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“They had really disruptive pandemic-related effects to their careers, losing jobs or losing their routine. Some of them have young children, too,” he said. “We know that alcohol is used as a coping mechanism for stress. What starts as a habit can become addictive or a substance disorder.” A surge of stress-related drinking and alcohol-related deaths brought on by the COVID-19 pandemic in the U.S. has not tapered off the way Dr. Brian Lee, a transplant hepatologist at the University of Southern California’s Keck School of Medicine, had hoped. The Centers for Disease Control and Prevention (CDC) were alerted to the first confirmed case of COVID-19 in the U.S. on 22 January 2020; the first reported death occurred on 29 February 2020 in Washington state 12,13. Due to concern over the contagiousness of COVID-19 and the harm suffered if contracted, the Washington governor declared a state of emergency that same day (29 February 2020) 14.
While hand sanitizer containing alcohol may kill the virus on surfaces, drinking alcohol doesn’t cure or prevent a COVID-19 infection. Though the researchers couldn’t answer exactly why alcohol consumption was so high among the US adults surveyed, Lee has a few hypotheses. When stress exceeds a certain Does gabapentin help you sleep limit, it might trigger brain inflammation, resulting in symptoms like those seen in ME/CFS, including alcohol intolerance. Ongoing research, including advanced brain scans, aims to further investigate these connections.
Van Laar et al., (2020) reported that the proportion of women in the Netherlands who used cannabis more often since the lockdown was higher than the proportion of men. We also compared current alcohol consumption and the prevalence of binge drinking and extreme binge drinking in the past 30 days between participants who reported being very impacted by COVID-19 versus those who did not (Aim 2). Lastly, we examined whether U.S. adults reported that their alcohol intake had changed in the past 30 days compared to their drinking behaviors prior to COVID-19, and the reasons given for any perceived changes in their consumption (Aim 3). However, although almost two-thirds of the sample reported that their alcohol consumption had increased during COVID-19, it should be noted that 12.8% of the participants reported that their alcohol consumption had decreased.
National Pandemic Emotional Impact Report, compared to men, women reported higher rates of pandemic-related changes in productivity, sleep, mood, health-related worries, and frustrations with not being able to do enjoyable activities. Women with children under age 18 had higher rates of clinically significant anxiety, compared to men with children under age 18 and to women with no minor children. Women are more likely to shoulder the burden of household tasks, caregiving, and child-rearing than men. Stay-at-home orders to stop transmission of COVID-19 led to decreased childcare support and the additional burden of remote schooling. The survey screener question asking if participants were 21 years of age or older was completed by 998 participants.
Consuming any alcohol poses health risks, but consuming high-strength ethyl alcohol (ethanol), particularly if it has been adulterated with methanol, can result in severe health consequences, including death. Finally, some jurisdictions loosened alcohol restrictions during the pandemic. Many policy changes and trends are likely to continue long after the pandemic ends, increasing the risk of alcohol-related problems.
Moreover, nearly two-thirds of the participants reported that their drinking had increased compared to their consumption rates prior to COVID-19. Reasons for this increase were increased stress, increased alcohol availability, and boredom. One perhaps surprising risk factor in the included studies was parental status (those with children were more likely to increase their alcohol use during the pandemic). During lockdown, many parents had to ‘home-school’ their children alongside continuing to work at home. Study authors suggest that this may have led to role overload and distress and consequently heavier drinking (Sallie et al., 2020). In sum, alcohol use in the U.S. is a public health problem that appears to have worsened since the onset of COVID-19.
In the former study, participants without access to legal cannabis and those with fewer responsibilities were more likely to report decreased frequency of cannabis (Boehnke et al., 2020). Six studies reported a statistically significant role of younger age in increasing drug use during lockdown. Ballivian et al., (2020) report that being younger predicted drug use during quarantine. Czeisler et al. (2020) reported that substance use increase was most reported in persons aged 18–24 years and that prevalence decreased progressively with age. Wainwright et al. (2020) found that patients tested positive for selected drugs during the COVID-19 period were significantly younger compared with the period before COVID-19.
It was really no surprise that during the first year of the pandemic, alcohol sales jumped by nearly 3%, the largest increase in more than 50 years. Multiple small studies suggest that during the pandemic, about 25% of people drank more than usual, often to cope with stress. While hand sanitizers containing 60-95% ethyl alcohol can help destroy the coronavirus on surfaces, drinking alcohol offers no protection from the virus. The COVID-19 pandemic is affecting every family across the country and will likely have a long-lasting impact on public health and well-being. Alcohol misuse is already a public health concern in the United States, and alcohol has the potential to further complicate the COVID-19 pandemic in multiple ways. Below are links to important resources for the public, clinicians, and researchers from NIAAA.
As Table 1 shows, the frequency of drinking is difficult to compare, and the measurement and results show wide variance across studies. During the pandemic, the proportion of individuals consuming alcohol varied across samples from 21.7% (Knell et al., 2020) to 81.4% (Romero-Blanco et al., 2020). Likewise, hazardous drinking ranged from 28.2% (Chodkiewicz at al., 2020) to 52.7% (Newby et al., 2020) with binge drinking from 7.1% (Gritsenko et al., 2020), to 20% (Silczuk, 2020). Problematic alcohol was 7.1% (Panno et al., 2020), harmful drinking 0.7% (Chodkiewicz at al., 2020) and possible addiction 0.9% (Chodkiewicz at al., 2020).
In the meantime, healthcare providers should take alcohol intolerance into account when evaluating and treating post-COVID symptoms. While research on post-COVID alcohol intolerance is still limited, anecdotal evidence suggests that it’s a symptom experienced by many people following the virus. “Alcohol has diverse adverse effects throughout the body, including on all cells of the immune system, that lead to increased risk of serious infections,” said Dr. E. Jennifer Edelman, a Yale Medicine addiction medicine specialist. Two primary members of the study team independently screened articles by abstract and title based on the above criteria. Furthermore, a quantitative assessment of methodological quality was undertaken using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data (Munn et al., 2015). We did not include studies if they were deemed “high risk” and were deficient in more than five of the out of nine of the quality criteria or had a small sample size (i.e. less than 100 due to a high possibility of selection bias).
One example is an NIAAA-supported study showing that fewer college students had AUD symptoms during the COVID-19 pandemic. Here we present such data as are available on per capita alcohol sales during the COVID-19 pandemic. NIAAA Director, Dr. George Koob, discusses what we know about how alcohol affects our immune and stress systems, along with issues related to treatment access during the pandemic. Alcohol use might also cause or worsen certain mental health conditions during the pandemic. In more serious cases, mixing alcohol with medications can cause internal bleeding and organ problems. For example, alcohol can mix with ibuprofen or acetaminophen to cause stomach problems and liver damage.
