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Lac A. Drinking to Cope With the COVID-19 Pandemic Mediates Pathways From COVID-19 Anxiety to Alcohol Use and Alcohol Myopia Consequences. J Dual Diagn 2024:1-13. [PMID: 38742669 DOI: 10.1080/15504263.2024.2343372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE People may consume alcohol to cope with the stressors and anxieties of the COVID-19 pandemic. The present study applied the self-medication hypothesis, tension reduction hypothesis, and alcohol myopia theory to understand COVID-19 alcohol coping as a mediator of the pathways from COVID-19 anxiety to alcohol use and alcohol consequences. METHODS Participants (N = 477) were undergraduate college students. The mean age was 22.14 (SD = 5.66) years. Gender distribution included 73% females, 26% males, and 1% transgender. Racial categories included 70% White, 11% Latino, 5% Black, 5% Asian, and 9% multiracial. They completed the Coronavirus Anxiety Scale, the COVID-19 Alcohol Coping Scale developed and validated in the present study, measures of drinking frequency and drinking quantity, and the Alcohol Myopia Scale to assess alcohol consequences. RESULTS First, confirmatory factor analysis supported the measurement structure of the COVID-19 Alcohol Coping Scale. Second, a general structural equation model containing only latent factors provided evidence for the following pathways: COVID-19 anxiety to COVID-19 alcohol coping to overall alcohol use to alcohol myopia consequences. Third, a specific structural equation model separated the overall alcohol use factor into two measures of drinking frequency and drinking quantity. Results found that COVID-19 alcohol coping uniquely explained drinking frequency (but not drinking quantity), indicating that the pursuit of alcohol to cope with the pandemic was related to more frequent days of alcohol use but not more concentrated use on drinking days. Tests of indirect effects corroborated the mediational pathways in the explanatory models. CONCLUSIONS The research offers insights into understanding that the risk connections from COVID-19 anxiety to alcohol behavioral outcomes are mediated by alcohol use to cope with the pandemic.
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Affiliation(s)
- Andrew Lac
- Department of Psychology, University of Colorado, Colorado Springs, Colorado, USA
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2
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Jose R, Wang W, Sherman G, Rosenthal RN, Schwartz HA, Ungar LH, McKay JR. Tapping into alcohol use during COVID: Drinking correlates among bartenders and servers. PLoS One 2024; 19:e0300932. [PMID: 38625926 PMCID: PMC11020438 DOI: 10.1371/journal.pone.0300932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/06/2024] [Indexed: 04/18/2024] Open
Abstract
The COVID pandemic placed a spotlight on alcohol use and the hardships of working within the food and beverage industry, with millions left jobless. Following previous studies that have found elevated rates of alcohol problems among bartenders and servers, here we studied the alcohol use of bartenders and servers who were employed during COVID. From February 12-June 16, 2021, in the midst of the U.S. COVID national emergency declaration, survey data from 1,010 employed bartender and servers were analyzed to quantify rates of excessive or hazardous drinking along with regression predictors of alcohol use as assessed by the 10-item Alcohol Use Disorders Identification Test (AUDIT). Findings indicate that more than 2 out of 5 (44%) people surveyed reported moderate or high rates of alcohol problem severity (i.e., AUDIT scores of 8 or higher)-a rate 4 to 6 times that of the heavy alcohol use rate reported pre- or mid-pandemic by adults within and outside the industry. Person-level factors (gender, substance use, mood) along with the drinking habits of one's core social group were significantly associated with alcohol use. Bartenders and servers reported surprisingly high rates of alcohol problem severity and experienced risk factors for hazardous drinking at multiple ecological levels. Being a highly vulnerable and understudied population, more studies on bartenders and servers are needed to assess and manage the true toll of alcohol consumption for industry employees.
