Alcohol use and the COVID-19 pandemic: Historical trends in drinking, contexts, and reasons for use among U.S. adults

Reasons for alcohol use from 1976 to 2020 in the United States among individuals aged 18 to 30: Historical changes and mediation of cohort effects in binge drinking

BACKGROUND

Alcohol use is declining among US adolescents/early young adults and increasing among other adults, with increases in adult binge drinking more concentrated in females than males. Reasons for drinking are historically patterned by age and sex, and if historically variant, could suggest that changes over time could in part explain age- and sex-differential cohort effects.

METHODS

We analyzed longitudinal Monitoring the Future data for individuals born from 1958 to 1990. These individuals were aged 29/30 from 1987 to 2020, and first surveyed at age 18 from 1976 to 2008 (N = 14,190). Five reasons for drinking were analyzed (social, enhancement, avoid problems, relax, boredom). Drinking for social reasons and to relax were most prevalent. Total effects of birth cohort predicting past-2-week binge drinking were estimated with polynomial regression models by age; indirect effects through mediators were estimated.

RESULTS

Drinking reasons exhibited dynamic time trends across birth cohort and sex. Notable increases were observed in social reasons: among women aged 29/30, social reasons increased from 53% to 87% from 1987 to 2020. Social reasons to drink had prominent positive indirect effects at adult ages (age 23/24 and above among men; age 19 and above among women), indicating that binge drinking would have increased less were it not for the increase in social reasons for drinking. Social reasons also mediated adult male/female differences, indicating that part of the reason sex differences are diminishing is the more rapid increases in social reasons for drinking among women. Indirect effects were also observed for drinking to relax and for boredom, and limited indirect effects were observed for enhancement and to avoid problems.

CONCLUSION

Changing endorsement of drinking reasons, especially social reasons, among US adult drinkers mediate cohort effects in binge drinking in the US adult population and explain in part why binge drinking is converging by sex.

Alcohol-related non-fatal motor vehicle crash injury in the US from 2019 to 2022

Background: Information on recent alcohol-related non-fatal motor vehicle crash (MVC) injuries is limited.Objectives: To analyze alcohol-related non-fatal MVC injuries, 2019-2022, considering COVID-19 and Stay-at-Home policies.Methods: State-level counts of alcohol-related non-fatal MVC injuries (involving individuals age 15+) from Emergency Medical Services data in 18 US states, chosen for comprehensive coverage, were analyzed for the annual rate. The total non-fatal MVC injury count in each state served as the denominator. We used analysis of variance to evaluate annual rate changes from 2019 to 2022 and used robust Poisson regression to compare annual mean rates to the 2019 baseline, pre-pandemic, excluding Quarter 1 due to COVID-19's onset in Quarter 2. Additional Poisson models compared rate changes by 2020 Stay-at-Home policies.Results: Data from 18 states were utilized (N = 1,487,626, 49.5% male). When evaluating rate changes of alcohol-related non-fatal MVC injuries from period 1 (Q2-4 2019) through period 4 (Q2-4 2022), the rate significantly increased from period 1 (2019) to period 2 (2020) by 0.024 (p = .003), then decreased from period 2 to period 4 (2022) by 0.016 (p = .04). Compared to the baseline (period 1), the rate in period 2 was 1.27 times higher. States with a 2020 Stay-at-Home policy, compared to those without, had a 30% lower rate (p = .05) of alcohol-related non-fatal MVC injuries. States with partial and mandatory Stay-at-Home policies had a 5.2% (p = .01) and 10.5% (p < .001) annual rate decrease, respectively.Conclusion: Alcohol-related non-fatal MVC injury rates increased initially (2019-2020) but decreased thereafter (2020-2022). Stay-at-home policies effectively reduced these rates.

Differential change in alcohol consumption during the COVID-19 pandemic: the role of loneliness, socialization, and mental well-being

Introduction

The COVID-19 pandemic led to a surge in mental health issues and psychological distress, disruption to work/studying conditions, and social isolation particularly among young adults. Changes in these factors are differentially associated with alcohol use. Moreover, the relationship between these factors are bidirectional and may have fluctuated throughout the different phases of the pandemic. However, studies focusing on young adults had conflicting results, short follow-up periods, and lacked comprehensive data to describe underlying mechanisms.

Methods

1067 young adults participated in repetitive measures termed wave 4 (2021) of the Survey of Adolescent Life in Västmanland Cohort "SALVe" Cohort. Of these, 889 also completed pre-pandemic measurements termed wave 3 (2018). Participants completed the Alcohol Use Disorders Identification Test (AUDIT) to evaluate alcohol consumption and harmful use. Cross-sectional associations between perceived changes in alcohol use and shift in individual, mental health, and work environment factors were examined using Chi-square tests. Logistic regression was utilized to identify pre-pandemic predictors of harmful consumption during the pandemic.

Results

Harmful consumption decreased only in females following the COVID-19 pandemic. Participants who reported increased feelings of depression, anxiety, and loneliness were more likely to increase their alcohol use. Interestingly, the subgroup who felt less lonely and met their friends more often, as well as those who continued working/studying from their regular workplace also had an increased likelihood of higher consumption. Only pre-pandemic ADHD and delinquency symptoms predicted harmful alcohol consumption following the pandemic.

