Reduced alcohol consumption during the COVID-19 pandemic: Analyses of 17 000 patients seeking primary health care in Colombia and Mexico

Abstract

Background During the COVID-19 pandemic, an increase of heavy alcohol use has been reported in several high-income countries. We examined changes in alcohol use during the pandemic among primary health care (PHC) patients in two middle income countries, Colombia and Mexico. Methods Data were collected during routine consultations in 34 PHC centres as part of a large-scale implementation study. Providers measured patients’ alcohol consumption with the three item ‘Alcohol Use Disorders Identification Test’ (AUDIT-C). Generalized linear mixed models were performed to examine changes in two dependent variables over time (pre-pandemic and during pandemic): 1) the AUDIT-C score and 2) the proportion of heavy drinking patients (8+ on AUDIT-C). Results Over a period of more than 600 days, data from N = 17 273 patients were collected. During the pandemic, the number of patients with their alcohol consumption measured decreased in Colombia and Mexico. Each month into the pandemic was associated with a 1.5% and 1.9% reduction in the mean AUDIT-C score in Colombia and Mexico, respectively. The proportion of heavy drinking patients declined during the pandemic in Colombia (pre-pandemic: 5.4%, 95% confidence interval (CI) = 4.8% to 6.0%; during the pandemic: 0.8%, 95% CI = 0.6% to 1.1%) but did not change in Mexico. Conclusions Average consumption levels declined and the prevalence of heavy drinking patterns did not increase. In addition to reduced opportunities for social drinking during the pandemic, changes in the population seeking PHC and restrictions in alcohol availability and affordability are likely drivers for lower levels of alcohol use by patients in this study.

Substance use and common contributors to morbidity: A genetics perspective

“…61 While anecdotal information indicated protective effects of smoking tobacco and cannabis (in contrast to cannabidiol 62 ), clinical data overwhelmingly documented that individuals with SUDs were more likely to require hospitalization or die due to COVID-19 (Wang et al, 2021), those with opioid use disorders being particularly at high risk. Despite expectations that pandemic-related stress would promote heavier substance use, results were mixed for substances such as alcohol 63,64 and indicative of escalating use for others, such as opioids and polysubstance use. 65,66 Collectively, these epidemiologic studies have shown robust phenotypic correlations between SUDs and these four medical conditions.…”

Detección del consumo de alcohol en el primer nivel de atención en México durante la pandemia de COVID-19

“…En otros países, durante la pandemia, se han identificado cambios en los patrones de consumo de alcohol; por un lado, mayor consumo entre consumidores de alto riesgo previos (es decir, quienes ya bebían en niveles excesivos antes de la pandemia de COVID-19) y, por otro lado, una disminución del consumo entre consumidores de alcohol de bajo riesgo (17). Esta tendencia también se observó en la Ciudad de México (15,18). Es preocupante que, entre quienes presentaron consumo de riesgo alto, 50,8% eran mujeres.…”

“…En la Ciudad de México, a partir de septiembre de 2019, se llevó a cabo una investigación cuasiexperimental denominada proyecto SCALA, con la finalidad de evaluar la mejor estrategia para la implementación de un modelo de detección, intervención breve y referencia para el tratamiento del consumo de alcohol en centros de salud de tres países latinoamericanos: Colombia, México y Perú (13)(14)(15). En el estudio se compraron los cambios en la medición del consumo de alcohol en cuatro condiciones experimentales en cada país.…”

Costs of an Alcohol Measurement Intervention in Three Latin American Countries

“…Future studies could benefit from collecting data throughout a longer implementation of community support. In addition to impeded program implementation and health care delivery, the COVID-19 pandemic has also been linked to reduced alcohol consumption [ 27 ]. During this public health emergency, resources have been prioritised for more pressing health care issues than for preventive measures.…”