Addressing excessive alcohol consumption during the COVID-19 pandemic

Alcohol consumption is a common coping response to stress, and historically, it has increased in the United States following catastrophic events, such as terrorist attacks and large-scale natural disasters. Considering COVID-19, experts at McLean Hospital have published a viewpoint article in the Journal of General Internal Medicine that examines potential ways to moderate and reduce rising alcohol consumption in the face of the pandemic.

Because the COVID-19 pandemic is longer lasting and more extensive than previous traumatic events—with widespread social disruption and isolation, limited social support and access to medical care, and negative domestic and global economic impacts—it could have an even greater effect on population-wide alcohol use.

"We hope this article will call attention to the pandemic's effects on alcohol use and offer mitigating approaches to this under-recognized public health concern," said co-author Dawn E. Sugarman, Ph.D., a research psychologist in the Center of Excellence in Alcohol, Drugs, and Addiction at McLean Hospital.

The article stresses that public health messages should include education about managing stress and anxiety without using alcohol, drinking within safe limits during physical distancing and social isolation, and knowing when an individual ought to be concerned about themselves or someone else.

The authors also call for greater efforts to screen for alcohol use disorders during primary care visits and to provide treatments for individuals at risk for relapse or exacerbation of heavy drinking. Telehealth services that use mobile and online programs may help provide access to such care. Ensuring adequate insurance for treatment will be essential with the added concern that many individuals have lost their employer-based health insurance and may have reduced access to health care and addiction treatment programs.

"Increasing identification of harmful alcohol use in patients and intervening early are key components of addressing this problem. In addition, recognition of the problem from policymakers could lead to changes in federal regulations—such as we have seen with telehealth—and improvements in access to health care," said co-author Shelly F. Greenfield, MD, MPH, director of the Alcohol, Drug, and Addiction Clinical and Health Services Research Program at McLean Hospital.

Sugarman and Greenfield note that the full impact of COVID-19 on alcohol use is not yet known, but rising rates during the first few months of the pandemic point to the urgent need for effective public health and medical responses.