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Affiliation(s)
- Rupa Jose
- Positive Psychology Center, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Weixi Wang
- Department of Computer Science, Stony Brook University, Stony Brook, New York, United States of America
| | - Garrick Sherman
- Positive Psychology Center, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Richard N. Rosenthal
- Department of Psychiatry, Stony Brook University, Stony Brook, New York, United States of America
| | - H. Andrew Schwartz
- Department of Computer Science, Stony Brook University, Stony Brook, New York, United States of America
| | - Lyle H. Ungar
- Positive Psychology Center, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - James R. McKay
- Philadelphia Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, United States of America
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Cheslack-Postava K, Forthal S, Musa GJ, Ryan M, Bresnahan M, Sapigao RG, Lin S, Fan B, Svob C, Geronazzo-Alman L, Hsu YJ, Skokauskas N, Hoven CW. Persistence of anxiety among Asian Americans: racial and ethnic heterogeneity in the longitudinal trends in mental well-being during the COVID-19 pandemic. Soc Psychiatry Psychiatr Epidemiol 2024; 59:599-609. [PMID: 37624465 DOI: 10.1007/s00127-023-02553-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE To examine within-individual time trends in mental well-being and factors influencing heterogeneity of these trends. METHODS Longitudinal telephone survey of adults over 3 waves from the New York City (NYC) Metropolitan area during the COVID-19 Pandemic. Participants reported depression using the Patient Health Questionnaire (PHQ)-8, anxiety using the Generalized Anxiety Disorder (GAD)-7, and past 30-day increases in tobacco or alcohol use at each wave. Adjusted mixed effects logistic regression models assessed time trends in mental well-being. RESULTS There were 1227 respondents. Over 3 study waves, there were statistically significant decreasing time trends in the odds of each outcome (adjusted OR (95% CI) 0.47 (0.37, 0.60); p < 0.001 for depression; aOR (95% CI) 0.55 (0.45, 0.66); p < 0.001 for anxiety; aOR (95% CI) 0.50 (0.35, 0.71); p < 0.001 for past 30-day increased tobacco use; aOR (95% CI) 0.31 (0.24, 0.40); p < 0.001 for past 30-day increased alcohol use). Time trends for anxiety varied by race and ethnicity (p value for interaction = 0.05, 4 df); anxiety declined over time among white, Black, Hispanic, and Other race and ethnicity but not among Asian participants. CONCLUSIONS In a demographically varied population from the NYC Metropolitan area, depression, anxiety and increased substance use were common during the first months of the pandemic, but decreased over the following year. While this was consistently the case across most demographic groups, the odds of anxiety among Asian participants did not decrease over time.
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Affiliation(s)
- Keely Cheslack-Postava
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA.
| | - Sarah Forthal
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - George J Musa
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Megan Ryan
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Michaeline Bresnahan
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Rosemarie G Sapigao
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- CUNY Graduate School of Public Health and Health Policy, New York, USA
| | - Susan Lin
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Bin Fan
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Connie Svob
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lupo Geronazzo-Alman
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Yi-Ju Hsu
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Norbert Skokauskas
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Christina W Hoven
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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Veldhuis CB, Kreski NT, Usseglio J, Keyes KM. Are Cisgender Women and Transgender and Nonbinary People Drinking More During the COVID-19 Pandemic? It Depends. Alcohol Res 2023; 43:05. [PMID: 38170029 PMCID: PMC10760999 DOI: 10.35946/arcr.v43.1.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
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.
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Affiliation(s)
- Cindy B Veldhuis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Noah T Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia Irving Medical Center, Columbia University, New York, New York
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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5
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Trangenstein PJ, Greenfield TK, Karriker-Jaffe KJ, Kerr WC. Beverage- and Context-Specific Alcohol Consumption During COVID-19 in the United States: The Role of Alcohol To-Go and Delivery Purchases. J Stud Alcohol Drugs 2023; 84:842-851. [PMID: 37449953 PMCID: PMC10765975 DOI: 10.15288/jsad.22-00408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/09/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVE Alcohol delivery and to-go sales may contribute to changes in drinking patterns, including where and what people drink. This study tested whether home delivery and to-go alcohol purchases were associated with context- and beverage-specific consumption volumes during the first year of the COVID-19 pandemic after adjusting for pre-pandemic consumption volumes. METHOD Data from a pre-pandemic panel were compared to a during-pandemic panel of the National Alcohol Survey (n = 1,150 adult drinkers, 52.7% female). Outcomes were past-year alcohol consumption volumes in standard drinks (overall, by beverage type, and by location). Independent variables included past-year alcohol delivery and to-go purchases (separately). Covariates comprised baseline beverage- or context-specific volume, demographics, COVID-19 impacts, and drinking motivations. Negative binomial regression tested associations between alcohol purchases and change in overall, beverage-, and context-specific consumption. RESULTS On average, respondents who had alcohol delivered (vs. not) reported consuming larger volumes overall (incidence rate ratio [IRR] = 1.58, 95% CI [1.07, 2.32], p = .02), of wine (IRR = 2.90, 95% CI [1.50, 5.63], p < .04), of spirits (IRR = 1.59, 95% CI [1.03, 2.44], p = .04), and at home (IRR = 1.59, 95% CI [1.10, 2.31], p = .01). People who bought alcohol to go (vs. not) reported larger volumes of wine (IRR = 1.41, 95% CI [1.02, 1.96], p = .04), at home (IRR = 1.60, 95% CI [1.10, 2.32], p = .01), and in bars (IRR = 4.55, 95% CI [2.55, 8.11], p < .001). Finally, people who had alcohol delivered reported drinking smaller volumes in bars (IRR = 0.49, 95% CI [0.24, 0.98], p = .04). CONCLUSIONS During the first year of the pandemic, adults who had alcohol delivered or bought it to go reported larger volumes for several locations and beverage types.
