The impact of the COVID-19 pandemic on alcohol consumption is far from ‘one size fits all’

An ongoing analysis of the effects of the COVID-19 pandemic on alcohol and related outcomes shows that COVID-related stressors experienced by study participants – including work-, financial-, and family-related stressors – are having a varied impact on individuals with and without alcohol use disorders (AUDs). These results will be shared at the 44th annual scientific meeting of the Research Society on Alcoholism (RSA), which will be held virtually this year from the 19th – 23rd of June 2021 due to the COVID-19 pandemic.

“The diverse and pervasive impact of the COVID-19 pandemic continues to unfold globally on individuals, communities, health systems, and the economy,” said Vijay Ramchandani, senior investigator and Chief of the Laboratory of Human Psychopharmacology in the Division of Intramural Clinical and Biological Research at the NIAAA. “Stress, social isolation, economic losses, and uncertainty can significantly affect mental health and alcohol use; therefore, it is critical to assess the effect of the pandemic on alcohol use and associated behaviors and outcomes.” Ramchandani will discuss these findings at the virtual RSA meeting on 20 June 2021.

Ramchandani, along with co-principal investigator Nancy Diazgranados and colleagues, invited approximately 1,200 adults who were previously enrolled in an NIAAA natural-history study – non-drinkers as well as heavy drinkers with an AUD diagnosis who had gone through inpatient treatment – to participate in the current study. Participants complete electronic surveys at intervals ranging from weekly to every six months for two years. The survey included the Alcohol Use Disorder Identification Test, along with questionnaires assessing alcohol sensitivity/tolerance, impaired control and craving, as well as perceived stress, negative life events, social isolation, resilience, depression and anxiety symptoms, and quality of life. In addition, a COVID-19 Impact Scale assessed the pandemic’s impact on employment, finances, family, and living situations as well as health symptoms and behaviors such as social-media use.

“Our study is ongoing and the full picture of the pandemic’s impact on alcohol and related outcomes will take some time to be fully understood,” said Ramchandani. “At this point in time, we have data from about 440 individuals that appear to suggest there was tremendous variability in patterns of alcohol use during the first six to eight months of the pandemic, and in the change of alcohol use from pre-pandemic levels. Overall, approximately one-fourth of the sample showed increases, one-fourth showed decreases, and about half of the sample showed no change in alcohol use during this six-to-eight-month period.”

While the patient groups showed, on average, little to no change in drinking, it was the non-patient groups that showed changes in drinking that was inversely proportional to their pre-pandemic drinking, Ramchandani added. “In other words, those that had higher drinking prior to the pandemic seemed to show a decrease in drinking, while those with lower drinking prior to the pandemic showed, disturbingly, a pattern of escalation of drinking.” That escalation appeared to be related to COVID-related stressors.

“Another important aspect to this study involves examining racial disparities of the pandemic’s impact,” said Ramchandani. “Different racial/ethnic groups have been and continue to be differentially affected by the pandemic; in fact, vulnerable groups who have experienced the highest level of stress exposure to the pandemic may be most at risk for increased alcohol use and problems following the pandemic.”