Alcohol sales in the United States increased significantly at the start of the COVID-19 pandemic, especially in March 2020, with the implementation of stay-at-home orders. This has led to increased concerns among physicians, health care providers, family members, and public health experts for people’s well-being and their approaches to coping with the stress of the pandemic.
Zeina Saliba, MD, addictionologist, psychiatrist, and family physician at the George Washington University (GW) Medical Faculty Associates and assistant professor of psychiatry and behavioral sciences at the GW School of Medicine and Health Sciences, discusses the increase in alcohol consumption, the effects of using alcohol to cope with stressful situations, and the steps people can take to curb their reliance on alcohol.
Q: Many areas have reported increased alcohol sales during the course of the pandemic. Why do situations like a pandemic lead people to turn to alcohol?
Saliba: Not only did alcohol sales increase, early surveys showed that consumption also increased (especially among women), as did negative effects from the drinking. There are many reasons that alcohol drinking would increase during the pandemic: for example, increased anxiety, boredom, problems sleeping, and loneliness. Studies are ongoing to learn more about the drinking changes during the pandemic.
Q: How concerning is a situation like this for people with alcohol use disorder, currently in recovery?
Saliba: For people in recovery, many of the things that have helped them stay sober are unavailable or less available during a pandemic. In a lockdown situation, they are limited from engaging in some of their coping strategies, their daily routines and structure can be disrupted, and social interactions that help sustain them become limited. At the start of the pandemic, most peer support groups like Alcoholics Anonymous and SMART [Self-Management and Recovery Training] Recovery had to stop meeting in person. Many moved online and some met by phone, but not everyone has access to video devices or reliable internet access. Likewise, many clinicians and treatment programs stopped in-person appointments, which has been destabilizing for many.
Q: What effect can the combination of alcohol and stressful situations have on a person?
Saliba: In addition to the negative physical and social consequences of drinking, during a pandemic there are additional concerns. People may be drinking more in private, and studies have shown that drinking alone can be more dangerous. Additionally, alcohol affects the immune system in several ways. It can increase the risk of becoming infected with the virus and getting COVID-19. Longer-term alcohol use also has been shown to increase the risk of developing acute respiratory distress syndrome, which has implications for recovery from infection and is possibly associated with more severe illness.
Q: Some people have had trouble sleeping during the pandemic. Would a glass of wine or a few shots help make sleep easier and more restful?
Saliba: Prioritizing sleep is great. Sleep is an important part of health and wellness, impacting many parts of our lives, including our thinking and our mood. Before taking anything to treat sleep problems, it is important to work with one's doctor(s) to identify the cause. Alcohol affects everyone a bit differently, but generally, while drinking alcohol might make you feel sleepy and sometimes even help you fall asleep faster, it changes the quality and duration of your sleep. Alcohol can limit REM [rapid eye movement] sleep, causing more sleep disruptions throughout the night, especially toward the end, and an overall lower quality of sleep. People tend to wake up groggier and are less alert throughout the next day. If you have sleep apnea, it can make those symptoms worse. Some people have trouble sleeping because of the anxiety or worry that they experience during stressful situations. Whether or not this is the case for you, it is important to speak with your doctor, either a primary care physician, a sleep specialist, or a psychiatrist, who can work with you to identify the cause of the insomnia and help you find strategies to get better sleep.
Q: What can people do to recognize and curb their intake and reliance on alcohol?
Saliba: Some signs that you could be drinking too much are negative effects on your health, legal problems, relationship conflicts, drinking more than you had set out to, difficulty stopping or cutting down, experiencing withdrawal when going without alcohol, cravings, giving up things that you used to enjoy, and lying to people around you. If you are around other people, consider asking them for their observations of your drinking behavior. Have there been any changes in your patterns of use? Have they noticed any changes in your behaviors or moods when you drink? Help and treatment are available! Stopping drinking abruptly can be dangerous. Speak to your doctor to make a plan together: Some people can stop drinking on their own, others can do so at home with physician guidance. For another group of people, the safest option to decrease or stop drinking is to be in a supervised or hospital setting.