Alcohol and COVID-19: How the Pandemic Has Changed Alcoholism

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During this pandemic, if you have found yourself consuming more alcohol, you are not alone. There is a strong relationship between how people use alcohol and COVID-19; alcohol sales have spiked since the pandemic started in March 2020.¹

You may also have found it difficult to find counseling, therapy, or alcohol addiction treatment. However,  virtual and remote resources have become increasingly available during the pandemic and more in-person services have reopened since vaccines received emergency approval.

Why Has Alcohol Use Increased During the Pandemic?

Social trends in alcohol use are often associated with psychological stressors. Pandemic conditions have caused job loss, housing instability, loss of life, and increased anxiety and isolation. Researchers believe that these and other pandemic-related stressors have directly caused increased alcohol use.²

One study of 1,540 adults who were chosen to reflect demographics in the U.S., showed that 3 out of 4 adults consumed alcohol one more day a month than they had pre-pandemic.³ In another proportion-based study, about 20% more people reported binge drinking than before the pandemic.⁴

Economic Instability

One survey found that at the beginning of the pandemic, 1 in 4 Americans lost a job or had reduced income due to COVID-19. The majority of people also rated their lives as being more stressful.²

In Canadian study indicates that those who dealt with loss of income are at a greater risk of increased alcohol use, especially if they already had alcohol-related problems before the pandemic. Additionally, adults who provide for children are also more likely to consume more alcohol because of the added financial responsibilities.⁵

Job and financial stress have also contributed to housing insecurity. In December 2020, 11 million U.S. households were significantly behind on their housing payments.⁶ Though no current research links housing insecurity caused by the pandemic directly to alcohol use, housing insecurity in general is a known risk factor for problematic alcohol use.

Grief, Anxiety, and Isolation

Many have experienced intense mental health symptoms during the pandemic. Grief has become a common form of psychological distress as so many people have lost loved ones and many have been unable to gather for conventional celebration of life and funerary traditions. Grief can also be experienced due to distance from family members and other forms of loss.

Many also deal with the anxiety of a loved one or themselves contracting the virus. In addition to medical and health uncertainties, uncertainties exist about how much longer the COVID-19 virus will be of concern and, in turn, how much longer daily life will be impacted. Anxiety may also be felt about stable food and housing, finances, healthcare, and future politics.

One way in which COVID-19 has impacted daily life for many is that it has created social and emotional isolation. In the Canadian survey, reduced social contact was linked to increased alcohol use.⁵

How Has COVID-19 Affected Alcohol Misuse and Addiction?

Certain populations face unique impacts of the COVID-19 pandemic that are a risk factor for problematic alcohol use and potential addiction.

Individuals With an Existing Depression or Anxiety Diagnosis

Alcohol misuse has been documented to frequently be a form of self-medication for individuals dealing with intense mental health symptoms.

Those who have depression or anxiety or who have a history of substance misuse are more likely to rely on alcohol more during the pandemic compared to those who have fewer mental health symptoms or other coping mechanisms.^7,8

Students and Young Adults

Students experienced a disruption to their lives when campuses closed in the spring of 2020 and required students to complete the term online. On one college campus, students reported experiencing greater mood disorder symptoms, stress, and alcohol use compared to students who had completed the university’s survey prior to the pandemic.⁷

Students near the end of high school, college students, and young adults in this age group of approximately 18-35 may face all the same stressors of the general population, compounded with sudden isolation, reduced opportunity, and feelings of purposelessness.

Suddenly being isolated from peers and the lack of having the typical college experience could contribute to depression, anxiety, and, in turn, increased alcohol use. On another college campus, students completed a survey in spring 2020, and they also reported more mood disorder symptoms, stress, and alcohol use than students who had completed the survey before the pandemic.⁹

Older Adults

A study published in April 2021 shows that those who are 40-59 years of age, or older than 60 years of age, and have mental health concerns such as depression or anxiety, have a higher likelihood of increased alcohol use during the pandemic compared to others in these age groups without mental health concerns.¹⁰ Researchers speculated on several reasons for these differences, including increased loneliness because family members were discouraged from visiting adults in this demographic in person.

For the age group older than 60 years, increased alcohol use can be particularly concerning since alcohol misuse has a higher risk of medical consequences. Depending on any medical or mental health conditions a person may have, there may be no safe level of alcohol use for those older than 60 years of age.¹¹

Racial and Ethnic Minority Populations

Marginalized racial and ethnic groups have experienced profound disservices when it comes to health and healthcare during the pandemic. These disserves stem from a number of causes, but include:

• Medical racism—Many people of color encounter systemic racism in the healthcare system, such as their being considered exaggerated and less serious, leading to late diagnosis of life-threatening COVID-19 complications.
• Systemic inequities—The pandemic highlighted a multitude of systemic inequities, but it also created inequities such as fewer testing sites in neighborhoods that house predominately people of color.
• High rates of financial disadvantage—Populations of color have been more likely to experience economic distress during the pandemic. For example, essential and low-income workers—including retail workers, agricultural laborers, and factory workers—are disproportionately people of color and these jobs are less likely to offer sick leave, paid time off, or employer health benefits.

