Alcohol and other substance use during the COVID-19 pandemic: A systematic review PMC

While one preprint study suggests that alcohol intolerance is a common symptom of long COVID, there’s very little research on the topic. For example, some research suggests that poor sleep can make long COVID worse, and difficulty sleeping is a common side effect of drinking alcohol. For many struggling with alcoholism, creating and maintaining healthy social connections fuels their motivation to either stay sober or continue working toward sobriety.

WHO recommendations on alcohol consumption during the COVID-19 pandemic

The effects of the pandemic on alcohol-related problems have not been the same for everyone, though. One example is an NIAAA-supported study showing that fewer college students had AUD symptoms during the COVID-19 pandemic. Apart from the intensively and analyzed trends and motivations of adults’ alcohol consumption, there are several sensitive and less discussed issues, with potential long-term consequences, that would deserve more attention. Alcohol use might also cause or worsen certain mental health conditions during the pandemic. For example, beta-blockers can help control the physical responses to anxiety, such as increased heart rate.

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The data on increases in emergency admissions relating to overdose provides information which may be useful to emergency services and emergency response planners, in relation to future crises and pandemics. Time-series analyses comparing periods of lockdown, where individuals were restricted in their movement, to the previous year, showed that alcohol problems increased during lockdown (Grigoletto et al., 2020, Leichtle et al., 2020). For example, in one study of data taken from hospitals in Italy, when compared to the same time period in https://rehabliving.net/ 2019, despite a lower number of attendances to the Emergency Department, the absolute number of patients presenting with severe alcohol intoxication increased (25 vs. 15). This number increased further immediately after the easing of lockdown measures (11.3%) (Grigoletto et al., 2020). Likewise, a timepoint analysis from two psychiatric hospitals in Italy showed that admissions related to alcohol increased from 3.7% and 23.5–6.1% and 36.9% of the total when comparing the first two months of 2020 with March-May 2020 (Luca et al., 2020).

5. Patient and public involvement

As Table 1 shows, the frequency of drinking is difficult to compare, and the measurement and results show wide variance across studies. During the pandemic, the proportion of individuals consuming alcohol varied across samples from 21.7% (Knell et al., 2020) to 81.4% (Romero-Blanco et al., 2020). Likewise, hazardous drinking ranged from 28.2% (Chodkiewicz at al., 2020) to 52.7% (Newby et al., 2020) with binge drinking from 7.1% (Gritsenko et al., 2020), to 20% (Silczuk, 2020). Problematic alcohol was 7.1% (Panno et al., 2020), harmful drinking 0.7% (Chodkiewicz at al., 2020) and possible addiction 0.9% (Chodkiewicz at al., 2020). Across all studies, the percentage of individuals who did not drink during the study period ranged from 17% (Håkansson, 2020) to 32.1% (Đogaš et al., 2020).

1. Strengths and limitations of the study

Where there was insufficient information to make a judgement on the eligibility criteria, we excluded the study from the review. Physical distancing (which can lead to “social distancing”) during the pandemic also has profound implications for access to treatment services for those with alcohol problems. Social support is a very powerful reinforcer for humans and is highly beneficial for helping people avoid relapse or an escalation in alcohol use.

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More people may drink and people may drink more heavily to cope with stress, sleep disturbances, and even boredom increasing their risk for alcohol use disorder and other adverse consequences. Although alcohol temporarily dampens the brain and body’s response to stress, feelings of stress and anxiety not only return, but worsen, once the alcohol wears off. Over time, excessive alcohol consumption can cause adaptations in the brain that intensify the stress response. As a result, drinking alcohol to cope can make problems worse and one may end up drinking to fix the problem that alcohol caused. Two studies reported a statistically significant role of the level of education in increasing alcohol use during lockdown. Specific factors of the increase in alcohol use were reported in one study as a high level of education (Rolland et al., 2020) and in another that college graduates had significantly lower odds of decreased alcohol consumption compared to people who were not graduates (Knell et al., 2020).

No research suggests that you’ll develop long COVID if you drink alcohol while you have a COVID-19 infection. It’s also worth noting that the effects of alcohol — and a hangover — may be particularly unpleasant if you also have COVID-19 symptoms. If you’re ready to enter treatment and stop drinking, you’ll likely have to wait until your COVID-19 infection is no longer transmissible before you enter a detox program. Alcohol can also weaken your immune system and contribute to risk-taking behavior (like not wearing a mask) that could increase your chances of contracting the virus.

It’s typically related to an inability to properly process or metabolize alcohol. There’s growing evidence that it may be a unique symptom of long COVID, particularly the post-viral fatigue syndrome (PVFS) type. That said, evidence also shows that even smaller amounts of alcohol can affect the immune system. According to the Cleveland Clinic, once you take a sip of alcohol, your body prioritizes breaking down alcohol over several other bodily functions. The body doesn’t have a way to store alcohol like it does with carbohydrates and fats, so it has to immediately send it to the liver, where it’s metabolized. When the body is unable to clear a pathogen, an infection can worsen and lead to more severe, life threatening complications.

These effects of alcohol consumption have important implications for the management of patients with COVID‐19. History of alcohol use could be an important predictor for disease severity and ICU admission, and could contribute to treatment strategy for COVID‐19 patients with chronic alcohol consumption and alcohol use disorders (AUDs). Therefore, the role of alcohol consumption on severity of illness in patients with COVID‐19 should be explored, and a history of alcohol consumption should be included as a probable risk factor of disease severity in COVID‐19 studies. The review included large studies from a number of countries and the finding seems valid.

