Three studies specifically reported a negative effect of the epidemic on the use of substances (Czeisler et al., 2020, Gritsenko et al., 2020, Rogers et al., 2020). In general population US samples, an additional 5.0% started using cannabis, 5.6% started using stimulants and 5.6% opioids since the COVID-19 outbreak (Rogers et al., 2020). Equally, in Russia, those who reported substance use in the last month before COVID 19 reported their use increased as a COVID-19 consequence. Among substance users, there were increases in specific drugs including 27.3% cannabis, 16.7% Ritalin or similar substance, 18.2% pain relievers, and 23.5% sedatives (Gritsenko et al., 2020).
Appendix 1. : Methodological quality, risk of bias, and quality assessment for the 53 initial studies
An online survey in nine European countries 49 reported reduced alcohol use and harmful drinking secondary to lockdown and restrictions on sales, especially among young women 50,51,52. Among regular drinkers in France, alcohol consumption reduced during lockdown 53. Two studies reported a statistically significant role of ethnicity in increasing drug use during lockdown. In the US, black patients made up a relatively larger proportion of opioid overdose visits during lockdown compared with the previous year (Ochalek et al., 2020). Likewise, those of Hispanic (21.9%) or Black (18.4%) ethnicity had 3.33 times the odds of increased substance use, according to Czeisler et al. (2020). Three studies exclusively reported a decrease in alcohol use because of the pandemic (López-Bueno et al., 2020, Đogaš et al., 2020, Wang et al., 2020).
2. Characteristics of studies
Although some studies observed an increase in drinking among women 27,35, others did not observe gender differences in alcohol use patterns 36. Some studies report relative increase in drinking among black and non-Hispanic population 27,37▪▪. In a study from the UK on persons with registered alcohol use disorders prelockdown 38, there was greater relapse secondary to lockdown; past abstinence attempts were not protective, and people who relapsed had increased harmful drinking. One perhaps surprising risk factor in the included studies was parental status (those with children were more likely to increase their alcohol use during the pandemic). During lockdown, many parents had to ‘home-school’ their children alongside continuing to work at home.
- Mental health factors were the most common correlates or triggers for increased use of both alcohol and other substances.
- Read stories about the efforts underway to prevent, detect, and treat COVID-19 and its effects on our health.
- Alcohol can cause digestive upset, difficulty sleeping, trouble with concentration, and other unpleasant side effects that may worsen your symptoms.
- In fact, it is possible that alcohol consumption may increase the chance of developing severe illness as a result of COVID-19.
- This could influence their future risk for problem drinking, AUD, and health problems related to alcohol use.
Among patients with alcohol-related liver disease, caution is warranted related to use of medications, and outcomes appear to be worse. It has also been observed that alcohol increased the risk of COVID-19 infection. Alcohol users may not adhere to social distancing norms, increasing their risk of COVID-19. Anecdotal reports from Thailand suggest outbreaks of COVID-19 among families attending alcohol parties 88. Further, among young adults with hazardous drinking, adherence to public policies was low and declined over a period of time during the lockdown 89.
Our search was restricted to articles published in peer-reviewed journals, from December 1, 2019 to November 30, 2020. Fear and misinformation have generated a dangerous myth that consuming high-strength alcohol can kill the COVID-19 virus. Consuming any alcohol poses health Alcohol use disorder and Timeline of Alcohol Withdrawal Symptoms risks, but consuming high-strength ethyl alcohol (ethanol), particularly if it has been adulterated with methanol, can result in severe health consequences, including death.
Product Reviews
Although evidence would suggest substance and alcohol use may change during this pandemic and this may result in hazardous or harmful use which may result in requiring emergency health care treatment, there has been no full review or synthesis of the evidence around this. The Centers for Disease Control and Prevention defines excessive alcohol use as binge drinking, heavy drinking, alcohol use by people under the minimum legal drinking age, and alcohol use by pregnant women. AUD is a clinical diagnosis that indicates someone’s drinking is causing distress and harm.
A monthly cross-sectional survey in England that compared smoking and drinking practices for a year before and after lockdown found that, following lockdown, attempts to quit among smokers increased and alcohol use among high-risk drinkers reduced 55. The review included studies that consider both general and clinical populations of human participants (any gender and age range) and included experimental studies, control trials, cohort studies, case series reports, and qualitative studies. We excluded studies if they failed to report findings relating to alcohol and other substance use or were not published in English. Where there was insufficient information to make a judgement on the eligibility criteria, we excluded the study from the review. We’ve also seen more people end up in hospitals due to alcohol misuse and its consequences, including withdrawal symptoms and liver disease. People seeking liver transplants because of alcohol misuse are younger than ever, with many transplant centers reporting that some of their patients haven’t even reached the age of 30.