked a little bit about sort of the factors. Help us understand more what actually makes someone likely to binge drink.
Dominique Moreno 医生: 嗯，我认为，对很多人来说，这取决于“年龄”（ages），对吧？我认为年轻人经常会“狂饮”，坦白说，是因为“缺乏经验”（inexperience），不了解酒精的作用。你知道，不知道自己的“极限”（limits）。需要喝多少才能醉，保持醉意，甚至喝到非常不舒服，你知道吗？而且我认为“同伴压力”（peer pressure）在这方面起着很大的作用。你知道，当人们说，“来吧，我们都在喝酒，再来一杯，再来一杯。”我的意思是，“再来一杯烈酒。”等等。很多人没有足够的“自信”（self-confidence）或“心理力量”（psychological strength）来说，“其实，我没事了。我现在这样挺好的。”你知道，他们想跟着大家一起走。而且他们常常不考虑自己以后可能会面临的“潜在后果”（potential consequences）。“人格特质”（personality traits），比如“冲动性”（impulsivity）、“寻求新奇感”（sensation seeking）、“低尽责性”（low conscientiousness），这是一种由“大五人格清单”（Big five personality inventory）衡量的特质，有时高“压力”（stress）、“焦虑”（anxiety）、“抑郁”（depression），“遗传因素”（genetic factors）也可能起作用，比如“遗传性”（heritability），如果你的父母或祖父母有“饮酒问题”（issues with alcohol）或“冒险饮酒”（risky drinking），那么下一代更有可能……是的，我想这些是主要的影响因素。
Original English
>>: Yeah, I mean, I, I think, you know, for many people, well, it depends on people's ages, right? I think young people often will binge drink, frankly, because of inexperience, not understanding how alcohol works. You know, what their own limits are. How much is it going to take for them to get drunk, stay drunk, go beyond drunk to quite ill, you know, and I think peer pressure has a big role to play in that. You know, when people are like, come on, we're all drinking and you know, another one, another one. I mean like, let's do another shot. Whatever. It's it's a lot of people don't have the self-confidence or, you know, let's just say psychological strength to say, you know, actually I'm good. I'm good where I am. You know, they want to kind of go along for the ride. And they aren't often thinking about the potential consequences that they may find themselves with later personality traits, like an increased likelihood of impulsivity, sensation seeking, low conscientiousness, which is a personality trait that's measured by something called the Big five personality inventory, sometimes high stress, obviously, anxiety, depression, genetic factors can play a role like heritability, like if your parents grandparents had issues with alcohol or risky drinking, it is more likely that. You know the next generation will. Yeah, I would say those are the biggest factors at play.
主持人: 是的。可能有些人，我们的一些同事，在我们刚开始谈论这个话题时，就曾谈到“狂饮”的定义，对此感到惊讶。而且你刚才对“品脱”的定义，可能让他们更加惊讶。但你能否阐述一下“狂饮”的“风险”（risks）？有些人可能认为自己有“控制力”（control），但这种控制力在何时会动摇？总的来说，“狂饮”的风险是什么？
Original English
>>: Yeah, there. There might be people who even even colleagues of ours, when we first started talking about this story, talked about, you know, what is that definition of binge drinking and being surprised and probably with your definition, you know, of what a pint is, might even surprise them a little bit more. But can we can you help lay out the risks associated with binge drinking where, you know, some people might say or have this understanding that there is some control, that I do have control of this, but at what point does that teeter or what are the risks overall with binge drinking?
Dominique Moreno 医生: 是的。那么，“立即的风险”（immediate risks）包括喝太多酒，通常，最明显的风险之一就是做出“糟糕的决定”（making poor decisions），对吧？所以，人们常常会做一些事情，变得“无所顾忌”（uninhibited），做出有关行为的决定，你知道，做出“过激行为”（acting out）。可能参与“不安全的性行为”（unsafe sexual behaviours）、与他人进行“危险活动”（unsafe activities）、“暴力行为”（violence）。他们可能会遭受“意外伤害”（unintentional injuries），比如摔倒、绊倒、开车事故。你知道，我们知道这是个大问题。我们知道“暴力行为”（violent behaviour）会随着饮酒而增加。当然还有“酒精中毒”（alcohol poisoning），这并不少见，而且可能是“致命的”（fatal），我认为很多人不知道这一点。所以，这些是“狂饮”行为本身，或“狂饮”本身的风险。然后，我认为随着时间的推移，“长期持续狂饮”（chronic risks of continuing to binge drink）的风险与许多“酒精使用障碍”相关的风险有关，你知道，比如“肝脏疾病”（liver disease）、“癌症”（cancer）、“高血压”（high blood pressure）、“心脏病”（heart disease），当然还有“酒精依赖”（alcohol dependence）。
Original English
>>: Yeah, I mean, so the immediate risks of drinking too much often, you know, one of the most obvious ones is making poor decisions, right? So oftentimes people will do things or be uninhibited and make decisions, you know, about behaviours, you know, acts acting out. Maybe participating in unsafe sexual behaviours, unsafe activities with other people, violence. They may have unintentional injuries like falls, tripping, crashing cars. You know, we know that that's a big one. We know that violent behaviour can increase with drinking. And of course there's alcohol poisoning, which is not uncommon and which can be fatal, which I think a lot of people don't know. So those are the, you know, the, the behaviours of binge drinking itself or the risks of binge drinking itself. And then I think chronic risks of continuing to binge drink over time are related to, you know, many of the risks associated with alcohol use disorder, you know, like liver disease, cancer, high blood pressure, heart disease, and of course, alcohol dependence.