Conclusion

Females reduced harmful alcohol consumption during the COVID-19 pandemic. While those who suffered the burden of social isolation and distress were more likely to increase their alcohol use, young adults who felt less lonely and met their friends more often also had a similar outcome. The relationship between loneliness and alcohol consumption among young adults is influenced by the social factors that may be facilitated by drinking.

Exercising healthy behaviors: A latent class analysis of positive coping during the COVID-19 pandemic and associations with alcohol-related and mental health outcomes

OBJECTIVE

To identify latent classes of positive coping behaviors during the COVID-19 pandemic and examine associations with alcohol-related and mental health outcomes across participants with and without a history of alcohol use disorder (AUD).

METHODS

Baseline data from 463 participants who were enrolled in the NIAAA COVID-19 Pandemic Impact on Alcohol (C19-PIA) Study were analyzed. Latent class analysis (LCA) was applied to five positive coping behaviors during COVID-19: taking media breaks, taking care of their body, engaging in healthy behaviors, making time to relax, and connecting with others. Latent class differences and the moderating role of history of AUD on six alcohol-related and mental health outcomes were examined using multiple regression models.

RESULTS

LCA revealed two latent classes: 83.4% High Positive Coping and 16.6% Low Positive Coping. Low Positive Coping was associated with higher levels of perceived stress, anxiety symptoms, and loneliness. A history of AUD was consistently associated with higher levels of alcohol-related and mental health outcomes. Significant interactions between Coping Latent Classes and history of AUD indicated that the associations of Low Positive Coping with problematic alcohol use, depressive symptoms, and drinking to cope motives were either stronger or only significant among individuals with a history of AUD.

CONCLUSIONS

Individuals with a history of AUD may be particularly vulnerable to depressive symptoms and alcohol-related outcomes, especially when they do not utilize positive coping strategies. The promotion of positive coping strategies is a promising avenue to address alcohol-related and mental health problems during a public health crisis and warrants future research.

Are Cisgender Women and Transgender and Nonbinary People Drinking More During the COVID-19 Pandemic? It Depends

PURPOSE

This narrative review of research conducted during the first 2 years of the COVID-19 pandemic examines whether alcohol use among cisgender women and transgender and nonbinary people increased during the pandemic. The overarching goal of the review is to inform intervention and prevention efforts to halt the narrowing of gender-related differences in alcohol use.

SEARCH METHODS

Eight databases (PubMed, APA PsycInfo, CINAHL, Embase, Scopus, Gender Studies Database, GenderWatch, and Web of Science) were searched for peer-reviewed literature, published between March 2020 and July 2022, that reported gender differences or findings specific to women, transgender or nonbinary people, and alcohol use during the pandemic. The search focused on studies conducted in the United States and excluded qualitative research.

SEARCH RESULTS

A total 4,132 records were identified, including 400 duplicates. Of the remaining 3,732 unique records for consideration in the review, 51 were ultimately included. Overall, most studies found increases in alcohol use as well as gender differences in alcohol use, with cisgender women experiencing the most serious consequences. The findings for transgender and nonbinary people were equivocal due to the dearth of research and because many studies aggregated across gender.

DISCUSSION AND CONCLUSIONS

Alcohol use by cisgender women seems to have increased during the pandemic; however, sizable limitations need to be considered, particularly the low number of studies on alcohol use during the pandemic that analyzed gender differences. This is of concern as gender differences in alcohol use had been narrowing before the pandemic; and this review suggests the gap has narrowed even further. Cisgender women and transgender and nonbinary people have experienced sizable stressors during the pandemic; thus, understanding the health and health behavior impacts of these stressors is critical to preventing the worsening of problematic alcohol use.

The Role of Shame in the Relationship between Alcohol Use Severity and Relational Intimacy among Sexual Minority Women

Background: Sexual Minority Women (SMW) are disproportionately likely to struggle with substance use and shame, two factors that are associated with poorer relationship quality and decreased relational intimacy (Doyle & Molix, 2015). However, there is a dearth of research examining shame and substance use concurrently among SMW. Objectives: The current study elucidated the role of shame-based cognitions (SBCs) and shame-based behaviors (SBBs) in explaining the relationship between alcohol use severity and relational intimacy. We recruited adult cisgender women (N = 105) in a romantic relationship who self-identified as a sexual minority and reported alcohol use during the past three months through Amazon Mechanical Turk. Participants completed an online survey assessing alcohol use, SBCs, SBBs, and relational intimacy. Results: There was a significant positive relationship between alcohol use severity with SBCs (r = .29, p = .003) and with SBBs (r = .62, p <.001). SBBs were shown to be negatively correlated with relational intimacy (r = -.48, p < .001). Parallel mediation analysis demonstrated that SBCs and SBBs accounted for approximately 34.4% of the variance in intimacy. The indirect effects of SBCs were significant (β = .10, 95% CI [.02, .18] while SBBs (β = -.14, 95% CI [-.29, .01]) did not show effects. Discussions: Given the disproportionate rates of alcohol use among SMW, this study offers a nuanced picture of the relationships between constructs known to impact alcohol use. The findings underscore the importance of SBCs and point to a potential treatment target among SMW presenting with alcohol use and diminished relational intimacy.

