Effects of the COVID-19 pandemic and lockdown on alcohol use disorders and complications

Abstract

Purpose of review To understand the effect of COVID-19 pandemic and lockdown on persons with alcohol use disorders. Recent findings From a total of 455 titles on COVID-19 and alcohol, 227 abstracts were screened, and 95 articles were reviewed (on November 25 th , 2020). The immediate effect was an increase in alcohol related emergencies including alcohol withdrawal, related suicides, and methanol toxicity. Although there are mixed findings with respect to changes in the quantity of drinking, there are reports of binge/heavy drinking during the lockdown as well as relapse postlockdown. Psychological, social, biological, economic and policy-related factors appear to influence the changes in drinking. Although preliminary data suggest no change in alcohol use among persons with comorbid mental illness, findings in this population are presently limited. Among patients with alcohol related liver disease, outcomes appear worse and caution is warranted with the use of medications. Alcohol also appears to increases the risk of COVID-19 infection and complicates its course. Although some nations banned alcohol sales completely during lockdown, others declared it as an essential commodity, resulting in different problems across countries. Alcohol use has added to the burden of the problem particularly among vulnerable groups like the adolescents, elderly, patients with cancer, as well as health professionals. Services for patients with alcohol use disorders have been affected. Summary The COVID-19 pandemic has had considerable impact on alcohol use, with an increase in alcohol related emergencies, changes in alcohol use patterns, increased risk of contracting COVID-19, effect on alcohol policies and sales, and an effect on vulnerable groups. It is essential to understand and respond to the current situation, intervene early, and prevent further repercussions of the pandemic. Video abstract link: https://drive.google.com/file/d/1IJWtIs6e554PryKWhdma4VB--mjSZq1C/view?usp=sharing .

Changes in Alcohol Consumption during the COVID-19 Pandemic Are Dependent on Initial Consumption Level: Findings from Eight European Countries

“…In contrast, some studies have found that an increase in consumption was associated with a lower initial consumption level [ 10 , 39 ]. In line with our findings, previous studies have also reported indications that heavy drinking has increased during the pandemic [ 18 , 38 ]. For instance, in England, the proportion of heavy drinkers (scoring 5+ on AUDIT-C) increased from 25% pre-pandemic to 38% during the April 2020 lockdown [ 26 ].…”

“…Other studies have examined whether changes in alcohol consumption during the pandemic differed by initial consumption level. In addition to previous reports employing ESAC project data from Germany [ 22 ] and Norway [ 9 ], results from a number of studies employing other data sets and methods [ 21 , 36 , 37 , 38 ] corroborate our findings, showing that increased drinking was associated with higher initial consumption levels. In contrast, some studies have found that an increase in consumption was associated with a lower initial consumption level [ 10 , 39 ].…”

“…This study is based on data from a web-survey of convenience samples, employing various sampling methods [ 23 ], and although data were weighted, there may be biases in the consumption distribution [ 42 ] and in reported changes in consumption during the pandemic for each country and across countries. Underreporting in survey research on alcohol consumption is well-known [ 38 ]. In addition, the format of the ESAC survey failed to identify people who had been abstinent in the year before the pandemic, but who began drinking during the pandemic, which may have led to an underestimation of an increase in consumption.…”

“…The implications of our findings pertain in particular to the likely increase in the prevalence of heavy drinkers, who are more vulnerable than others to infectious diseases, including COVID-19 [ 38 ]. Moreover, an increase in the number of heavy drinkers implies an additional burden on a variety of health care services during an already challenging period, as heavy drinkers are at high risk of acute injuries and substantial risk of new—or complications of existing—somatic or mental health problems [ 1 , 38 , 42 ]. There is also some indication that heavy drinkers (especially when drinking) are less able or likely to comply with social distancing recommendations [ 44 , 45 ], or vaccination schedules, increasing the COVID-19-risk for this vulnerable group.…”

Psychiatric emergency visit trends and characteristics in a mental health epicenter in Istanbul during COVID-19 lockdown

“…Alcohol and substances are being used during the pandemic as a way to cope with psychological distress concerning COVID-19 [ 24 ]. Recent studies reported that COVID-19 pandemic has had considerable impact that increased alcohol and substance use and related emergencies, and alcohol and drug users have difficulties in treatment access and adherence which can aggravate the ASUDs [ 25 – 28 ]. Our result showing the increase in the volume and the rate of ASUD-related PED visits within the 10-month period in 2020 was probably resulted from the increased use of the alcohol and drugs in general population in spite of the decreased capacity of the ASUD outpatient units as consistent with the literature.…”