Monday, November 9, 2020

Stress from COVID-19 pandemic fuels increased alcohol misuse

- Jennifer Middleton, MD, MPH

A survey of 1540 adults in the United States recently found that alcohol use has increased over the last year, especially in women:

On average, alcohol was consumed 1 day more per month by 3 of 4 adults. For women, there was also a significant increase of 0.18 days of heavy drinking (95% CI, 0.04-0.32 days) increase of 41% over baseline....For women there was an average increase in the Short Inventory of Problems scale of 0.09 (95% CI, 0.01-0.17 items)...representing a 39% increase, which is indicative of increased alcohol-related problems independent of consumption level for nearly 1 in 10 women.

Memes jesting about "mommy juice" abound right now, along with depictions of wine and coffee arguing regarding "who she loves more." These memes reflect the increasing normalization of alcohol as a coping mechanism but also trivialize the physical and psychological consequences of increased alcohol consumption. Excess alcohol use is linked with cardiovascular disease, several cancers, and intimate partner violence; it exacerbates depression and anxiety; and it can result in injuries, including motor vehicle accidents. An increase in these short- and long-term conditions will place further stress on individuals, families, workplaces, and healthcare systems already buckling under the weight of COVID-19. 

The pandemic has increased stress for countless individuals, and reports suggest women are bearing a disproportionate share. Women have been more likely to lose their jobs and are more likely to be primarily managing child care given decreased daycare access and increased virtual schooling. The pandemic's effect on women of color is even more profound. COVID-19 is widening gender-poverty gaps in the US and abroad. It's no surprise that alcohol misuse is increasing. 

The United States Preventive Services Task Force (USPSTF) recommends screening all adults for hazardous alcohol consumption and providing brief counseling to those who screen positive; we must urgently identify our patients who are using alcohol to cope with COVID-19 and offer help. 

There's an AFP By Topic on Alcohol Use Disorders if you'd like to read more, and this 2019 Community Blog post provides a brief overview of alcohol screening and treatment. The CDC also has a webpage with a lengthy list of resources for coping with increased stress due to COVID-19.