Hallucinogen use among young adults ages 19-30 in the United States: Changes from 2018 to 2021

BACKGROUND AND AIMS

Given the shifting landscape of hallucinogen use, particularly with increased therapeutic use, understanding current changes in use is a necessary part of examining the potential risk hallucinogens pose to vulnerable populations, such as young adults. This study aimed to measure hallucinogen use among young adults aged 19-30 years from 2018 to 2021.

DESIGN, SETTING AND PARTICIPANTS

This was a longitudinal cohort study among young adults aged 19-30 years from the US general population, interviewed between 2018 and 2021. Participants comprised 11 304 unique respondents, with an average number of follow-ups of 1.46 (standard deviation = 0.50). Of the observed data points, 51.9% were among females.

MEASUREMENTS

We examined past 12-month self-reported use of lysergic acid diethylamide (LSD), as well as hallucinogens besides LSD (e.g. psilocybin), monitoring any use as well as frequency, overall and by sex.

FINDINGS

From 2018 to 2021, past 12-month use of LSD among young adults in the US remained relatively unchanged, from 3.7% [95% confidence interval (CI) = 3.1-4.3] in 2018 to 4.2% in 2021 (95% CI = 3.4-5.0). Non-LSD hallucinogen [e.g. 'shrooms', psilocybin or PCP (phenylcyclohexyl piperidine)] use, however, increased in prevalence from 3.4% (95% CI = 2.8-4.1) to 6.6% from 2018 to 2021 (95% CI = 5.5-7.6). Across years, the odds of non-LSD use were higher for males [odds ratio (OR) = 1.86, 95% CI = 1.52-2.26] and lower for black than white participants (OR = 0.29, 95% CI = 0.19-0.47) and those without a college-educated parent (OR = 0.80, 95% CI = 0.64-0.99). Demographic disparities were similar for LSD use.

CONCLUSION

Prevalence of past-year use non-lysergic acid diethylamide (LSD) hallucinogen was twice as high in 2021 as in 2018 among US young adults. Correlates of non-LSD hallucinogen use included being male, white and from higher socio-economic status backgrounds.

Child and Adolescent Psychopathology and Subsequent Harmful Behaviors Associated with Premature Mortality: A Selective Review and Future Directions

In the United States (U.S.), premature mortality in adulthood from suicide, alcohol-related disease, and substance overdoses has increased steadily over the past two decades. To better understand these trends, it is necessary to first examine the harmful behaviors that often precede these preventable deaths (i.e., suicidal ideation and attempts, and harmful alcohol and substance use). Representing critical developmental periods in which psychopathology is most likely to emerge, childhood and adolescence provide an informative lens through which to investigate susceptibility to harmful behaviors. This article synthesizes current evidence describing these rising U.S. mortality rates and the prevalence rates of harmful behaviors linked to these types of mortality. A brief selective review of longitudinal research on harmful behaviors in relation to the most relevant categories of child and adolescent psychopathology is then provided. Finally, recommendations for future research and implications for prevention are discussed.

Alcohol protective behavioral strategies for young adults: a content analysis across drinking contexts and gender

Background: Protective behavioral strategies (PBS) are specific harm reduction behaviors which mitigate alcohol-related consequences among young adults. Prior work indicates PBS utilization varies according to drinking context and gender, suggesting a need for further research assessing whether young adults employ unidentified PBS according to such factors.Objectives: This study examined alcohol PBS young adults suggest using across drinking contexts and gender to inform alcohol-related harm reduction interventions.Methods: An online survey with 514 young adult heavy drinkers (n = 269 female, Mage = 22.36 years) assessed PBS use generally, and across 12 physical and social contexts. We utilized qualitative content analysis methods to code and derive themes from open-ended responses from a prompt asking participants to state additional PBS used per context. The frequency of each theme's appearance was calculated across the overall sample, by gender, and within each context.Results: PBS endorsement varied across context and gender within each theme. Young adults who reported PBS use most frequently endorsed utilizing strategies related to drink content (18.30%), social support (12.36%), and engaging in other activities (10.34%). Participants infrequently endorsed strategies related to awareness of time (0.23%), standards of behavior (0.78%) and avoiding environments (0.87%).Conclusions: Young adults endorse utilizing additional PBS in varying frequency according to drinking context and gender. Given PBS are often a key component of alcohol harm reduction interventions, monitoring trends in young adult PBS use is crucial to ensure continued relevance and efficacy of such interventions to minimize harms associated with young adult heavy alcohol use.

Decreasing alcohol use among young adults presenting for service in the U.S. Air Force: An epidemiological surveillance study

U.S. surveys demonstrate recent decreases in the prevalence of alcohol use and binge drinking among young adults. The current study aims to determine whether similar trends are evident in a similarly aged cohort of service members in the US Air Force to inform ongoing prevention efforts. Participants were 103,240 Air Force personnel in entry-level training between 2016 and 2019. Participants anonymously completed the AUDIT (Alcohol Use Disorder Identification Test) regarding their pre-service drinking. Logistic regression analyses and the Cochran-Armitage test were conducted to measure population trends over the study duration with stratification by age (<21 vs. ≥21) and evaluation of specific alcohol behaviors. Between 2016 and 2019, the proportion of young service members endorsing any alcohol use significantly decreased for both the <21 group (i.e. from 38.9% to 32.6%) and the ≥21 group (i.e. from 80.6% to 77.5%). Among those who endorsed drinking, a decrease over time in binge use was also observed from 46.6% to 37.8% for the <21 group and from 34.2% to 27.5% for the ≥21 group. Responses to other specific alcohol risk items and total AUDIT scores also demonstrated decreases. Binge use and risky drinking remained disproportionately common among those under the legal drinking age. It is encouraging to observe a shift toward abstinence and decreased binge use among this population of young military recruits. However, given the risk for many adverse health and legal consequences in this population, more work is needed to prevent problematic drinking, especially among those under the legal drinking age.