酒精获取与政策影响
主持人: 我想谈谈“获取渠道”（access）。我们知道，在安大略省，酒精现在可以在“杂货店”（grocery stores）购买，在“便利店”（convenience store）也能买到。这在多大程度上加剧了问题？
Original English
>>: I want to talk about access. As we know in Ontario, alcohol is now available at grocery stores. They're at your convenience store. How much does that add to the problem?
Dominique Moreno 医生: 唉，是的。实际上，我从事“酒精与公共健康”（alcohol and public health）领域的工作，你可能不信，从我十几岁就开始了。所以几十年了。我的一位导师是“酒精政策”（alcohol policy）方面的专家。昨天我还在和他谈论这件事。他说，他说：“毫无疑问，增加获取渠道与增加问题是相关的。”（increasing access is linked to increased problems）。我们知道，人们对酒精的“可及性”（availability）越高，问题就越严重。这……我想在很多国家有数百项研究表明，“便利性”（ease of access）与公共健康问题增加之间的联系。而“实体可及性限制”（physical availability restrictions）长期以来一直是“全面酒精政策”（comprehensive alcohol policy）的基本组成部分。我们知道，当购买酒精的地方变少，营业时间缩短，并且有“年龄限制”（age limitations）时，可以降低“危险和有害饮酒”（hazardous and harmful drinking）的费率。研究表明，这些限制措施减少了与机动车相关的死亡、暴力行为，甚至“凶杀率”（homicide rates）。
Original English
>>: Well, yeah, actually I've been working in the area of alcohol and public health, believe it or not, since I was a teenager. So for decades and one of my mentors was a huge expert in alcohol policy. And I was talking with him about this yesterday. And, you know, he was saying he was saying this. There's no there's no doubt that increasing access is linked to increased problems. And we know that the more availability people have to alcohol, the worse the problems are. This is I think I think there's been hundreds of studies across many countries showing the link between ease of access and increased public health problems and physical availability. Restrictions have been a basic part of comprehensive alcohol policy for a long time. We know that they can reduce rates of hazardous and harmful drinking when there are fewer places to buy alcohol, when the hours are reduced, when there's a. When there age limitations on drinking and. Studies have shown that these restrictions have reduced motor vehicle related deaths, violent acts, even homicide rates.
主持人: 另一方面，我们确实知道酒精是“大生意”（big money）。安大略省的“酒类管制局”（LCBO，Liquor Control Board of Ontario）预计在 2526 财年能带来约 17 亿美元的收入。我很好奇，这是否会引起担忧，即省政府可能会因为“利润丰厚”（lucrative）的收入而“不太积极”（less motivated）地解决与酒精相关的危害？
Original English
>>: On the flip side of this, we do know that alcohol is big money. The LCBO, the Liquor Control Board of Ontario, is bringing in about $1.7 billion. If we look at the 2526 year, I'm curious, does that raise concerns that the province might be less motivated to deal with the harms related to alcohol, with the revenue being so lucrative?
