Alcohol Use and Misuse during the COVID-19 Pandemic: A Potential Public Health Crisis?
Research correspondence
Summary
The authors discuss the risks of alcohol use during COVID-19 lockdown measures in developing addiction in the long-term. The potential public health effects of long-term isolation on alcohol use and use disorder are unknown.
Stress is a prominent risk factor for the onset and maintenance of heavy alcohol use. For example, chronic alcohol use results in neuroadaptations in stress and reward pathways. In turn, these neuroadaptations lead to increased cravings for alcohol in response to stress. The effects of long-term social isolation on stress levels, including increased neuroendocrine responses and stress reactivity, have been described in non-human animals. However, the ongoing lockdowns across many countries are unique and little is known of the effects on the general population of chronic isolation (with respect to health and wellbeing) in these circumstances.
A risk factor for the onset and maintenance of heavy alcohol use and alcohol use disorder is trait impulsivity (i.e., the tendency to take risks or act without adequate forethought or reflection). Impulsivity can moderate stress-induced consumption of alcohol and is also associated with relapse in addicted individuals. Thus, this period of isolation might lead to a spike in heavy alcohol use, relapse, and potentially, development of alcohol use disorder in at-risk individuals, therefore placing further strain on addiction and mental health services, and the health service in general, during and after the pandemic.
Most governments, including the UK Government, have responded to the COVID-19 pandemic by advising the public to remain indoors, avoid unnecessary social contact, to protect themselves and health-care systems, and to save lives.
The authors suggest that, as well as this important public health advice, governments should give public health warnings about alcohol consumption during isolation to protect vulnerable individuals.