The COVID-19 Pandemic and Coronary Heart Disease: the Next Surge

PURPOSE OF REVIEW

In this narrative review, we highlight different ways in which the COVID-19 pandemic has impacted coronary heart disease (CHD) burden and how a surge in morbidity and mortality may be expected in the near future. We also discuss potential solutions, and the direction subsequent research and corrective actions should take.

RECENT FINDINGS

COVID-19 has been implicated in the development and worsening of CHD via acute and chronic mechanisms in the form of plaque rupture, destabilization, and sustenance of a chronic inflammatory state leading to long COVID syndrome and increased rates of myocardial infarction. However, indirectly the pandemic is likely to further escalate the CHD burden through poor health behaviors such as tobacco consumption, reduced physical activity, economic devastation and its associated sequelae, and regular cardiac care interruptions and delays. COVID-19 has increased the total CHD burden and will require extensive resource allocation and multifaceted strategies to curb future rise.

The moderating role of mental health on the association between COVID-related stress, isolation, and economic hardship and using substances to cope

Since young adulthood is a vulnerable period for adverse mental health experiences and high-risk substance use, it is critical to understand the impact of the COVID-19 pandemic on young adult mental health and substance use behaviors. Therefore, we determined whether the relationship between COVID-related stressors and using substances to cope with COVID-related social distancing and isolation was moderated by depression and anxiety among young adults. Data were from the Monitoring the Future (MTF) Vaping Supplement (total N = 1244). Logistic regressions assessed the relations between COVID-related stressors, depression, anxiety, demographic characteristics, and interactions between depression/anxiety and COVID-related stressors with vaping more, drinking more, and using marijuana to cope with COVID-related social distancing and isolation. Greater COVID-related stress due to social distancing was associated with vaping more to cope among those with more depression symptoms and drinking more to cope among those with more symptoms of anxiety. Similarly, COVID-related economic hardships were associated with using marijuana to cope among those with more symptoms of depression. However, feeling less COVID-related isolation and social distancing stress was linked to vaping and drinking more to cope, respectively, among those with more symptoms of depression. These findings suggest that the most vulnerable young adults are seeking substances to cope with the pandemic, while potentially experiencing co-occurring depression and anxiety along with COVID-related stressors. Therefore, intervention programs to support young adults who are struggling with their mental health in the aftermath of the pandemic as they transition into adulthood are critical.

Longitudinal factors associated with increased alcohol consumption in adults during the COVID-19 pandemic

Background: Alcohol is the most abused substance among adults in the United States. The COVID-19 pandemic impacted patterns of alcohol use, but data are conflicting, and previous studies are largely limited to cross-sectional analyses.Objective: This study aimed to longitudinally assess sociodemographic and psychological correlates of changes in three patterns of alcohol use (number of alcoholic drinks, drinking regularity, and binge drinking) during COVID-19.Methods: We studied changes in self-reported drinking behaviors in 222,195 Mayo Clinic patients over 21 years of age (58.1% female and 41.9% male) between April 1, 2019, and March 30, 2021. Logistic regression models were used to estimate associations between patient characteristics and change in alcohol consumption.Results: Sociodemographically younger age, White race, having a college degree, and living in a rural area were associated with increased alcohol use regularity (all p < .05). Younger age, male, White, high-school education or less, living in a more deprived neighborhood, smoking, and living in a rural area were associated with increases in number of alcohol drinks (all p ≤ .04) and binge drinking (all p ≤ .01). Increased anxiety scores were associated with increased number of drinks, while depression severity was associated with both increased drinking regularity and increased number of drinks (all p ≤ .02) independent of sociodemographic characteristics.Conclusion: Our study showed that both sociodemographic and psychological characteristics were associated with increased alcohol consumption patterns during the COVID-19 pandemic. Our study highlights specific target groups previously not described in the literature for alcohol interventions based on sociodemographic and psychological characteristics.

Age- and Sex-Varying Associations Between Depressive Symptoms and Substance Use from Modal Ages 35 to 55 in a National Sample of U.S. Adults

It is important to examine normative age-related change in substance use risk factors across the lifespan, with research focusing on middle adulthood particularly needed. The current study examined time-varying associations between depressive symptoms and alcohol, cigarette, and marijuana use from modal ages 35 to 55 in a national sample of US adults, overall and by sex. Data were obtained from 11,147 individuals in the longitudinal Monitoring the Future study. Participants were in 12th grade (modal age 18) in 1976-1982 and (for the data reported in this study) were surveyed again at modal ages 35 (in 1993-1999), 40, 45, 50, and 55 (in 2013-2019). Weighted time-varying effect modeling was used to examine age-related change in associations among depressive symptoms, any and heavy use of cigarettes, alcohol, and marijuana. Across midlife, greater depressive symptoms were associated with decreased odds of any alcohol use during the 40 s and 50 s, but with increased odds of binge drinking from ages 35-40, and-at most ages-any and pack + cigarette use and any and frequent marijuana use. The association between depressive symptoms and substance use was generally similar for men and women. Results highlight the increased risk for binge drinking, smoking, and marijuana with higher levels of depressive symptoms and underscore the importance of screening and interventions for depressive symptoms and substance use in midlife.