Dominique Moreno 医生: 我认为，如果政客们没有看到“相关成本”（costs involved），那么是的，这会产生影响。你知道，如果他们只看“头条新闻”（headlines）或“大数字”（big numbers），而不看与酒精危害相关的其他所有数字，那么他们，你知道，他们可能会被迷惑，认为这是一场大胜利。但关于收入，你知道，来自税收或 LCBO 的收入，它们远远不足以支付酒精造成的“健康成本”（hospitalizations）、“过早死亡”（premature deaths）、“刑事司法”（criminal justice enforcement）、为饮酒者提供的“社会服务”（social services）以及“工作场所问题”（problems in work settings）所带来的成本。昨天我还在查阅一些统计数据，我看到有说法称，除了生命损失之外，酒精是加拿大“最昂贵的物质”（most costly substance），在“医疗保健”（health care）、“执法”（law enforcement）和“生产力损失”（lost productivity）方面，2020 年的成本约为 200 亿加元。所以，17 亿加元，你知道，全国 200 亿加元，它们不是同等的数字。而且我认为，你知道，省政府可能因“增加限制”（increased restrictions）而损失的收入，比如将酒精从杂货店、便利店等地方撤出，这很容易通过节省“医疗成本”（healthcare costs）、“社会服务”（social services）来弥补，而且消费者会在经济的其他领域花费更多。你知道，我有一些患者因为购买酒精而刷爆了信用卡，但当他们不再把钱花在酒精上时，他们实际上会把钱花在“教育”（education）上，花在“技能提升”（skills to help their own health）上，这显然会带来很多好处。
Original English
>>: I think if the I think if the politicians aren't looking at the costs involved, then yes, it would be impactful. You know, if they're just looking at the headlines or the big numbers and not all of the other numbers that are related to alcohol harms, then they, you know, they might get confused and think that this is a big win. But regarding revenues, you know, from taxes or, you know, from the LCBO, they don't come close to paying for the costs attributed to alcohol from hospitalizations, premature deaths, criminal justice enforcement, social services for drinkers and problems in work settings. I was looking up some statistics yesterday and, you know, I saw something that said alcohol beyond loss of life. Alcohol is the most costly substance in Canada in terms of health care, law enforcement and lost productivity, measured about it, measured the cost being about 20,000,000,000 in 2020 for Canada. So 1.7 billion, you know, 20 billion across the country. It's they're not equivalent figures. And I think that, you know, the revenues that might be lost to provinces with, you know, increased restrictions on availability, such as taking it out of grocery stores, corner stores, things like that can easily be recouped by savings in healthcare costs, social services, and the fact that consumers are going to be spending more money in other parts of the economy. You know, I have patients that have maxed out credit cards from alcohol purchases, but when they're not spending money on alcohol, they're actually spending money on education, on, you know, skills to help their own health, you know, and that has that's obviously going to have a lot of benefits. Well, with multiplied.
寻求帮助的建议
主持人: 话虽如此，Morizono 医生，您在临床领域工作。我想问问，对于一个正在经历“狂饮”并为此感到担忧的人，您有什么“建议”（advice）？您能为他们提供什么建议？
Original English
>>: Well, with that being said, Doctor Morizono, you you work in the clinical space. I do want to ask, you know, what's one piece of advice for someone who is experiencing binge drinking and is concerned? What what advice do you have for them?
Dominique Moreno 医生: 是的。首先，最重要的一点是，一个人承认自己有问题，这就是最重要的。所以这是件好事。如果有人说，“我觉得我真的喝太多了。”对吧？所以，人们可以随时与他们的“初级保健医生”（primary care doctor）谈谈资源和“简短干预”（brief interventions）之类的事情。在安大略省，有很多“酒精相关服务”（alcohol related services）是由“OHIP”（安省健康保险计划）覆盖的，“Connects Ontario”（C o n n e x Ontario）是一个很好的资源，可以帮助找到这些地方。对于我那些担心实际出门的患者，我总是说，试着想想你的“限制”（limit），想想你个人的“临界点”（tipping point），然后坚持住这个限制。我经常建议人们在饮品之间“穿插喝水”（intersperse drinks with water）。所以如果你喝了一杯，然后喝一杯水，看看你对下一杯的渴望程度。让朋友们互相“监督”（accountability），比如“今晚我们只喝这么多”或者“我只喝这么多，请帮我坚持住”。然后，是的，在需要时“寻求帮助”（seeking help）。
Original English
>>: Yeah, I mean, so first things first, the fact that someone is acknowledging that they have a problem is the most important point. So that's a that's a good thing. If someone says, I think I'm actually drinking too much, right? So we, someone can always talk to their primary care doctor about resources and brief interventions and things like that. In Ontario, there are a lot of alcohol related services that are covered by OHIP connects Ontario, C o n n e x. Ontario is a great resource for finding those places and for my, you know, patients that are concerned about actually going out. You know, I always say like, try to think about your limit, try to think about your personal limit for what's your tipping point, you know, and stick to that limit. And I often suggest that people intersperse drinks with water. So if you have a drink, then have a glass of water and see how much you want the next drink. Having some accountability across friends like, let's only drink this much tonight or I'm only going to drink this much, please help me stick to that. And then yeah, seeking help when needed.
主持人: Marc Garneau 医生，我们今天就到这里。但非常感谢您的见解，真的。
Original English
>>: Doctor Marc Garneau, we are going to have to leave it there. But thank you so much for your insights, really. Thank you for it.
Dominique Moreno 医生: 是的，很高兴能来。很高兴能来。
Original English
>>: Yeah, Appreciate being on. Appreciate being on.