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Affiliation(s)
| | | | - Katherine J. Karriker-Jaffe
- RTI International, Center for Behavioral Health Epidemiology, Implementation & Evaluation Research, Berkeley, California
| | - William C. Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California
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6
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Musich M, Costa AN, Salathe V, Miller MB, Curtis AF. Sex-Specific Contributions of Alcohol and Hypertension on Everyday Cognition in Middle-Aged and Older Adults. J Womens Health (Larchmt) 2023; 32:1086-1095. [PMID: 37023399 DOI: 10.1089/jwh.2022.0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Background: Separate lines of research have linked hypertension and alcohol use disorder to cognition among adults. Despite known sex differences in both of these conditions, studies examining associations on cognition are limited. We aimed to determine whether hypertension impacts the relationship between alcohol use and everyday subjective cognition and whether sex moderates this relationship in middle-aged and older adults. Materials and Methods: Participants (N = 275) 50+ years of age, who reported drinking, completed surveys measuring alcohol use (Alcohol Use Disorder Identification Test consumption items), self-reported history of hypertension, and everyday subjective cognition (Cognitive Failures Questionnaire [CFQ]). Regression was used to test a moderated moderation model examining independent and interactive roles of alcohol use, hypertension, and sex on cognition (CFQ scores: total, memory, distractibility, blunders, and names). Analyses controlled for age, years of education, race, body mass index, smoking status, depressive symptoms, global subjective sleep quality, number of prescription medication used, and number of comorbid medical conditions. Results: Sex moderated the interactive associations of hypertension and alcohol use frequency on CFQ-distractibility. Specifically, in women with hypertension, more alcohol use was associated with greater CFQ-distractibility (B = 0.96, SE = 0.34, p = 0.005). Discussion: Sex moderates the interactive association of hypertension and alcohol use on some aspects of subjective cognition in mid-to-late life. In women with hypertension, alcohol use may exacerbate problems with attentional control. Further exploration of sex- and or gender-specific mechanisms underlying these is warranted.