This means that these populations experience a disproportionately greater amount of mental health and substance use concerns while at the same time having less access to treatment.¹²

In a few surveys, adults who self-identify as Hispanic tended to report higher levels of stress due to lack of food or stable housing during the pandemic compared to other ethnic groups. Hispanics have also reported depressive symptoms more frequently than those of other groups.¹²

In one particular survey, about 37% of Hispanic adults reported depressive symptoms and a greater increase in substance use compared to adults in other demographics. These respondents also reported a higher rate of onset—or new substance use—starting during the pandemic compared to 14-16% of all other respondents.¹²

Sexual Minority Populations

Individuals may also experience healthcare disparities due to their sexual orientation or gender identity. Individuals in the lesbian, gay, bisexual, transgender, and queer community, as well as other marginalized sexual and gender groups (LGBTQ+) are highly likely to experience discrimination, homelessness, and mental health symptoms regardless of pandemic conditions. All of these conditions are considered risk factors for substance use.

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In a national sample, LGBTQ+ adults reported changes in mental health, physical health, quality of life, stress, and psychological distress due to COVID-19 at much higher levels compared to straight, cisgender people (i.e., people who identify with the gender they were assigned at birth).¹³

LGBTQ+ people can also experience an additional layer of isolation due to family estrangement or rejection related to their identity. This is a well-documented contributing factor to LGBTQ+ youth homelessness.¹³

LGBTQ+-specific COVID-19 resources related to health and legal concerns are available through GLAD Legal Advocates and Defenders. GLAD also offers resources to connect individuals to other members of the community.¹⁴

Essential Workers

Essential workers such as grocery store employees, food delivery workers, postal employees, and healthcare workers have a higher risk of contracting COVID-19 because they are in regular contact with the public. Research from a U.S.-representative sample found increased psychological distress, economic stress, and substance use to be multiplied among essential workers compared to the general population.¹⁵

Many healthcare workers also have experienced trauma-like symptoms from working with patients whose family and friends are not able to visit them in the hospital. These doctors and nurses have had to witness patients saying goodbye to loved ones via video chat or phone call. While there is no link in the research literature between status as a healthcare workers and alcohol use during the COVID-19 pandemic specifically, some may drink alcohol more to cope with such trauma as traumatic experiences are a well-documented risk factor for substance use.

Women

After the start of the pandemic, surveys found that women have tended to exceed their drinking limits more than men.⁴ Furthermore, more alcohol use disorders (AUDs) have been diagnosed in the pandemic for women but not for men.⁸

Though the research does has not identified the cause of this gendered disparity, women have self-reported certain stressors that do not seem as common for men that may be connected. Women are more likely to report:²

• Managing more responsibility since the start of the pandemic, such as overseeing children who are learning from home while working full-time
• Sleep disruptions
• Pandemic-related stress
• Health-related worry

While parents and caregivers include men and women, research indicates that many of these responsibilities fall to women in the U.S. Parents and caregivers are more likely to experience mental health symptoms compared to those not providing caregiving to others, particularly if they care for an adult with mental health or substance use concerns.¹⁶

Hospitals have also seen an increase in alcohol-related liver disease cases.¹⁷ No data is available specific to women; however, given the rise in alcohol consumption and AUD diagnoses among women, hospitals may be seeing a higher amount of cases of alcohol-related liver disease among women.

Individuals With Addiction

During the COVID-19 pandemic, many substance use treatment programs reduced their hours or bed availability, which has put those struggling with substance use disorders (SUDs) at risk for worsening symptoms and associated risks such as overdose. Insufficient resources for COVID-19 transmission control, increased staff fatigue, and staff reduction have contributed to a decrease in service availability.¹⁸

Such difficulties experienced by treatment programs have led to impacts on patients such as:¹⁸

• Delaying the start of treatment
• Receiving fewer services while in treatment
• Not completing treatment
• Being discharged from treatment early due to economic barriers

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What Can I Do to Minimize My Risks Associated with COVID-19?

If you deal with a substance use disorder (SUD) such as alcohol use disorder (AUD), you are at increased risk of becoming severely ill from the COVID-19 virus due to the effects that substance use has on the immune system.

You can reduce your risk of contracting the COVID-19 virus by:¹⁹

• Working with a healthcare provider and take medication only as prescribed
• Exploring options for medications to treat AUD
• Attending virtual treatment
• Continuing with treatment, therapy, or support appointments as much as possible whether in-person or via telehealth
• Getting the COVID-19 vaccine and booster when it is available to you
• Wearing a mask and stay at least 6 feet apart from others
• Avoiding crowds and small or poorly ventilated indoor spaces
• Washing your hands often with soap and water for at least 20 seconds, as well as using hand sanitizer or wipes with at least 60% alcohol when handwashing is not available
• Avoiding touching your face with bare hands

What Services Are Currently Available for Alcohol Use Concerns?

