Mental health consequences of pandemic-era drinking

By Sarah Handzel, BSN, RN | Medically reviewed by Amanda Zeglis, DO, MBA
Published June 28, 2022

Key Takeaways

  • Before the COVID-19 pandemic, the majority of Americans used alcohol.

  • Rates of alcohol use disorder (AUD)-related mortality and the consequences of drinking have risen dramatically since 2020.

  • Clinicians should be familiar with signs of AUD so they can help patients stop.

Americans have a complicated relationship with alcohol. According to data gathered in 2019, most people over 18 in the US—85.6%—have had a drink at some point in their lives.[]

While many are satisfied after a drink or two, almost 15 million people over age 12 were diagnosed with alcohol use disorder (AUD) as of 2019, according to the data.

That was before the pandemic. COVID-19 drove a wedge of fear and uncertainty through our global social distancing measures, profoundly impacted Americans’ mental health and coping capabilities. Now, research suggests an even greater increase in the amount of alcohol consumed by US adults.

It's essential for clinicians to be aware of the signs of AUD, not only in their patients, but also in themselves.

As the US adjusts to a new normal after the pandemic’s peak, it will be important for people to get the help they need to curb excessive alcohol use.

Alcohol consumption, consequences on the rise

Recent evidence from a variety of studies demonstrates just how serious Americans’ alcohol use has gotten during and after the pandemic.

A 2020 study examined the initial consequences of excessive alcohol use during the first year of COVID-19.[] Of the 1,540 adults studied, frequency of alcohol consumption increased among all participants.

Additionally, three out of four adults reported consuming alcohol one additional day per month compared to their pre-pandemic drinking levels. Women, in particular, ,further showed a significant increase in heavy drinking and a total increase in alcohol-related problems regardless of consumption level.

According to a 2022 study, alcohol sales and consumption—as well as the consequences of its use—have increased since 2020.[] Overall AUD-related deaths increased by almost 25% in the first year of the pandemic; in 2021, those mortality rates jumped almost 22%.

The biggest increase in AUD mortality seems to be among the youngest age group studied, people aged 25 to 44. The increase was approximately the same among males and females.

According to the 2020 JAMA study, heavy drinking among women jumped by 41% in the months following the first COVID-19 outbreak. The exact reasons for this increase are unknown, but the Director of the National Institute on Alcohol Abuse and Alcoholism speculated it could be due to:

  • Feelings of social isolation

  • Financial pressures brought on by unemployment due to pandemic layoffs

  • Interruptions in, or cancelation of, treatment services resulting from physical distancing measures

  • Stress and anxiety about COVID-19 and its global impact

  • Attempts to cope with boredom, sleep disturbances, or other issues

Helping those with risky drinking behavior

The precise definition of at-risk drinking can be a moving target, but in general, women should consume no more than seven drinks each week. Men should have no more than 14 per week.[] Additionally, women should drink no more than three drinks per day, and men should have no more than four daily.

Even if a person drinks less than this recommended threshold, it’s still important to examine your relationship with alcohol, especially if you or your patient is concerned that they have a problem.

The person with a suspected drinking problem should think about why, when, and how much they drink. They should reflect on whether they worry about seemingly minor issues such as running out of alcohol on any given day.

It should also be noted whether alcohol interferes with sleep or seems to contribute to increased anxiety or depression.

These can be signs that a person’s relationship with alcohol is unhealthy, especially if it’s interfering with their daily life. Many benefit from group therapy in organizations like Alcoholics Anonymous, but others may need more intensive treatment and counseling.

The CAGE Substance Abuse Screening Tool questionnaire can be helpful in identifying alcohol abuse in patients. Its four questions can be easily discussed in any healthcare setting or appointment.

Change is possible, but it may take substantial effort on the patient’s and clinician’s parts.

What this means for you

Alcohol use has increased across the board since the beginning of the COVID-19 pandemic in 2020. A variety of factors may play into increased consumption. Clinicians should be aware of the signs of alcohol use disorder and be prepared to help patients receive necessary treatment or appropriate referrals for management of their alcohol use.

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