Likewise, those of Hispanic (21.9%) or Black (18.4%) ethnicity had 3.33 times the odds of increased substance use, according to Czeisler et al. (2020). Three studies exclusively reported a decrease in alcohol use because of the pandemic (López-Bueno et adult children of alcoholics screening quiz al., 2020, Đogaš et al., 2020, Wang et al., 2020). A further three studies from Canada and USA reported that the overall percentage who used alcohol did not change dramatically from pre-COVID to post-COVID (Dumas et al., 2020, McPhee et al., 2020, Wardell et al., 2020).

Electronic searches of databases (MEDLINE, Embase, PsycINFO, CINAHL, Sociological Abstracts) were conducted using a combination of keywords relating to alcohol and other substance use during the Covid-19 pandemic. Our search was restricted to articles published in peer-reviewed journals, from December 1, 2019 to November 30, 2020. In fact, it is possible that excessive alcohol consumption can increase the risk of developing COVID-19-induced illness, as this can affect the immune system. Fear and misinformation have generated a dangerous myth that consuming high-strength alcohol can kill the COVID-19 virus. 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.

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. By 20 April 2020, all but eight states had issued state-wide shelter-at-home orders requiring residents to stay home unless conducting “essential activities” 15. Concurrently, many states relaxed their alcohol laws to provide economic support for restaurants and liquor stores. For example, in many states, adults could, for the first time, order beer, wine, spirits—and sometimes even cocktails—for curbside or home delivery 16. A qualitative study from India analysing 350 online newspaper articles during 1 month of lockdown reflected the lack of a comprehensive alcohol policy in India 102. COVID-19 and the related lockdown has affected the mental health of people, particularly vulnerable populations 56.

One study reported that patients and residential patients with ongoing or previous substance use disorders reported low cravings (Martinotti et al., 2020). The global SARS-CoV-2 (COVID-19) pandemic has had a substantial impact on the lives of people around the world including intensifying mental health difficulties (Czeisler et al., 2020). The spread of the disease has necessitated quarantine or “lockdown” measures as the principal containment tool (Rubin and Wessely, 2020). These factors are likely to affect other health-related behaviours and may generate a change in the consumption of alcohol and other substances (Carrico et al., 2020, Clay and Parker, 2020). Women have twice the risk of men for depression and anxiety, and heavy alcohol use exacerbates depression, anxiety, and insomnia — symptoms experienced by many people during this pandemic. Heavy alcohol use contributes to intimate partner violence, and the COVID-19 pandemic has created a dangerous situation of high stress, increased alcohol use, and decreased escape options for women living with an abusive partner.

3. Participants

One such example is e-consult for people with SUD during the pandemic and training support to healthcare workers in distant places to manage with SUD 118. Telehealth, group meetings and online consultations can be some ways to handle the increased demand during and after pandemic 119. In the UK, alcohol purchase increased by 40% during lockdown across all strata 103. The US reported increased alcohol sale during the initial part of the lockdown 104.

1. In this review to understand the effects of alcohol during the COVID-19 pandemic, changes in the pattern of use of alcohol and resultant effects are evident.
2. In contrast, seven studies reported an increase in the use of alcohol during the pandemic (Ahmed et al., 2020, Boehnke et al., 2020, Gritsenko et al., 2020, Lechner et al., 2020, Rogers et al., 2020, Sidor and Rzymski, 2020, Sun et al., 2020).
3. For example, antidepressants can treat the symptoms of depression in some people.
4. 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.
5. In Iran, misinformation related to alcohol being a ‘neutralizing agent’ and consumption of illicit alcohol led to a ‘syndemic of COVID-19 and methanol poisoning’.

Role of funding source

Adjustment predictors, including depression and fear of the infectivity of COVID-19, predicted using solitary substance use during the pandemic (Dumas et al., 2020). In another study, having lower social support predicted drug use during quarantine (Ballivian et al., 2020). Across substances, levels of COVID-19-related worry and fear were highest among those people who initiated substances during the COVID-19 pandemic compared to those who used substances prior and those who never used (Rogers et al., 2020). Likewise, anxiety about Covid was a reason for an increase in use in medical cannabis users (Boehnke et al., 2020).

Though the researchers couldn’t answer exactly why alcohol consumption was so high among the US adults surveyed, Lee has a few hypotheses. “I was hopeful that we would see declines in alcohol use, but I’m a practicing liver specialist, and the reality is, we had definitely seen a rise in patients with liver failure, which is really an extreme, I think, clinical condition from excessive alcohol use,” Lee said. “So we had definitely seen a surge with the pandemic. And if you look at my clinic and in the hospital, at least from my experience, it hasn’t gone down.” Treatment for long COVID, including symptoms like alcohol intolerance, typically involves a multidisciplinary approach aimed at managing specific symptoms and improving overall well-being.

Are you truly equipped to handle anxious patients?

There’s growing evidence that it may be a unique symptom of long COVID, particularly the post-viral fatigue syndrome (PVFS) type. Long COVID refers to persistent symptoms that occur more than three weeks after the initial COVID-19 infection. Lee and Chhatwal also suggest that more and better messaging on the risks of overconsumption could help counter these effects. Chhatwal recommends heavier taxation and limiting sale hours within retailers to decrease alcohol accessibility. The authors would like to thank the various organizations and individuals who helped distribute the survey and Brian Neelon for his statistical guidance. Surveys from Australia have found no increase in the alcohol use in persons with preexisting mental illness 64▪.

1. COVID-19 Survey Demographics

Of the full sample, 12.8% reported that their drinking had decreased and 27.0% reported that there had been no change in their drinking behavior pre- and post-COVID-19. Over half (58.1%) reported that their drinking had decreased because of diminished alcohol availability, 29.7% reported that their drinking had decreased because of less free time, and 12.2% reported that their drinking had decreased because of having less money. About one-fifth (21.6%) listed some combination of these three reasons and the remainder gave some other reason (25.7%).

Some studies report relative increase in drinking among black and non-Hispanic population 27,37▪▪. In a study from the UK on persons with registered alcohol use disorders prelockdown 38, there was greater relapse secondary to lockdown; past abstinence attempts were not protective, and people who relapsed had increased harmful drinking. To put the first aim in context, according to data from the 2018 NSDUH 19, U.S. adults in 2018 consumed alcohol on an average of 4.8 days and 12.0 alcohol drinks over the past 30 days. Almost a third (31.8%) reported engaging in binge drinking and 3.7% reported engaging in extreme binge drinking.