While some treatment programs may have limited services currently, you have many online options for therapy and support. Some therapists and addiction providers hold appointments via telehealth. Telehealth includes remote sessions through telephone or via secure healthcare versions of services such as Zoom.¹⁹

Virtual peer support groups are also available, such as online Alcoholics Anonymous (AA) meetings.

Further, with increased rates of vaccination, more in-person therapy and recovery services may now be available compared to the start of the pandemic.

If you need assistance finding the best treatment options, please call 800-948-8417 Who Answers? and speak with our specialists. Professional treatment can be the way to mitigate concerns you have about changes in your alcohol use since the start of the pandemic.

Resources

1. National Institutes of Health. Alcohol Sales During the COVID-19 Pandemic. National Institute on Alcohol Abuse and Alcoholism.
2. Palsson, O.S., Ballou, S., & Gray, S. (2020). The U.S. National Pandemic Emotional Impact Report.
3. Pollard, M.S., Tucker, J.S., & Green Jr.,H.D. (2020, September 29). Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the U.S. Journal of the American Medical Association Network Open, 3(9), e2022942.
4. Barbosa, C., Cowell, A.J., & Dowd, W.N. (2021). Alcohol Consumption in Response to the COVID-19 Pandemic in the United States. Journal of Addiction Medicine, 15(4), 341-344.
5. Wardell, J.D., Kempe, T., Rapinda, K.K., Single, A., Billevicius, E., Frohlich, J.R., Hendershot, C.S., & Keough, M.T. (2020, September 01). Drinking to Cope During COVID-19 Pandemic: The Role of External and Internal Factors in Coping Motive Pathways to Alcohol Use, Solitary Drinking, and Alcohol Problems. Alcoholism: Clinical and Experimental Research, 44(10), 2073-2083.
6. Consumer Financial Protection Bureau. (2021). Housing Insecurity and the COVID-19 Pandemic.
7. Lechner, W.V., Laurene, K.R., Patel, S., Anderson, M., Grega, C., & Kenne, D.R. (2020). Changes in Alcohol Use as a Function of Psychological Distress and Social Support Following COVID-19 Related University Closings. Addictive Behaviors, 110, 106527.
8. Boschuetz, N., Cheng, S., Mei, L., Loy, V.M. (2020). Changes in Alcohol Use Patterns in the United States During COVID-19 Pandemic. Wisconsin Medical Journal, E1-E6.
9. Charles, N.E., Strong, S.J., Burns, L.C., Bullerjahn, M.R., & Serafine, K.M. (2021). Increased Mood Disorder symptoms, Perceived Stress, and Alcohol Use Among College Students During the COVID-19 Pandemic. Psychiatry Research, 296,
10. Capasso, A., Jones, A.M., Ali, S.H., Foreman, J., Tozan, Y., & DiClemente, R.J. (2021). Increased Alcohol Use During the COVID-19 Pandemic: The Effect of Mental Health and Age in a Cross-Sectional Sample of Social Media Users in the U.S. Preventative Medicine, 145, 106422.
11. Satre, D.D., Hirschritt, M.E., Silverberg, M.J., & Sterling, S.A. (2020, April 17). Addressing Problems With Alcohol and Other Substances Among Older Adults During the COVID-19 Pandemic. American Journal of Geriatric Psychiatry, 28(7), 780-783.
12. McKnight-Eily, L.R., Okoro, C.A., Strine, T.W., et al. (2021). Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic — United States, April and May 2020. Morbidity and Mortality Weekly Report, 70, 162-166.
13. Fish, J.N., Salemo, J., Williams, N.D., Rinderknecht, R.G., Drotning, K.J., Layer, L., & Doan, L. (2021). Sexual Minority Disparities in Health and Well-Being as a Consequence of the COVID-19 Pandemic Differ by Sexual Identity. LGBTQ Health, 8(4).
14. GLAD Legal Advocates and Defenders. (2020). COVID-19 Resources.
15. McKay, D., & Asmundson, G.J.G. (2020). Substance Use and Abuse Associated with the Behavioral Immune System During COVID-19: The Special Case of Healthcare Workers and Essential Workers. Addictive Behaviors, 110, 106522.
16. Czeisler, M.E., Rohan, E.A., Melillo, S., et al. (2021). Mental Health Among Parents of Children Aged <18 Years and Unpaid Caregivers of Adults During the COVID-19 Pandemic — United States, December 2020 and February–⁠March 2021. Morbidity and Mortality Weekly Report, 70(24), 879-887.
17. Chen, P., Ting, P., Almazan, E., Chander, G., Cameron, A.M., & Gurakar, A. (2021). Inter-Hospital Escalation-of-Care Referrals for Severe Alcohol-Related Liver Disease with Recent Drinking During the COVID-19 Pandemic. Alcohol and Alcoholism.
18. Pagano, A., Hosakote, S., Kapiteni, K., Straus, E.R., Wong, J., & Guydish, J.R. (2021). Impacts of COVID-19 on Residential Treatment Programs for Substance Use Disorder. Journal of Substance Abuse Treatment, 123, 108255.
19. Centers for Disease Control and Prevention. (2021, July 13). COVID-19 and People at Increased Risk.