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Affiliation(s)
- Madison Musich
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Amy N Costa
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Victoria Salathe
- Department of Biological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Mary Beth Miller
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri, USA
| | - Ashley F Curtis
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri, USA
- College of Nursing, University of South Florida, Tampa, Florida, USA
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7
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Sutariya R, Hamzeh M, Desale S, Mete M, Mazer-Amirshahi M, Nelson LS. Impact of the COVID-19 pandemic on emergency department alcohol intoxication presentations and positive screens for problem drinking. Alcohol Alcohol 2023; 58:547-552. [PMID: 37553859 DOI: 10.1093/alcalc/agad053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/28/2023] [Accepted: 07/12/2023] [Indexed: 08/10/2023] Open
Abstract
Our aim was to assess the changes in patients presenting with acute alcohol intoxications or positive screens for problem drinking during the COVID-19 pandemic compared to before the pandemic in a seven-hospital health system. A retrospective chart review of emergency department (ED) visits from seven hospitals in the Washington, DC/Baltimore, and MD area from January 2019 to June 2021 is provided. The health system utilizes a validated system for Screening, Brief Intervention, and Referral to Treatment (SBIRT) for ED patients. We evaluated trends in patients who had a positive SBIRT screen for problem drinking (AUDIT-C score ≥ 3 in women, 4 in men), alcohol misuse (≥5), and those presenting with acute alcohol intoxication before March 2020 and during the early COVID pandemic period. There were 510 648 patients who were screened, ranging from ages of 16 to 95 years during the study period. There was an overall increase in patients who screened positive for problem drinking, alcohol misuse, and acute intoxications. While there was an overall decrease in the total number of ED visits during the start of the pandemic, which later increased near prepandemic levels, alcohol-related presentations as a percentage of total visits increased during the early pandemic period. There was an overall decrease in ED visits during the COVID-19 pandemic study period; problem drinking and acute intoxication presentation held steady, leading to an overall increase in proportion compared to pre-COVID-19 levels. Future research should focus on lessons learned during this time and should navigate the postpandemic care of patients with AUD. There was an increase in the proportion of ED visits for alcohol intoxications and positive screens for problem drinking during the COVID-19 pandemic in our seven-hospital system.
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Affiliation(s)
- R Sutariya
- Georgetown University School of Medicine, Washington, DC 20007, United States
| | - M Hamzeh
- Georgetown University School of Medicine, Washington, DC 20007, United States
| | - S Desale
- MedStar Health Research Institute, Washington, DC 20010, United States
| | - M Mete
- MedStar Health Research Institute, Washington, DC 20010, United States
| | - M Mazer-Amirshahi
- Georgetown University School of Medicine, Washington, DC 20007, United States
- Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC 20010, United States
| | - Lewis S Nelson
- Rutgers University School of Medicine, Newark, NJ 07103, United States
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8
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Tucker JS, Seelam R, Green HD, Rodriguez A, Pollard MS. Alcohol and cannabis co-use in a national sample of U.S. adults ages 30-80. Addict Behav 2023; 142:107663. [PMID: 36842190 PMCID: PMC10049786 DOI: 10.1016/j.addbeh.2023.107663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/30/2023] [Accepted: 02/09/2023] [Indexed: 02/22/2023]
Abstract
INTRODUCTION Growing cannabis legalization has coincided with an increased focus on use of both alcohol and cannabis (AC co-use) among younger people; however, little is known about AC co-use among adults over age 30. This study examines the prevalence of different types of AC co-use among adults, as well as compares AC co-users and alcohol-only users on individual, social network, and neighborhood characteristics. METHODS Data come from three annual surveys of a nationally representative sample of 1,770 U.S. adults, initially between the ages of 30-80, conducted between 2019 and 2021. The baseline sample is 52.8 years old on average, 51.8 % female, and 60.1 % non-Hispanic White. RESULTS Past month co-use at baseline was reported by 8.4% of adults, and mostly consisted of simultaneous use, with less than 5% of the sample initiating co-use over the two-year follow-up period. Multivariable models indicate AC co-use was cross-sectionally associated with respondents being male, younger, Hispanic (vs White), and having more alcohol use and related problems, and with their social network composition (e.g., having more drinking buddies and cannabis users in the network). However, co-use status was not associated with mental health, physical ailments, or neighborhood quality. Longitudinal analyses indicated that AC co-use at baseline predicted more alcohol use one year later and alcohol related problems two years later among men only. CONCLUSIONS AC co-use among adults over age 30 deserves further attention given its prevalence and associations with heavier drinking and related problems. Network-focused interventions may be a promising approach for reducing AC co-use.
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Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States.
