Strategies to maintain recovery from alcohol problems during the COVID-19 pandemic: Insights from a mixed-methods national survey of adults in the United States

Abstract

The COVID-19 pandemic has been associated with poorer mental health and, in some cases, increased alcohol consumption; however, little is known about the pandemic’s effects on people in recovery from alcohol use disorder (AUD), especially how they have coped with novel stressors. Our mixed-methods study investigated strategies used to maintain recovery during the pandemic, with attention to variation by gender. We analyzed data obtained in fall 2020 from an online US national survey of adults with resolved AUD (n = 1,492) recruited from KnowledgePanel, a probability-based cohort of non-institutionalized adults maintained by Ipsos for internet-based research. Participants endorsed possible coping strategies on a 19-item choose-all-that-apply list, which were analyzed using chi-square tests. In addition, 1,008 participants provided text responses to an open-ended question about their strategies to maintain recovery during the pandemic, which were coded and analyzed using an inductive, thematic approach. The majority of our sample met criteria for severe lifetime AUD (72.9%), reported being in recovery more than five years (75.5%), and had never used specialty AUD services or mutual-help groups (59.7%). The ordering of the coping strategies was quite similar for women and men; however, the top strategy (talking with family and friends by phone, text, or video) was endorsed more frequently by women than men (49.7% vs. 36.1%; p < .001). Among qualitative themes, “staying connected” was the most common. It was dominated by statements about family, with women mentioning children more often than men. Among other themes, “cognitive strategies” mirrored established therapeutic modalities, and “active pursuits” aligned with many recent recommendations for service providers working with substance-using populations during the pandemic. A minority of participants invoked “willpower” for recovery or stated that pandemic restrictions helped by reducing exposure to relapse risks. These findings shed light on recovery mechanisms during the COVID-19 pandemic and suggest potential intervention targets to support recovery during other catastrophic events, such as natural disasters.

Evaluation of 6 years of eHealth data in the alcohol use disorder field indicates improved efficacy of care

“…In sharp contrast to reports by others (18,19), COVID-19 did not affect the monitored patient population in any dramatic manner (Figure 1). This observation could imply that the eHealth tool served as a sufficiently protective measure for the patients also under the unusual circumstances of COVID-19.…”

“…Worldwide, the COVID-19 pandemic had a considerable impact on alcohol use, with an increase in alcohol related emergencies and changes in alcohol use patterns (18). Also, individuals with AUD were at greater risk for relapse into drinking and had an increased risk of contracting the disease (19). This must be kept in mind when interpreting characteristics over time.…”