As the U.S. battles a global pandemic that has taken the lives of more than 213,000 Americans, it faces an accelerating public health crisis: increasing alcohol use and related harms. It’s a particularly harmful side effect of shelter in place orders but also fueled by political decisions to weaken alcohol policies.
In this compelling guest expert blog, Alicia explains changes in alcohol use behavior during COVID-19 and what effects the deregulation of alcohol laws has. And she gives a glimpse into raising civil society efforts to stem the tide of alcohol harm.

This guest expert opinion is written by Alicia Sparks, PhD, Vice Chair, U.S. Alcohol Policy Alliance

As the U.S. battles a global pandemic that has taken the lives of more than 213,000 Americans, it faces a dilemma that much of the world confronts. Steps such as sheltering in place designed to protect people against COVID-19 can produce other undesirable health outcomes, including increased drug misuse and a rise in intimate partner violence. In the U.S., a particularly harmful side effect of shelter in place orders is increased alcohol consumption, aggravated by a weakening of alcohol regulations intended to protect public health and safety. 

Changes in Alcohol Use Behavior During COVID

Initial data presented by Dr. David Jernigan at one of the U.S. Alcohol Policy Alliance’s Interactive Dialogues showed that early in the pandemic, sales of off-premise alcoholic beverages increased by 55% over a one-week period, compared with the same week a year before. A week later, sales remained 22% higher than the previous year.

recent study in the U.S. found an overall increase in the frequency of alcohol consumption between 2019 and 2020, particularly for women and non-Hispanic white individuals. The study also found an increase in alcohol-related problems such as damaging family or friend relationships in nearly 1 in 10 U.S. women. 

Increases in Alcohol-Related Harms 

There’s no safe level of alcohol consumption. It can lead to long-term health problems such as cancer and liver disease and a number of physical health issues, including injuries, falls, and drowning. In times of the pandemic it’s especially important to underscore that heavy alcohol use at home can be associated with other concerns, including increased polysubstance use, intimate partner violence, depression, and anxiety.

While COVID-19 may lead to more alcohol use and related harms, evidence also suggests that consuming alcohol may increase the risk of contracting COVID-19 and its severity. The World Health Organization (WHO) has stated that “alcohol compromises the body’s immune system and increases the risk of adverse health outcomes. Therefore, people should minimize their alcohol consumption at any time, and particularly during the COVID-19 pandemic.” 

Rates of substance use disorder and mental health concerns have jumped during the COVID-19 pandemic, particularly for younger adults and racial/ethnic minorities. Over a one week period in June, 

  1. 40% of U.S. adults reported struggling with mental health or substance use (many including alcohol as well as opioids and other substances);
  2. 13% reported starting or increasing their substance use to cope with COVID-19 stress or emotions; and
  3. 31% reported anxiety or depression symptoms.

We are also seeing increases in polysubstance use as more individuals use alcohol, opioids, and other substances at increasing rates while they shelter in place and deal with the numerous traumas and challenges associated with the pandemic.

Additionally, intimate partner violence is increasing as alcohol consumption rises and survivors are stuck at home with their abuser, with few options for seeking support or safety. 

What Laws Are We Seeing Change as a Result of the Pandemic?

The alcohol landscape has rapidly changed as a result of the weakening of policies during COVID-19 pandemic.

As the country has shut down, misguided governments have designated alcohol outlets as “essential businesses.”

Alicia Sparks, PhD

As the country has shut down, misguided governments have designated most liquor stores and alcohol outlets as “essential businesses,” meaning that they remain open while most other retailers have shut down. This message incorrectly conveys that the sale of alcohol is an essential part of daily life. 

In many states and cities, bars and restaurants are closed to dining, which has led to the normalization of home alcohol delivery and carry-out cocktails. In fact, at the season opener of our local baseball team, I drove by the stadium to see people in their cars picking up hot dogs and low-priced beer. 

We’re also seeing changes in the way the alcohol industry markets its products. We’ve seen a number of brands hosting online events such as virtual trivia or even a virtual college graduation ceremony. There’s also been an increase in social media campaigns amplifying alcohol as a coping mechanism during COVID-19, a time when stress and anxiety are high. For example, the Foundations for Alcohol Research and Education (FARE) and the Cancer Council WA Alcohol Program found that in one hour on a single Friday night, there were 107 sponsored alcohol advertisements on one person’s Facebook and Instagram social media accounts – nearly one alcohol ad every 35 seconds. 

What Can We Do About These Harmful Changes?

Interest in battling these damaging deregulatory moves is high. Nearly 1,000 people registered for the U.S. Alcohol Policy Alliance’s Interactive Dialogues, which kicked off with a series on the harms of alcohol deregulation as a result of the COVID pandemic. An additional 300 registered for a dialogue focused on strategies to combat deregulation. We’ve seen some great examples of localities taking action to reverse some of the new laws passed as a result of the pandemic. For example, in North Carolina, a group of dedicated volunteers successfully organized a campaign to fight a proposal to allow curbside sale of mixed beverages.

Interest in battling these damaging deregulatory moves is high.”

Alicia Sparks, PhD

Additionally, the Alliance conducted a survey of the strategies and priorities of the U.S. alcohol policy field and found a jump in activism. In the 12 months before the survey (August 2019-August 2020), approximately 6% of the 95 respondents said they worked on reducing home delivery, while 27% said they were planning on focusing on home delivery in the next 12 months. Interest in reducing curbside delivery policies showed a similar pattern. The increased focus in curbside beverages and home delivery are likely due to the COVID-19 pandemic and the deregulation of alcohol policies across the nation. 


Alcohol is not an essential product. In fact, it leads to numerous harms that contribute to multiple public health crises facing Americans. Alcohol is not central to anyone’s daily wellbeing; it is counterproductive.

The proposed U.S. dietary guidelines recommend that if you have to consume alcohol, both men and women should limit themselves to one alcoholic drink a day on days when alcohol is consumed. That is a decrease from previous dietary guidelines recommendation. Yet we’re seeing an increase in availability and access to alcohol when we should focus on improving and maintaining our health as opposed to putting ourselves at greater risk.

There remains a great deal that we don’t know about the current pandemic, but we do know how to prevent alcohol harms. We have ample data to support policies that are effective in this fight, including limiting how and where alcohol can be sold. It’s critical to organize to push back against alcohol deregulation. We must emphasize that we can’t focus solely on COVID-19 when we need to protect the public’s health in more than one way. 

About our guest expert

Alicia Sparks, Vice Chair, U.S. Alcohol Policy Alliance

Alicia Sparks, PhD

Alicia Sparks, PhD, is a Senior Associate at Abt Associates who focuses on community-level interventions to prevent alcohol and other drug use.

She serves as the Vice Chair of the U.S. Alcohol Policy Alliance and as the Co-Chair of the Alcohol Policy Conference.

You can follow her on Twitter: @asparks416