Trends in Young Adult Alcohol and Cannabis Use Through the First 1.5 Years of the COVID-19 Pandemic From a Community Cohort Sample

OBJECTIVE

There has been concern regarding increased substance use during the COVID-19 pandemic, particularly among young adults, but much of this concern stemmed from cross-sectional or short-term data collected early in the pandemic. This study followed a young adult community cohort throughout the first 1.5 years of the pandemic to examine longer-term trends/trajectories in alcohol and cannabis use behaviors.

METHOD

Beginning before the COVID-19 pandemic (January 2020), 656 young adults completed up to eight surveys on substance use and other behaviors, which extended through August 2021. Multilevel spline growth models estimated changes in alcohol/cannabis use in three segments: (a) from pre-pandemic to April 2020, (b) from April 2020 to September/October 2020, and (c) from September/October 2020 to July/August 2021. Abstainers were removed from the analyses, yielding subsamples for alcohol models (n = 545; M age = 25.6 years; 59.8% female) and cannabis models (n = 303; M age = 25.6; 61.4% female).

RESULTS

Drinking frequency initially increased (3% per month), decreased in the second segment (4% per month), and plateaued in the final segment. Drinking quantity significantly decreased in all three segments: 4% per month in segment one, 3% per month in segment two, and 1% per month in the final segment. Cannabis frequency and quantity showed no significant changes across the first two segments, then significantly decreased in the final segment (3% and 6% per month, respectively). The significant changes for cannabis frequency/quantity were moderated by age, such that older participants had steeper decreases in the final segment.

CONCLUSIONS

Findings highlight that young adult alcohol and cannabis use generally declined across the first 1.5 years of the COVID-19 pandemic, contrary to widespread concerns.

The association between psychological distress and alcohol consumption and physical activity: a population-based cohort study

Introduction

The COVID-19 pandemic and infection control measures caused changes to daily life for most people. Heavy alcohol consumption and physical inactivity are two important behavioral risk factors for noncommunicable diseases worldwide. The COVID-19 pandemic, with its social distancing measures, home office policies, isolation, and quarantine requirements may have an impact on these factors. This three-wave longitudinal study aims to investigate if psychological distress and worries related to health and economy were associated with levels and changes in alcohol consumption and physical activity during the two first years of the COVID-19 pandemic in Norway.

Methods

We used data collected in April 2020, January 2021, and January 2022 from an online longitudinal population-based survey. Alcohol consumption and physical activity status were assessed at all three measuring points via the Alcohol Use Disorder Identification Test (AUDIT-C) and the International Physical Activity Questionnaire (IPAQ-SF). COVID-19-related worries, home office/study, occupational situation, age, gender, children below 18 years living at home, and psychological distress (measured with the Symptom Checklist (SCL-10)) were included as independent variables in the model. A mixed model regression was used and presented with coefficients with 95% confidence intervals (CI).

Results

Analysis of data from 25,708 participants demonstrates that participants with substantial symptoms of psychological distress more often reported higher alcohol consumption (1.86 units/week, CI 1.48-2.24) and lower levels of physical activity [-1,043 Metabolic Equivalents of Task (METs) per week, CI -1,257;-828] at baseline. Working/studying from home (0.37 units/week, CI 0.24-0.50) and being male (1.57 units/week, CI 1.45-1.69) were associated with higher alcohol consumption. Working/studying from home (-536 METs/week, CI -609;-463), and being older than 70 years (-503 METs/week, CI -650;-355) were related to lower levels of physical activity. The differences in activity levels between those with the highest and lowest levels of psychological distress reduced over time (239 METs/week, CI 67;412), and similarly the differences in alcohol intake reduced over time among those having and not having children < 18 years (0.10 units/week, CI 0.01-0.19).

Conclusion

These findings highlight the substantial increases in risks related to inactivity and alcohol consumption among those with high levels of psychological distress symptoms, and particularly during the COVID-19 pandemic, and increase the understanding of factors associated with worries and health behavior.

The Involvement of Age, Gender, and Personality Variables in Alcohol Consumption during the Start of the COVID-19 Pandemic in Romanian University Students

This study aimed to explore the age, gender, and personality variables involved in alcohol consumption (AC) at the start of the COVID-19 pandemic in Romania among 210 bachelor's and master's students aged between 19 and 25 years. The results of the Freiburg Personality Inventory-Revised and the Alcohol Use Disorders Identification Test were examined using a logistic model and cluster analysis. The prevalence of problematic AC was relatively low (10.5%). The risk of males being part of the problematic AC cluster was 5.223 times higher than that of females (p < 0.001). Increasing age was associated with a decrease in the risk of belonging to the problematic cluster by a factor of 0.733 (p = 0.001). Increasing scores on the Frankness and Somatic Complaints personality scales were associated with a decreased risk of belonging to the problematic cluster of AC, with factors of 0.738 (95% CI, 0.643 to 0.848), Wald χ²(1) = 18.424, and p < 0.001 and 0.901 (95% CI, 0.813 to 0.999), Wald χ²(1) = 3.925, and p = 0.048, respectively. More action to prevent AC is needed in men, especially in those at the beginning of their university studies. It is necessary to intervene to decrease the interest in making a good impression (low scores on the Frankness Scale) so as to increase healthy autonomy using critical thinking and find a balance between the internal and external loci of control. Students from faculties with profiles that deal with health and its promotion are less vulnerable to problematic alcohol consumption, even if they have a withdrawn, pessimistic personality (low scores on Somatic Complaints).

