Drinking In Quarantine: Alcohol Use (and Abuse) during the Coronavirus Pandemic

Survey shows many Americans are drinking more now, especially those at high risk.

Whether you’re an essential worker or not, most of us have spent a lot more time at home this past year than we ever have before, and – let’s face it – there’s not that much to do there. We made our sourdough bread, we binge-watched Queen’s Gambit, but anecdotally – Americans have been doing something else a lot more since they’ve been stuck at home – drinking.

And a new study from the American Journal of Drug and Alcohol Abuse suggests this is more than just anecdote. The pandemic has upped our alcohol consumption – particularly those among us who drink more anyway.

Now, caveats abound for this survey study, which recruited participants via social media. The response rate was less than 6%, but at the very least it’s good to put some numbers to the problem and identify some directions for future research.

OK 1,928 self-selected participants from across the US completed the online survey in the early months of the pandemic. It asked a slew of questions about psychiatric history, pandemic behaviors (like the time spent in lockdown) and drinking habits.

All-in-all this was an affluent group – 75% had a household income exceeding $80,000 a year and 88% said their job was not impacted by the pandemic. On average, the respondents had been sheltering-in-place for about 4 weeks.

32 percent of the respondents said they had increased their alcohol intake during the pandemic, compared to just 10% who reported their consumption went down. Understandable. But there might be a bigger problem under the surface. 34% of the survey population were classified as binge drinkers – men that drink more than 5 drinks in a sitting or women who drink more than 4. The increase in alcohol consumption among binge drinkers was significantly higher than among non-binge drinkers – 60% of binge drinkers reported further increases in alcohol intake, compared to 30% of non-binge drinkers.

Typically, stratified populations “regress to the mean”.

I want to point out that this is a little bit odd from an epidemiology standpoint.  Typically, when you stratify a population by some continuous variable, the people on the high end come down and the people on the low end come up – this is known as regression to the mean.  Like, if you take a group of people and divide them into those with high blood pressure and low blood pressure and measure their blood pressures over time, the high group tends to come down a bit and the low group tends to go up a bit – this is expected.

We see the opposite signal here when it comes to drinking – people who already drank a lot drank more - which suggests this is a particularly potent finding. The fact that the population studied is a fairly affluent group further suggests that the problem may be even larger than what was measured here.

There was only one factor that was statistically linked to increased drinking among the historic binge drinkers – depression. The authors examined the impact of time spent under stay-at-home orders and did not detect an independent link to increased consumption. Nevertheless, I think we need to consider that increased alcohol abuse is a potential harm of the social isolation that COVID-19 has forced upon us. And no, the solution here is not to pretend that COVID-19 doesn’t exist.

By identifying the potential harms of social isolation, as these authors have started to do, we can start to create ways to mitigate them. Whether that’s increased access to drug and alcohol treatment, psychotherapy, or creating virtual social groups, anything we can do to make staying at home easier will have the side effect of ending the pandemic sooner.

This commentary first appeared on medscape.com.