Many policy changes and trends are likely to continue long after the pandemic ends, increasing the risk of alcohol-related problems. With other disasters, we’ve seen that these spikes in drinking last 5 or 6 years and then alcohol consumption slowly returns to usual levels. We hope that the high rates of alcohol use and negative health effects will decline over time as we return to more typical interactions with each other. As there are some countries in the second wave at the time of this review, we need newer protocols and cohorts to study the long-term effects on mental health and addiction of different populations 123. Despite World Health Organization (WHO) warnings, a lot of misinformation regarding a protective role of alcohol and tobacco has been circulating in the social media 107. A hospital-based study on patients tested for COVID-19 observed that chronic alcohol use does not protect against COVID-19 108.

How we reviewed this article:

Problematic alcohol was 7.1% (Panno et al., 2020), harmful drinking 0.7% (Chodkiewicz at al., 2020) and possible addiction 0.9% (Chodkiewicz at al., 2020). Across all studies, the percentage of individuals who did not drink during the study period ranged from 17% (Håkansson, 2020) to 32.1% (Đogaš et al., 2020). In England, the rates of smoking cessation and use of remote cessation support during lockdown were higher. Compared to prepandemic period, the use of evidence-based support to reduce the use of alcohol decreased among high-risk drinkers 55.

Alcohol sales during the COVID-19 pandemic

Though the researchers couldn’t answer exactly why alcohol consumption was so high among the US adults surveyed, Lee has a few hypotheses. Women also were more likely to be heavy drinkers, with 6.45% reporting as such, compared with 6.1% of men. Lockdown and sudden alcohol ban in many countries saw a sudden surge in complicated alcohol withdrawal 5▪▪,9. There were also reports of alcohol withdrawal resulting in cases of suicides during the COVID-19 pandemic from India 10,11, raising potential dilemmas of forced abstinence 12. There have also been instances of doctors prescribing alcohol for withdrawal management, which also raises ethical issues 13. Electronic searches of databases (MEDLINE, Embase, PsycINFO, CINAHL, Sociological Abstracts) were conducted using a combination of keywords relating to alcohol and other substance use during the Covid-19 pandemic.

1. “People need to know what is harmful alcohol use and what it does to your body,” Lee said.
2. During the COVID-19 pandemic, people may experience higher levels of stress, depression, and anxiety.
3. Furthermore, use of medications like Non-Steroidal Anti-Inflammatory Drugs in patients with alcohol use disorder poses a risk of hepatotoxicity.
4. The data on increases in emergency admissions relating to overdose provides information which may be useful to emergency services and emergency response planners, in relation to future crises and pandemics.

Two studies reported a statistically significant association between educational status and increasing drug use. The factor related to an increase in cannabis use was intermediate or low level of education, in a study by Rolland et al. (2020) whereas those starting medications/substances had a higher level of education in study by Boehnke et al., (2020). Five studies (11.1%) identified drug/ substance using longer questionnaires/instruments (seeTable 4). The remaining six studies (11.3%) used existing data and performed a time-series analysis linked to substance use (Glober et al., 2020, Leichtle et al., 2020, Marais et al., 2020, Ochalek et al., 2020, Slavova et al., 2020, Wainwright et al., 2020).

Alcohol and mental health

Furthermore, use of medications like Non-Steroidal Anti-Inflammatory Drugs in patients with alcohol use disorder poses a risk of hepatotoxicity. Overall, during the pandemic, there has been a surge in addiction related behaviours. Studies suggest an increase in alcohol, cannabis and tobacco use, screen time, behavioural addictions, higher salt and calorie intake 22–25. As expected, there was also an increase in risky health behaviours like physical inactivity, sedentary lifestyle, but some evidence suggests that people adapted to the changes towards the end of lockdown 26. Time-series analyses comparing periods of lockdown, where individuals were restricted in their movement, to the previous year, showed that alcohol problems increased during lockdown (Grigoletto et al., 2020, Leichtle et al., 2020). For example, in one study of data taken from hospitals in Italy, when compared to the same time period in 2019, despite a lower number of attendances to the Emergency Department, the absolute number of patients presenting with severe alcohol intoxication increased (25 vs. Drug Overdose Death Rates National Institute on Drug Abuse NIDA 15).

Links to NCBI Databases

In India, in the early period of lockdown, less than 20% of registered patients with alcohol dependence were able to seek treatment. It was observed that there were difficulties to get help for withdrawal management and access to medication for preventing relapses (like disulfiram) 92▪. Finally, among alcohol users diagnosed with COVID-19, treatment of patients with alcohol-related liver disease and heavy alcohol use warrants caution when medicines such as chloroquine or hydroxychloroquine, as combination can lead to hepatotoxicity 91. Hence, screening patients with alcohol use is important especially in areas with higher prevalence of alcohol use disorders or history of liver disease.

It will also explain how alcohol consumption affects mental health and discuss some ways to treat the symptoms of depression and anxiety. In this review to understand the effects of alcohol during the COVID-19 pandemic, changes in the pattern of use of alcohol and resultant effects are evident. Immediate effects have been an increase in alcohol-related emergencies including alcohol withdrawal, withdrawal-related suicides, methanol toxicity and alcohol-related motor vehicle accidents. Immediately post lockdown, a significant increase in the number of alcohol intoxication cases presenting to the emergency department (11.3%) compared to lockdown (0.8%) and in the previous year (2.9%), were reported from Italy 15. Peer reviewed articles in MEDLINE, Embase, PsycINFO, CINAHL complete and Sociological Abstracts were searched from December 2019 until November 2020.

To cope, many people turned to alcohol despite the risk of developing alcohol-related problems, including problem drinking and alcohol use disorder (AUD). At the same time, people with active alcohol use disorder shouldn’t suddenly stop drinking without medical supervision, as alcohol withdrawal can be dangerous. “They had really disruptive pandemic-related effects to their careers, losing jobs or losing their routine. Some of them have young children, too,” he said. “We know that alcohol is used as a coping mechanism for stress. What starts as a habit can become addictive or a substance disorder.” A surge of stress-related drinking and alcohol-related deaths brought on by the COVID-19 pandemic in the U.S. has not tapered off the way Dr. Brian Lee, a transplant hepatologist at the University of Southern California’s Keck School of Medicine, had hoped. While research on post-COVID alcohol intolerance is still limited, anecdotal evidence suggests that it’s a symptom experienced by many people following the virus.