The impact of the COVID-19 pandemic on alcohol and tobacco consumption: Evidence from Peru

The COVID-19 pandemic has introduced dramatic adversities for public health around the world, especially in low and middle-income countries. While research has shown the pandemic to have direct effects on a variety of major economic and health crises, its impact on health-related behaviors is not clear. In this paper, I examine how exposure to the pandemic affects alcohol use and smoking in Peru, which experienced one of the highest COVID-related death rates albeit implementing one of the strictest lockdown policies in the world. I find that post pandemic consumption of alcohol and smoking in the last 30 days decreases by 41.3% and 44.1% respectively when compared to pre-pandemic rates. I also conclude that the intensity of engaging in these behaviors change such that the frequency of consuming alcohol in the last 30 days, binge drinking and the probability of smoking daily falls. While drinking behavior returns to pre-pandemic levels, the negative effect on smoking weakens but remains for almost two years preceding the pandemic.

Alcohol misuse, health-related behaviors, and burnout among clinical therapists in China during the early Covid-19 pandemic: A Nationwide survey

Objectives

This study aimed to assess the extent of alcohol use and misuse among clinical therapists working in psychiatric hospitals in China during the early COVID-19 Pandemic, and to identify associated factors.

Methods

An anonymous nationwide survey was conducted in 41 tertiary psychiatric hospitals. We collected demographic data as well as alcohol use using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and burnout using the Maslach Burnout Inventory Human Services Survey.

Results

In total, 396 clinical therapists completed the survey, representing 89.0% of all potential participants we targeted. The mean age of participants was 33.8 years old, and more than three-quarters (77.5%) were female. Nearly two-fifths (39.1%) self-reported as current alcohol users. The overall prevalence of alcohol misuse was 6.6%. Nearly one-fifth (19.9%) reported symptoms of burnout with high emotional exhaustion in 46 (11.6%), and high depersonalization in 61 (15.4%). Multiple logistic regression showed alcohol use was associated with male gender (OR = 4.392; 95% CI =2.443-7.894), single marital status (OR = 1.652; 95% CI =0.970-2.814), smoking habit (OR = 3.847; 95%CI =1.160-12.758) and regular exercise (OR = 2.719; 95%CI =1.490-4.963). Alcohol misuse was associated with male gender (OR = 3.367; 95% CI =1.174-9.655), a lower education level (OR = 3.788; 95%CI =1.009-14.224), smoking habit (OR = 4.626; 95%CI =1.277-16.754) and high burnout (depersonalization, OR = 4.848; 95%CI =1.433-16.406).

Conclusion

During the COVID-19 pandemic, clinical therapists' alcohol consumption did not increase significantly. Male gender, cigarette smoking, and burnout are associated with an increased risk of alcohol misuse among clinical therapists. Targeted intervention is needed when developing strategies to reduce alcohol misuse and improve clinical therapists' wellness and mental health.

Alcohol use in the older adult US population: Trends, causes, and consequences

Alcohol use, binge drinking, and alcohol use disorders have been increasing among older adults in the US population, including adults over 50 as well as adults over 65. Increases in consumption are sharper among women, and among those who use additional substances such as cannabis, and those who are relatively healthy in older adulthood (i.e. those without multimorbidites). This commentary describes these trends as well as provides hypotheses, and the data underlying them, for both supply-side (alcohol marketing and messaging) and demand-side (healthier aging, increased financial stress) potential drivers of these increases. The need for additional resources and focus on older adult drinking is increasingly urgent, as alcohol-attributable deaths escalate among older adults in the United States.

Factors Associated with Self-Reported Changes in Alcohol Use among Young Adults during the COVID-19 Pandemic: A Comparative Analysis between Canada and France

While the COVID-19 pandemic impacted young adults' alcohol use patterns, little is known about how changes in alcohol use may differ across different settings. Our objective was to identify and compare factors associated with changes in alcohol use among young adults in Canada and France during the first year of the COVID-19 pandemic. We conducted an online cross-sectional survey in October-December 2020 with young adults aged 18-29 (n = 5185) in Canada and France. In each country, weighted multinomial logistic regressions were performed to identify factors associated with self-reported decrease and increase in alcohol use separately (reference: no change). Respectively, 33.4% and 21.4% reported an increase in alcohol use in Canada and France, while 22.9% and 33.5% reported a decrease. Being 25-29 was a predictor of decrease in Canada, while living away from family was associated with an increase in France. In both countries, participants were more likely to report an increase if they reported depressive symptoms, smoking tobacco, or cannabis use. Conversely, those who had been tested for COVID-19 and those who were highly compliant with COVID-19 preventive measures were more likely to report a decrease. Efforts are needed to develop alcohol use interventions for young adults, including in ways that prioritize those with mental health challenges.