You can take a couple of steps to avoid contracting or transmitting the COVID-19 virus while drinking. Going “cold turkey” when you have a physical dependence on alcohol can be dangerous. If you don’t have a physical dependency on alcohol, and you drink lightly or moderately, consider stopping while you have COVID-19. “The airway and lungs are not made to be exposed to even an aerosol of disinfectant …. Not even a low dilution of bleach or isopropyl alcohol is safe …. It’s a totally ridiculous concept.”

Although evidence suggests substance and alcohol use may change during the Covid-19 pandemic there has been no full review of the evidence around this. It will be valuable to see more attention paid to this issue by health authorities, researchers and practitioners with warnings being given on the probable effects of alcohol consumption in relation to COVID‐19. Sepsis, respiratory failure and acute respiratory distress syndrome (ARDS) have occurred in most fatal cases [1]. While hand sanitizers containing 60-95% ethyl alcohol can help destroy the coronavirus on surfaces, drinking alcohol offers no protection from the virus. Alcohol misuse is already a public health concern in the United States, and alcohol has the potential to further complicate the COVID-19 pandemic in multiple ways.

It can also interact with several common medications, such as ibuprofen, to cause further symptoms. In more serious cases, mixing alcohol with medications can cause internal bleeding and organ problems. For example, alcohol can mix with ibuprofen or acetaminophen to cause stomach problems and liver damage. According to a study in JAMA Internal Medicine, out of 201 people with COVID-19-induced pneumonia, 41.8% developed ARDS. It is possible for high concentrations of alcohol, such as 60–90%, to kill some forms of bacteria and viruses.

1. Adjustment predictors, including depression and fear of the infectivity of COVID-19, predicted using solitary substance use during the pandemic (Dumas et al., 2020).
2. Indeed, the current COVID-19 crisis appears to have already fueled increases in retail alcohol sales.
3. Across all studies, the percentage of individuals who did not drink during the study period ranged from 17% (Håkansson, 2020) to 32.1% (Đogaš et al., 2020).
4. The proportion of people consuming alcohol during the pandemic ranged from 21.7% to 72.9% in general population samples.
5. As more cases have come to light across the U.S., the pandemic has affected every American, causing widespread panic and uncertainty in this trying time.

Although alcoholism is a chronic, relapsing disease, with professional treatment and ongoing recovery efforts, this disease may be effectively managed.10 Treatment for problematic alcohol consumption can slow down, stop, or altogether reverse many otherwise progressive, drinking-related health issues. 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 https://rehabliving.net/alcohol-use-disorder-symptoms-and-causes-3/ 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).

All the participants drank at home during the lockdown, 20.7 % reported an increased consumption, mainly due to isolation (29.7 %), changes in everyday habits (27.5 %) or for coping with anxiety or depression (13.6 %) [41]. The American Heart Association recommends moderation in alcohol consumption for optimal cardiovascular health. If you do drink, talk with your doctor about the benefits and risks of consuming alcohol in moderation. Some people should not drink at all, like women who are pregnant or trying to get pregnant, people under age 21 and people with certain health conditions. The Association does not recommend drinking wine or any other form of alcohol to gain potential health benefits.

Obesity, another modifiable risk factor, has also been investigated with emerging evidence of an association [6, 7]. Obesity is closely related to two behavioural risk factors—poor diet and lack of physical activity [5]. Alcohol consumption has not been granted much attention, although several studies have reported that alcohol consumption increased the risk of ARDS in patients with critical conditions and the admission to intensive care unit (ICU) in patients with pneumonia [8, 9, 10]. At the time of writing, to our knowledge, no published study exploring the risk factors of disease severity in COVID‐19 patients has included alcohol consumption as a covariate.

Nick Hardinges is a London-based reporter who previously worked as a fact-checker at Reuters. Four minutes later, a journalist responded to Trump’s disinfectant comments by asking whether there was any scenario in which cleaning products like bleach and isopropyl alcohol would be injected into people. On April 23, 2020, Trump conducted an hourlong media briefing with members of the government’s coronavirus task force (transcript). Tequila’s unique character stems from its key ingredient – the blue agave plant (Agave tequilana Weber). This succulent, with its spiky leaves and a heart called “pina” (pineapple), takes a remarkable seven to ten years to mature. These sugars are then extracted and fermented using yeast, transforming them into alcohol.The magic of tequila lies in the strict regulations governing its production.

Long COVID refers to persistent symptoms that occur more than three weeks after the initial COVID-19 infection. Drinking also makes it harder for your body to properly tend to its other critical functions, like fighting off a disease. Read stories about the efforts underway to prevent, detect, and treat COVID-19 and its effects on our health. Learn how NIH has improved basic understanding of the SARS-CoV-2 virus and sped up the development of COVID-19 vaccines, treatments, and testing. Specialists from the World Health Organization have warned against the consumption of alcohol for therapeutic purposes [77].

In the meantime, healthcare providers should take alcohol intolerance into account when evaluating and treating post-COVID symptoms. For those who have a risk factor for COVID-19, like heart disease or diabetes, he recommends drinking even less. Soon after, the World Health Organization (WHO) also suggested that people cut back on drinking, since alcohol can increase the risk of experiencing complications from COVID-19. In contrast, seven studies reported an increase in the use of alcohol during the pandemic (Ahmed et al., 2020, Boehnke et al., 2020, Gritsenko et al., 2020, Lechner et al., 2020, Rogers et al., 2020, Sidor and Rzymski, 2020, Sun et al., 2020).