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States
| | - Harold D Green
- Indiana University School of Public Health, United States
| | - Anthony Rodriguez
- RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116, United States
| | - Michael S Pollard
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States
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9
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Linden-Carmichael AN, Mogle J, Miller SE. Associations between blackout drinking and self-reported everyday cognition among young adults. Addict Behav 2023; 141:107653. [PMID: 36773578 PMCID: PMC10001203 DOI: 10.1016/j.addbeh.2023.107653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Blackout drinking, or alcohol-induced memory loss during at least some part of a drinking occasion, is common among young adults and associated with negative alcohol-related consequences. One potential unique effect of blackout drinking episodes could be prolonged, general difficulties forming new memories through impairments in encoding, storage, or retrieval. The current study examined preliminary associations between blackout drinking and self-reported everyday cognitive functioning (i.e., memory lapses, non-memory cognitive difficulties, cognitive concerns) among a sample of young adults. We also examined the moderating role of key factors linked to blackout drinking: gender and frequent simultaneous alcohol and cannabis use. METHODS Participants (N = 479; 53% women) were aged 18-30 who reported past-year blackout drinking. Participants completed an online survey through Qualtrics Panels. RESULTS More frequent blackout experiences were found to be significantly related to more memory lapses, more non-memory cognitive difficulties, and more cognitive concerns even after controlling for typical alcohol use behavior. Men and individuals reporting frequent simultaneous use indicated stronger relationships between blackout drinking frequency and cognitive outcomes. DISCUSSION AND CONCLUSIONS Findings add to the growing body of literature supporting the uniquely hazardous effects of blackout drinking and identify individuals at heightened risk of harms. Given that associations between blackout drinking frequency and everyday cognitive functioning were identified even among a young adult sample suggests that blackout drinking may be a risky behavior that links to poorer cognitive functioning.
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Affiliation(s)
| | - Jacqueline Mogle
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, United States; Department of Psychology, Clemson University, United States
| | - Sara E Miller
- Department of Human Development and Family Studies, The Pennsylvania State University, United States
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10
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Srinagesh A, Forthal S, Madden SP, Stein LAR, Muench F. Impacts of COVID-19 on alcohol use among help-seeking adults. Adv Drug Alcohol Res 2023; 3:11159. [PMID: 38389810 PMCID: PMC10880767 DOI: 10.3389/adar.2023.11159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/02/2023] [Indexed: 02/24/2024]
Abstract
The coronavirus (COVID-19) pandemic has been associated with both increased and decreased alcohol use. Authors explored reasons for increased and decreased alcohol use since the COVID-19 lockdown (March 2020) in a sample of help-seeking adults (HSA) participating in a remote-based alcohol reduction text-messaging intervention in the USA. At the time of recruitment, the HSA in this study were interested in reducing rather than stopping their alcohol consumption. An optional self-report questionnaire was completed by 324 participants (mean age 41.6 ± 10.2 years; 71.5% female; 83.9% White) in February 2021. Survey questions assessed sociodemographic factors, social stressors (quarantine conditions, employment status, changes to daily routine), and drinking patterns. Authors fit two ordinal logistic regression models: one for increased drinking and one for decreased drinking, as functions of the potential predictors and control variables. Most participants (n = 281; 87.0%) reported drinking more than usual since COVID-19 lockdown began. The most common self-reported reasons for drinking more were increased stress/anxiety (74.7%), boredom (69.4%), and spending more time at home (65.5%) whereas reasons for drinking less were less socializing (33.7%) and worrying about how alcohol would impact the immune system (31.5%). Identifying as female, severity of changes to daily routine, and increased access to alcohol were significantly associated with drinking more than usual. These data suggest that the general consequences of the pandemic in the general population (e.g., boredom) led to greater alcohol use among help-seeking adults attempting to reduce their drinking. Identifying these factors may help create more targeted interventions during public health crises.
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Affiliation(s)
- Aradhana Srinagesh
- Department of Psychology, University of Rhode Island, South Kingston, RI, United States
| | - Sarah Forthal
- Partnership to End Addiction, New York, NY, United States
| | - Sean P Madden
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - L A R Stein
- Department of Psychology, University of Rhode Island, South Kingston, RI, United States
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11
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Colton KC, Godleski SA, Baschnagel JS, Houston RJ, DeHarder SM. Alcohol use during the COVID-19 pandemic: gender, parenthood, intimate partner violence, and stress. AIMS Public Health 2023; 10:360-377. [PMID: 37304583 PMCID: PMC10251053 DOI: 10.3934/publichealth.2023027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/18/2023] [Accepted: 04/16/2023] [Indexed: 06/13/2023] Open
Abstract
Some preliminary work during the COVID-19 pandemic indicates that adult alcohol use increased, particularly for parents. This cross-sectional study examined the quantity and frequency of adults' alcohol use during the early stages of the pandemic. Additionally, the influences of gender, parenthood, COVID-19-related stressors and intimate partner violence (IPV) on alcohol consumption were examined. The sample consisted of 298 adults (98 parents) from across the United States who completed self-report surveys through Qualtrics at the beginning of the pandemic in May 2020. In the present study, all men reported higher levels of drinking compared to all women. Although stress levels did not impact alcohol consumption, findings indicate that increased IPV experiences were associated with higher levels of heavy drinking during the pandemic. Results also suggested that having children in the home particularly impacted drinking levels during the pandemic, above and beyond the influence of gender, IPV, and stress levels. These findings suggest that parenthood may have had a cascading influence on drinking experiences during the COVID-19 pandemic. Implications and recommendations for further research are discussed.