COVID-19 pandemic-related changes in utilization of telehealth and treatment overall for alcohol use problems

BACKGROUND

During the COVID-19 pandemic, specialty alcohol treatment transitioned rapidly to telehealth, which may have created barriers for some patients but increased access for others. This study evaluated the impact of the COVID-19 pandemic on alcohol treatment utilization and potential disparities.

METHODS

We analyzed electronic health record and claims data from Kaiser Permanente Northern California for adults with alcohol use problems (alcohol use disorder or unhealthy alcohol use diagnoses) during pre-COVID-19 (March to December 2019, n = 32,806) and COVID-19 onset (March to December 2020, n = 26,763). Generalized estimating equation models were fit to examine pre-COVID-19 to COVID-19 onset changes in alcohol treatment initiation, engagement, and retention (days in treatment). Heterogeneity in pre-COVID-19 to COVID-19 onset changes in treatment utilization by age, race, and ethnicity; neighborhood deprivation index (NDI); and comorbid medical and psychiatric disorders were also examined.

RESULTS

Treatment initiation increased during the COVID-19 onset period (adjusted odds ratio [aOR] = 1.46; 95% CI = 1.41-1.52). The increases in odds of treatment initiation during the COVID-19 onset period compared with the pre-COVID period were largest among patients aged 18-34 years (aOR = 1.59; 95% CI = 1.48-1.71), those without medical conditions (aOR = 1.56; 95% CI = 1.49-1.65), and those without psychiatric disorders (aOR = 1.60; 95% CI = 1.51-1.69). Patients aged 18-34 years (aOR = 5.21; 95% CI = 4.67-5.81), those with the second highest NDIs (aOR = 4.63; 95% CI = 4.12-5.19), and those without medical (aOR = 4.34; 95% CI = 4.06-4.65) or psychiatric comorbidities (aOR = 4.48; 95% CI = 4.11-4.89) had the greatest increases in telehealth treatment initiation from pre-COVID-19 to COVID-19 onset. Treatment engagement and retention also increased during COVID-19 onset, with the greatest increase among patients aged 35-49 years who initiated treatment via telehealth (engagement: aOR = 2.33; 95% CI = 1.91-2.83; retention: adjusted mean difference [aMD] = 3.3 days; 95% CI = 2.6-4.1). We found no significant variation of changes in treatment utilization by race and ethnicity.

CONCLUSIONS

The transition to telehealth in this healthcare system may have attracted subgroups of individuals who have historically underutilized care for alcohol use problems, particularly younger and healthier adults, without exacerbating pre-pandemic racial and ethnic disparities in treatment utilization.

Assessment of the Prevalence of Alcoholic Beverage Consumption and Knowledge of the Impact of Alcohol on Health in a Group of Polish Young Adults Aged 18-35: A Cross-Sectional Study

Alcoholic beverages are widely consumed worldwide, especially by young adults. Their excessive consumption is associated with numerous health, social and financial damages. The level of knowledge of young adults about the health effects of consuming alcoholic beverages is low, and research in this area is conducted on small, unrepresentative groups. This cross-sectional study aimed to assess the prevalence of alcoholic beverage consumption and the level of knowledge about the impact of ethyl alcohol on health in a group of people aged 18−35. The survey results indicate that the majority of respondents regularly consume alcoholic beverages (94.6%), and they are at a low risk of excessive consumption (p < 0.0001). The most frequently chosen alcoholic beverage in the studied group was beer, and the least chosen one was vodka. The main motive for reaching for alcoholic beverages was the desire to improve mood. Respondents did not indicate significant changes in alcohol consumption during the COVID-19 pandemic, but participants in the high-risk group more often indicated an increase in alcohol consumption (p = 0.0025). The analysis of the level of knowledge showed that the participants in the study had an average or low level of knowledge about the effects of ethanol on health, with no significant relationships between the study groups. The obtained results indicate a strong need for the continuous education of young people on the effects of the excessive consumption of alcoholic beverages on the body, with particular emphasis on the consequences of using alcohol as a mood-enhancing agent.

Is There an Association between Being a Victim of Physical Violence by Intimate Partner and Binge Drinking in Men and Women? Secondary Analysis of a National Study, Peru 2020

The relationship between being a victim of physical violence by an intimate partner and binge drinking (BD) is a poorly explored line of research, especially in men. To determine the association between being a victim of physical violence by an intimate partner and BD in men and women in Peru in 2020, a secondary analytical cross-sectional study was conducted using the Demographic Health Survey. BD was categorized according to the Center of Disease Control definition for men and women, based on the type and amount of alcoholic beverage ingested. Physical violence was based the report of being hit with any part of the body or an object, by their intimate partner. To identify the association, a multivariable general linear model of the family and link log Poisson was used. The results were presented as prevalence ratios (PRs). In the adjusted models stratified by sex, a 90% greater likelihood of BD was found in male victims and an 80% higher probability among female victims (PRa 1.9, 95%CI 1.3;2.7, p < 0.001 vs. PRa 1.8, CI95% 1.1; 2.8, p = 0.013, respectively). An association was found between physical violence by an intimate partner and BD in the Peruvian population older than 15 years, in both men and women.

