Alcohol’s Impact Since COVID-19: Improving Our Approach

digital screening alcohol

By Cori E. McMahon, Psy.D., NCCE
VP of Clinical Services

Alcohol abuse, alcoholism, and alcohol use disorder (AUD) have had a persistent impact on society for as long as alcohol has existed. Today, these disorders kill over three million people each year, accounting for up to six percent of global deaths. In the U.S. alone, 95,000 people die annually from the effects of alcohol use.

Notably, about 60 percent of people increased their alcohol consumption during COVID-19 lockdowns. How does a stressful period like a global pandemic, which already strained our collective mental health, lead to higher alcohol consumption and affect our wellbeing? Now more than ever during Alcohol Awareness Month, it’s important to understand the disorder’s complex nature and appreciate the challenges those with it face, including stigma, access to care, and impact on overall health.

Alcohol alerts by age and sex

Fifteen percent of Tridiuum ONE® Adult Mental Health assessments completed in Q1 2022 resulted in a substance use alert (approximately 91,721 alerts from 53,676 unique patients). Such an alert is triggered when a patient screens positive for risky drinking on the US-AUDIT (Alcohol Use Disorders Identification Tool).

In the last two years, those data represent more female than male patients and largely represent the general adult population aged 18–59 years old, as seen in the graphs below. Not surprisingly, trends in our intake assessments that included substance use alerts showed an increase throughout 2020, significantly higher numbers in 2021, and similarly high statistics in Q1 2022.

Graph of alcohol alerts broken down by sex

 

Graph of alcohol alerts broken down by age group

Number of Intakes with a Substance Alert

 

Alcohol and the pandemic

As COVID-19 stay-at-home orders began in the U.S. in March 2020, Nielson reported a 54 percent increase in national sales of alcohol for the week ending on March 21. Compared to that same week in 2019, online sales increased by 262 percent. A study published in the International Journal of Mental Health and Addiction sought to understand the impact of individual characteristics, contextual factors, and mental health variables on alcohol consumption.

A survey of over 2,800 adults (79 percent women) revealed that 26.4 percent reported an increase in alcohol consumption during the COVID-19 lockdown. Those individuals were often older, more often working from home, more likely to have children, have higher education, and consume alcohol more frequently and in higher quantities than those who did not report a change in consumption.

Alcohol and mental health

In addition to a range of negative physical health associations, researchers note that excessive alcohol use may lead to or worsen existing mental health problems, such as anxiety or depression, which were also negatively affected by the pandemic. To that point, another study published in Preventive Medicine focused on whether age modified the association of anxiety and depressive symptoms with alcohol use during the pandemic. Out of 5,800 social media users surveyed twice, 29 percent reported increased alcohol use. While younger respondents (18–39 years) had a higher probability of increased alcohol use, the probability of older respondents (40–59 years and older) reporting increased drinking was much greater among those with symptoms of anxiety and depression. Because of this, researchers suggest age-differentiated public health messaging on the risks of excessive alcohol consumption and concern for use for middle-aged or older adults with symptoms of anxiety or depression.

How can we improve language surrounding Alcohol Use Disorder?

Clearly, alcohol consumption continues to affect many people of diverse age, sex, and walks of life, and has increased since the start of the pandemic. When it comes to reducing alcohol-related stigma for these individuals, words matter. The NIH Institute on Alcohol Abuse and Alcoholism provides recommendations to help alleviate stigma by using person-first language to describe alcohol concerns and the individual affected by them.

For example, “Alcohol Use Disorder” is preferred language to “alcohol abuse” and “person with alcohol use disorder” is preferred instead of “alcoholic.” We can refer to a “person in recovery” instead of a “recovering alcoholic.” Knowing that stigma is a significant barrier to an individual’s help-seeking behavior as well as access to quality care, any step we can take to make patients feel comfortable is a positive step toward addressing these issues.

How can we normalize alcohol use monitoring?

Making the patient’s alcohol use a routine point of discussion in medical encounters sends the very important message that alcohol use is a pertinent, allowable, and normal topic when considering overall health. Regular and consistent screening as a part of behavioral health assessment allows providers to keep track of any changes in health behaviors and gives patients regular opportunities to discuss this potentially sensitive topic.