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Tao R, Hsu M, Min K, Mo D, Geng F, Xia L, Liu T, Liu Y, Jiang F, Liu H, Tang YL. Alcohol misuse, health-related behaviors, and burnout among clinical therapists in China during the early Covid-19 pandemic: A Nationwide survey. Front Public Health 2023; 11:1084259. [PMID: 37089496 PMCID: PMC10118037 DOI: 10.3389/fpubh.2023.1084259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
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.
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Affiliation(s)
- Rui Tao
- Department of Substance-Related Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Substance-Related Disorders, Hefei Fourth People’s Hospital, Hefei, China
| | - Michael Hsu
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Kaiyuan Min
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Daming Mo
- Department of Substance-Related Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Substance-Related Disorders, Hefei Fourth People’s Hospital, Hefei, China
| | - Feng Geng
- Department of Psychiatry, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- Research Department, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- Research Department, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Feng Jiang
- Research Department, School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- Research Department, Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Huanzhong Liu
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
| | - Yi-lang Tang
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Mental Health Service Line, Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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Anouti A, Mellinger JL. The Changing Epidemiology of Alcohol-Associated Liver Disease: Gender, Race, and Risk Factors. Semin Liver Dis 2023; 43:50-59. [PMID: 36529138 DOI: 10.1055/a-2000-6680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cases of alcohol-associated liver disease (ALD) are increasing at a steady rate in the United States with more patients presenting with alcohol-associated hepatitis and alcohol-associated cirrhosis. While alcohol use has increased across many demographic groups, women are suffering from a greater increase in alcohol use disorder (AUD), and are at a greater risk of ALD due to pathophysiological differences which include absorption of alcohol, first pass metabolism, and hormonal differences. Differences across race have also been found with Native Americans and Hispanics suffering from some of the largest increases in ALD rates. Younger adults are heavily impacted by rising rates of both AUD and ALD. Comorbidities such as obesity and NASH have been shown to augment the deleterious effects of AUD and ALD, resulting in more advanced liver disease. Finally, COVID-19 and policies related to the pandemic have resulted in increased AUD across many cohorts, which have resulted in marked increases in ALD. In conclusion, ALD rates are rising, with young people and women particularly impacted.
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Affiliation(s)
- Ahmad Anouti
- Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jessica L Mellinger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
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Piornos JA, Koussissi E, Balagiannis DP, Brouwer E, Parker JK. Alcohol-free and low-alcohol beers: Aroma chemistry and sensory characteristics. Compr Rev Food Sci Food Saf 2023; 22:233-259. [PMID: 36398756 DOI: 10.1111/1541-4337.13068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 09/10/2022] [Accepted: 10/11/2022] [Indexed: 11/19/2022]
Abstract
Alcohol-free beers have gained popularity in the last few decades because they provide a healthier alternative to alcoholic beers and can be more widely consumed. Consumers are becoming more aware of the benefits of reducing their alcohol consumption, and this has increased the sales of nonalcoholic alternatives. However, there are still many challenges for the brewing industry to produce an alcohol-free beer that resembles the pleasant fruity flavor and overall sensory experience of regular beers. The aim of this review is to give a comprehensive overview of alcohol-free beer focusing on aroma chemistry. The formation of the most important aroma compounds, such as Strecker aldehydes, higher alcohols, and esters, is reviewed, aiming to outline the gaps in current knowledge. The role of ethanol as a direct and indirect flavor-active compound is examined separately. In parallel, the influence of the most common methods to reduce alcohol content, such as physical (dealcoholization) or biological, on the organoleptic characteristics and consumer perception of the final product, is discussed.