Solitary alcohol use in adolescence predicts alcohol problems in adulthood: A 17-year longitudinal study in a large national sample of US high school students

BACKGROUND

Identifying risk factors for alcohol use disorder (AUD) is important for public health. The social context of drinking-such as drinking alone-may be an independent and robust early risk marker for AUD symptoms later in life. We evaluated whether solitary alcohol use in adolescence (age 18) and young adulthood (age 23/24) was concurrently associated with binge drinking and prospectively predicted age 35 AUD symptoms, and whether associations differed by sex.

METHODS

Longitudinal data were from the Monitoring the Future study. Surveys were completed by adolescents in 12th grade at age 18 (1976-2002), young adults at age 23/24 (1981-2008), and adults at age 35 (1993-2019). Analyses included past 12-month alcohol users (n = 4464 for adolescent models; n = 4561 for young adult models). Multivariable regression analyses tested whether adolescent and young adult solitary alcohol use was associated concurrently with binge drinking frequency and prospectively with age 35 AUD symptoms.

RESULTS

Solitary alcohol use in adolescence and young adulthood was associated (a) concurrently with binge drinking and (b) prospectively with increased risk of age 35 AUD symptoms (even after controlling for earlier binge drinking, alcohol use frequency, and sociodemographic covariates). Adolescent solitary alcohol use was associated with age 35 AUD symptoms particularly among females; no interaction was observed between sex and young adult solitary alcohol use in predicting age 35 AUD symptoms.

CONCLUSIONS

Adolescent and young adult solitary alcohol use was associated with increased adult AUD symptoms above and beyond other risk factors; adolescent female solitary alcohol users were especially at risk.

Substance use and common contributors to morbidity: A genetics perspective

Excessive substance use and substance use disorders (SUDs) are common, serious and relapsing medical conditions. They frequently co-occur with other diseases that are leading contributors to disability worldwide. While heavy substance use may potentiate the course of some of these illnesses, there is accumulating evidence suggesting common genetic architectures. In this narrative review, we focus on four heritable medical conditions - cardiometabolic disease, chronic pain, depression and COVID-19, which are commonly overlapping with, but not necessarily a direct consequence of, SUDs. We find persuasive evidence of underlying genetic liability that predisposes to both SUDs and chronic pain, depression, and COVID-19. For cardiometabolic disease, there is greater support for a potential causal influence of problematic substance use. Our review encourages de-stigmatization of SUDs and the assessment of substance use in clinical settings. We assert that identifying shared pathways of risk has high translational potential, allowing tailoring of treatments for multiple medical conditions.

Funding

SSR acknowledges T29KT0526, T32IR5226 and DP1DA054394; RLK acknowledges AA028292; AA acknowledges DA054869 & K02DA032573. The funders had no role in the conceptualization or writing of the paper.

Alcohol Use Among Young Adults in Northern California During the COVID-19 Pandemic-An Electronic Health Records-Based Study

BACKGROUND

Individuals globally were affected by the COVID-19 pandemic in myriad of ways, including social isolation and economic hardship, resulting in negative impacts on mental health and substance use. Young adults have been subjected to extraordinary challenges such as job loss, virtual school, or childcare issues, but have received limited attention from research so far.

METHODS

Using electronic health record data from a large integrated healthcare system in Northern California, this longitudinal observational study examined changes in the prevalence of unhealthy alcohol use (identified via systematic alcohol screening in adult primary care) from pre- (3/1/2019-12/31/2019) to post-COVID onset (3/1/2020-12/31/2020) among young adults (18-34 years). Among the 663,111 and 627,095 young adults who utilized primary care in the pre- and post-COVID onset periods, 342,889 (51.9%) and 186,711 (29.8%) received alcohol screening, respectively. We fit generalized estimating equation Poisson models to estimate the change in prevalence of unhealthy alcohol use from pre- to post-COVID onset among those who were screened, while using inverse probability weighting to account for potential selection bias of receiving alcohol screening. Heterogeneity in the change of prevalence by patient characteristics was also examined.

RESULTS

Overall, the unadjusted prevalence of unhealthy alcohol use slightly decreased from 9.2% pre-COVID to 9.0% post-COVID onset. After adjusting for patient covariates, the prevalence of unhealthy alcohol use decreased by about 2% [adjusted prevalence ratio (aPR) = 0.98, 95% CI = 0.96, 1.00]. The prevalence of unhealthy alcohol use increased among women by 8% (aPR = 1.08, 95% CI = 1.06, 1.11), patients 18-20 years by 7% (aPR = 1.07, 95% CI = 1.00, 1.15), and Latino/Hispanic patients by 7% (aPR = 1.07, 95% CI = 1.03, 1.11). While the prevalence of unhealthy alcohol use decreased among men by 12% (aPR = 0.88, 95% CI = 0.86, 0.90), patients 21-34 years by 2% (aPR = 0.98, 95% CI = 0.96, 0.99), White patients by 3% (95% CI = 0.95, 1.00), and patients living in neighborhoods with the lowest deprivation indices by 9% (aPR = 0.91, 95% CI = 0.88, 0.94), their unadjusted prevalence remained higher than their counterparts post-COVID onset. There was no variation in the change of prevalence by comorbid mental health conditions or drug use disorders.

CONCLUSIONS

While changes in unhealthy alcohol use prevalence among young adults were small, findings raise concerns over increased drinking among women, those younger than the U.S. legal drinking age, and Latino/Hispanic patients.