Reports from around the world are showing a trend of increasing alcohol use during the COVID-19 pandemic. Research suggests traumatic events such as terrorist attacks and natural disasters lead to increased population level alcohol use. Considering the prolonged nature of the pandemic experts warn that the COVID-19 pandemic exacerbates the alcohol epidemic.

Reports are coming in from many countries around the world of increased alcohol use and related harms.

In Germany, more people have started seeking help for alcohol problems.

In the United Kingdom (UK), the Institute of Alcohol Studies (IAS) reports that similar numbers of people have been consuming more alcohol as well as less alcohol and there has been a rise in people going alcohol-free as well as becoming heavy alcohol users. In Scotland alcohol use has polarized similarly to England with heavy alcohol users consuming more alcohol and lighter alcohol users going alcohol-free.

In Norway, the Blue Cross Compass notes that retail alcohol sales have been reported to be rising during the COVID-19 lockdown in the country. They warn this could mean a wave of substance use disorders after the pandemic.

In Canada more people are consuming alcohol which is leading to deteriorating mental health.

In the United States alcohol use has skyrocketed during the pandemic.

In Australia the Foundation for Alcohol Research and Education (FARE) reported problematic trends in alcohol use. There have been increases in packaged alcohol sales. More people are seeking help for alcohol problems and a significant number of people are concerned about their or a household member’s alcohol use.

In India, when the country lifted their alcohol sales ban in May, 2020 an avalanche of alcohol harm was observed. This includes reported increases in violence and domestic violence, breaking of physical distancing measures and physical and mental health harms caused by alcohol which aggravates the burden on Indian healthcare, emergency services and treasury resources.

South Africa experienced a similar rise in alcohol harm when the country lifted their alcohol sales ban with a “nightmarish” rise in alcohol-related hospitalizations.

In East Africa, alcohol harm placed a heavy burden on communities across the region already before the current coronavirus crisis. As COVID-19 struck the region and governments responded in different ways, numerous concerns emerged regarding another wave of alcohol harm, such as alcohol law deregulation pushed for by Big Alcohol; normalization of alcohol use among children and their early initiation;

The World Health Organization’s (WHO) regional office for Europe reported a rise in alcohol related interpersonal violence across countries in the region.

Movendi International reported on community harm from indigenous communities in Australia and communities in the UK, illustrating how COVID-19 fuels alcohol harm.

Interim findings from the Global Drug Survey indicated two different trends in global alcohol use during the pandemic. A majority of users have changed their alcohol use, one group consuming more and another group consuming less alcohol:

  • Around 25% consume alcohol less frequently and 29.7% reported a reduction in binge alcohol use; and
  • Around 44% say they consume more alcohol.

Research suggests pandemic will worsen alcohol epidemic

Real world examples are already showing that the pandemic is leading to rising alcohol consumption and related harms – at least in specific groups of society – including alcohol use disorder, other mental health issues and violence.

Previous research shows that increased alcohol use is a response to traumatic events such as terrorist attacks and natural disasters. Researchers Sugarman and Greenfield from the alcohol, drug and addiction clinical and health services research program at McLean Hospital in Massachusetts, USA discuss the compounding effects of alcohol harm and COVID-19 and how to respond to the crisis in a research viewpoint published in the Journal of General Internal Medicine.

As Sugarman discusses with Healio Q&A, like other catastrophic events, increases in alcohol use have been linked with stress and anxiety related to the pandemic. However the pandemic is unique as there are increases in alcohol use because of isolation. The pandemic is also much longer lasting than other traumatic events. Therefore, people are experiencing the associated stress and anxiety for longer periods of time. There is still not enough data to estimate the full impact the pandemic will have on population-level alcohol use.

Similar concerns of surging alcohol and other drug use in Australia is highlighted in news reports. For instance, alcohol and other drug experts in Victoria, Australia are preparing for rising cases of substance use disorder and addiction due to the trauma of the coronavirus crisis. A recent study published on the Journal Addiction found that in Australia overall, heavy alcohol use decreased during social distancing measures. However, alcohol users experiencing high levels of stress reported a relatively higher shift in heavy consumption despite reporting a small decrease overall.

Emerging data from UK also show a rise in alcohol use as an unhealthy coping mechanism. A survey by Alcohol Change UK found that one in three alcohol users (29%) have been consuming alcohol at increasing or high risk levels over the past six months (over 14 units per week). Over half of alcohol users (53%) reported they have consumed alcohol for a mental health reason – such as feeling anxious, stressed or worried, feeling bored, having trouble sleeping, or feeling sad or low – at least once in the past six months.

Regarding approaches that can be taken in the United States to reduce the rising alcohol use during the pandemic and the resulting harms Sugarman recommends following approaches:

  • Increasing identification of heavy alcohol use in patients and intervening early,
  • Public health messages targeted to include managing stress and anxiety without using alcohol, and
  • Recognition of the problem by policy makers to bring about changes in federal regulations and improvements in access to health care.

Early identification can be improved by primary healthcare providers by asking patients a single screening question: “How many times in the past year have you had five (four for women) or more units of alcohol in a day?” If the patient’s response is one or more, further assessment with the Alcohol Use Disorders Identification Test, or AUDIT, is recommended. The AUDIT score will help the physician to determine if the patient has an alcohol problem and refer to support services as needed.

In the United States, the National Institute on Alcohol Abuse and Alcoholism has also recently launched an alcohol treatment navigator website to help connect individuals with evidence-based care.

World Health Organization (WHO) recommends action on alcohol to relieve pandemic burden

The WHO advises governments to reduce alcohol availability during COVID-19 lockdowns because alcohol increases the health, social and economic burden in countries adding to the pandemic burden.

The WHO policy brief on tackling non-communicable diseases (NCDs) during the pandemic makes a strong case for action on alcohol, including alcohol taxation and mainstreaming alcohol policy considerations into multiple policy areas beyond health, such as labor, finance and economy.

Global action to improve alcohol policy solutions, increase public awareness of alcohol harms specifically related to the pandemic and strengthen support services for recovery from alcohol problems are crucial steps which must be taken now in order to prevent the oncoming rise in the global alcohol epidemic.

[This article was updated on December 3, 2020 as per new information from Metro UK]


Sources

Healio: “Q&A: COVID-19 pandemic threatens to exacerbate alcohol use disorder, risky behaviors

The Australian: “Alcohol, drug use in Covid surges

Metro UK: “Millions drinking more heavily due to coronavirus pandemic