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Affiliation(s)
- José A Piornos
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Elisabeth Koussissi
- Research & Development Department, Heineken Supply Chain BV, Zoeterwoude, The Netherlands
| | | | - Eric Brouwer
- Research & Development Department, Heineken Supply Chain BV, Zoeterwoude, The Netherlands
| | - Jane K Parker
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
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Abstract
The objective of this study was to assess the direct and indirect (via perceived stress) effects of different types of pandemic-related concerns and increased alcohol use among adult women in the United States (US). We conducted a secondary analysis of cross-sectional survey data from April 2020 for adult females in the US who use alcohol (n = 1,089). The indirect effect model accounted for 19% of the variance in perceived stress and 8% of the variance in reporting increased alcohol use compared to no change or decreased use. Path analysis results indicated that concerns about isolation (odds ratio [OR] = 1.027, 95% confidence interval [CI] = 1.013-1.046), job/finances (OR = 1.025, 95% CI = 1.007-1.065), basic needs (OR = 1.021, 95% CI = 1.008-1.047), and concerns about government (OR = 1.038, 95% CI = 1.014-1.179]) were significantly related to reporting increased alcohol use through perceived stress. These findings can inform timely public health interventions to minimize alcohol-related harm among women.
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Bambrah V, Wardell JD, Keough MT. Longitudinal co-trajectories of depression and alcohol problems in adults during the COVID-19 pandemic. Curr Psychol 2022:1-17. [PMID: 36531195 PMCID: PMC9748906 DOI: 10.1007/s12144-022-04109-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
We examined person-centered heterogeneity in the longitudinal co-development of depression and alcohol problems during the COVID-19 outbreak. We also investigated the risk factors (personality and coping) for being in "higher" relative to "lower" risk subgroups of combined depressive symptoms and alcohol problems. Canadian participants (N = 364, M age = 32.16, 54.67% male) completed questionnaires four times every three months, starting approximately 2 months after Canada announced its COVID-19 State-of-Emergency. Parallel-process latent class growth analysis found evidence for three latent subgroups: a "moderate increasing depression and alcohol problems" subgroup (Class 1); a "moderate stable depression, moderate decreasing alcohol problems" subgroup (Class 2); and a "low-risk normative" subgroup (with mild depression that was stable and mild alcohol problems that decreased; Class 3). Multinomial logistic regressions found that higher levels of hopelessness, impulsivity, and boredom proneness distinguished Class 1 from Class 3. Further, lower levels of general self-efficacy distinguished Class 1 from Classes 2 and 3. Linear mixed models found that Class 1 increasingly used maladaptive avoidant coping strategies (denial, drugs/alcohol, behavioural disengagement) as the pandemic progressed, whereas Class 2 increasingly used adaptive approach-oriented strategies (planning, seeking emotional support from others). We analyzed longitudinal data to detect classes of individuals with depressive and alcohol-related difficulties during COVID-19 and to characterize the vulnerability factors for increased difficulties. Highlighting the heterogeneity in the co-trajectory of depression and alcohol problems during COVID-19 and the personality and coping factors associated with combined increases in these mental health difficulties can inform treatment practices and bolster peoples' preparedness and resilience for future pandemics. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-04109-4.
