Objectives: Excessive alcohol use is a serious and growing public health problem. Alcoholic beverage sales in the United States increased greatly immediately after the stay-at-home orders and relaxing of alcohol restrictions associated with the COVID-19 pandemic. However, it is not known to what degree alcohol consumption changed. This study assesses differences in alcohol drinking patterns before and after the enactment of stay-at-home orders. Methods: In May 2020, a cross-sectional online survey of 993 individuals using a probability-based panel designed to be representative of the US population aged 21 and older was used to assess alcohol drinking patterns before (February, 2020) and after (April, 2020) the enactment of stay-at-home orders among those who consumed alcohol in February, 2020 (n = 555). Reported differences in alcohol consumption were computed, and associations between differences in consumption patterns and individual characteristics were examined. Results: Compared to February, respondents reported consuming more drinks per day in April (+29%, P < 0.001), and a greater proportion reported exceeding recommended drinking limits (+20%, P < 0.001) and binge drinking (+21%, P = 0.001) in April. These differences were found for all sociodemographic subgroups assessed. February to April differences in the proportion exceeding drinking limits were larger for women than men ( P = 0.026) and for Black, non-Hispanic people than White, non-Hispanic people ( P = 0.028). Conclusions: There is an association among the COVID-19 pandemic, the public health response to it, changes in alcohol policy, and alcohol consumption. Public health monitoring of alcohol consumption during the pandemic is warranted.

Background and Aims Alcohol consumption increased during the COVID‐19 pandemic in 2020 in the United States. We projected the effect of increased alcohol consumption on alcohol‐associated liver disease (ALD) and mortality. Approach and Results We extended a previously validated microsimulation model that estimated the short‐ and long‐term effect of increased drinking during the COVID‐19 pandemic in individuals in the United States born between 1920 and 2012. We modeled short‐ and long‐term outcomes of current drinking patterns during COVID‐19 (status quo) using survey data of changes in alcohol consumption in a nationally representative sample between February and November 2020. We compared these outcomes with a counterfactual scenario wherein no COVID‐19 occurs and drinking patterns do not change. One‐year increase in alcohol consumption during the COVID‐19 pandemic is estimated to result in 8000 (95% uncertainty interval [UI], 7500–8600) additional ALD‐related deaths, 18,700 (95% UI, 17,600–19,900) cases of decompensated cirrhosis, and 1000 (95% UI, 1000–1100) cases of HCC, and 8.9 million disability‐adjusted life years between 2020 and 2040. Between 2020 and 2023, alcohol consumption changes due to COVID‐19 will lead to 100 (100–200) additional deaths and 2800 (2700–2900) additional decompensated cirrhosis cases. A sustained increase in alcohol consumption for more than 1 year could result in additional morbidity and mortality. Conclusions A short‐term increase in alcohol consumption during the COVID‐19 pandemic can substantially increase long‐term ALD‐related morbidity and mortality. Our findings highlight the need for individuals and policymakers to make informed decisions to mitigate the impact of high‐risk alcohol drinking in the United States.

Coronavirus disease 2019 (COVID-19) will have a lasting impact on public health. In addition to the direct effects of COVID-19 infection, physical distancing and quarantine interventions have indirect effects on health. While necessary, physical distancing interventions to control the spread of COVID-19 could have multiple impacts on people living with opioid use disorder, including impacts on mental health that lead to greater substance use, the availability of drug supply, the ways that people use drugs, treatment-seeking behaviors, and retention in care. The degree to which COVID-19 will impact the opioid epidemic and through which of the possible mechanisms that we discuss is important to monitor. We employed simulation modeling to demonstrate the potential impact of physical distancing on overdose mortality.

Alcohol SBIRT generates costs savings and improves health in both ED and outpatient settings. EDs provide better effectiveness at a lower cost and greater social cost reductions than outpatient.