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Affiliation(s)
- Veerpal Bambrah
- Department of Psychology, Faculty of Health, York University, Behavioural Sciences Building, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
| | - Jeffrey D. Wardell
- Department of Psychology, Faculty of Health, York University, Behavioural Sciences Building, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
| | - Matthew T. Keough
- Department of Psychology, Faculty of Health, York University, Behavioural Sciences Building, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
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Ozluk P, Cobb R, Sylwestrzak G, Raina D, Bailly E. Alcohol-Attributable Medical Costs in Commercially Insured and Medicaid Populations. AJPM Focus 2022; 1:100036. [PMID: 37791236 PMCID: PMC10546560 DOI: 10.1016/j.focus.2022.100036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Despite its social acceptance, excessive alcohol use remains among the top causes of preventable deaths in the U.S. Although there is a recognition of alcohol-related health and social costs, there are no current studies quantifying the medical costs incurred under health plans. Methods This study estimates the direct medical costs attributable to excessive alcohol use using claims records from a large national insurer. The sample consists of adults with commercial insurance and Medicaid between 2008 and 2019. A case-control matched study design is used to compare individuals with a condition considered 100% attributable to alcohol by the Centers for Disease Control and Prevention with similar individuals. Medical care use and costs are examined over a 12-month follow-up. Costs are broken down by healthcare setting and health conditions as defined by the Centers for Disease Control and Prevention's Alcohol-Related Disease Impact diagnoses codes. Results We find that having a diagnosis attributable to alcohol is associated with higher annual per-person healthcare expenditures in both commercially insured and Medicaid-insured participants by $14,918 (95% CI=$14,540, $15,297) and $4,823 (95% CI=$4,489, $5,158), respectively. We find that 60%‒75% of the additional costs of excessive alcohol use are driven by heart disease and stroke; conditions of the liver, gallbladder, and pancreas; and certain cancers as well as acute conditions that may be attributable to alcohol. Conclusions The findings suggest that public and private initiatives to target people vulnerable to the harms of excessive alcohol use may potentially help to cut down significant costs on the already strained healthcare system in the U.S.
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Wang X, Ma Z, Wang C. A Longitudinal Study on the Addictive Behaviors of General Population before and during the COVID-19 Pandemic in China. IJERPH 2022; 19:ijerph19105979. [PMID: 35627516 PMCID: PMC9141667 DOI: 10.3390/ijerph19105979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/27/2022] [Accepted: 05/12/2022] [Indexed: 01/27/2023]
Abstract
By using nationally representative longitudinal data, this study investigates the effects of the COVID-19 pandemic on the addictive behaviors (smoking and drinking) of the general population in China. From the China Family Panel Studies (CFPS) 2018 and 2020, we extract a sample of individuals over 16 years of age in China, consisting of 14,468 individuals and 28,936 observations. We decompose the sample into three age groups, that is, ages between 16 and 39, ages between 40 and 59 and ages above 60. The bootstrap method is used to estimate the confidence interval of the difference in the mean of addictive behaviors, and logit models are used in the regression analysis. Our results show that the COVID-19 pandemic reduces the smoking behavior of individuals above 40 years of age, and that it reduces the drinking behavior of individuals above 16 years of age. However, the pandemic increases the smoking behavior of individuals between 16 and 39 years of age. These results may be closely related to the characteristics of COVID-19 (that is, a respiratory system disease), the working and economic pressures of young Chinese and the role of drinking alcohol in building and maintaining social networks in China.
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Affiliation(s)
- Xiaoyu Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing 100006, China;
| | - Zaifei Ma
- School of Statistics, Renmin University of China, Beijing 100872, China;
| | - Chunan Wang
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beihang Hangzhou Innovation Institute Yuhang, Hangzhou 310023, China
- MoE Key Laboratory of Complex System Analysis and Management Decision, Beijing 100191, China
- Correspondence:
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Metz VE, Palzes VA, Chi FW, Campbell CI, Sterling SA. Alcohol Use Among Young Adults in Northern California During the COVID-19 Pandemic-An Electronic Health Records-Based Study. Front Psychiatry 2022; 13:883306. [PMID: 35903628 PMCID: PMC9315391 DOI: 10.3389/fpsyt.2022.883306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/21/2022] [Indexed: 12/05/2022] Open
Abstract
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.
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Affiliation(s)
- Verena E Metz
- Center for Addiction and Mental Health Research, Kaiser Permanente Division of Research, Oakland, CA, United States
| | - Vanessa A Palzes
- Center for Addiction and Mental Health Research, Kaiser Permanente Division of Research, Oakland, CA, United States
| | - Felicia W Chi
- Center for Addiction and Mental Health Research, Kaiser Permanente Division of Research, Oakland, CA, United States
| | - Cynthia I Campbell
- Center for Addiction and Mental Health Research, Kaiser Permanente Division of Research, Oakland, CA, United States.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.,Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States
| | - Stacy A Sterling
- Center for Addiction and Mental Health Research, Kaiser Permanente Division of Research, Oakland, CA, United States.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.,Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States
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