Summary: U.S. alcohol use increased during the COVID-19 pandemic and has stayed elevated post-pandemic, posing serious health risks. Heavy drinking rose by 20% during the pandemic, and the increase continued in 2022. This trend spanned across most demographics, with the highest rise among adults aged 40-49.
Researchers believe pandemic stress may have normalized drinking, contributing to sustained higher levels of alcohol use. Health experts urge more screenings and interventions to address this growing public health issue.
Key Facts:
- Heavy drinking increased by 20% from pre-pandemic to 2020 and remained high in 2022.
- Adults aged 40-49 had the highest rise in heavy alcohol use.
- The trend is widespread across age, gender, and racial demographics, with few exceptions.
Source: USC
Alcohol use increased during the COVID-19 pandemic and remained elevated even after the pandemic ended, according to a large nationally representative Keck Medicine of USC study published today in the Annals of Internal Medicine.
From pre-pandemic (2018) to the height of the pandemic (2020), heavy alcohol use among Americans rose by 20%, and any alcohol use rose by 4%. In 2022, the increases were sustained.
The rise in drinking was seen across all age groups, genders, race, ethnicities and regions of the country, except for Native Americans and Asian Americans. Adults ages 40-49 had the highest increase in heavy alcohol use.
“These numbers reflect an alarming public health issue that could result in severe health consequences for far too many people,” said Brian P. Lee, MD, MAS, a hepatologist and liver transplant specialist with Keck Medicine of USC and principal investigator of the study.
“Our results suggest men and women under 50 are at special risk.”
Excessive alcohol use is a leading preventable cause of illness and death in the United States, according to the Centers for Disease Control and Prevention. Half of all liver-related deaths are caused by alcohol, and alcohol-related cirrhosis is now the leading cause of liver transplants, according to Lee.
To reach their conclusions, researchers studied data from the National Health Interview Survey, one of the largest and most comprehensive health surveys in the country.
The survey collected alcohol use information as well as demographic and socioeconomic data for more than 24,000 adults age 18 or older. They compared 2018 with 2020 alcohol use numbers, then 2018 with 2022.
While the U.S. Department of Health and Human Services announced the official end of the pandemic in May 2023, the study defined the year 2022 as post-pandemic, as behaviors were beginning to return to normal.
Adults were characterized as having any alcohol use or heavy alcohol use within one year of the survey, and researchers calculated the rate of both measures of alcohol use.
Heavy drinking was defined as greater than or equal to five drinks a day or 15 drinks a week for men, and greater than or equal to four drinks a day or eight drinks a week for women.
The study did not analyze why there was an increase in alcohol consumption between 2018 to 2022, but Lee hypothesizes that pandemic stress may have caused drinking to become more normalized.
He further speculates that the effects of the pandemic, including disruptions to school and work, may have driven the increases in alcohol use in adults ages 40-49.
Lee hopes the study will bring more awareness to the issue. “We encourage health care providers to offer more screenings for harmful drinking as well as interventions for at-risk populations,” he said.
Divya Ayyala-Somayajula, MD, from Thomas Jefferson University in Philadelphia, was lead author of the study.
Jennifer Dodge, MPH, an associate professor of research medicine and population and public health science at the Keck School of Medicine of USC, Adam Leventhal, PhD, professor of population and public health sciences at the Keck School and director of the USC Institute for Addiction Science, and Norah Terrault, MD, a Keck Medicine gastroenterologist and division chief of gastroenterology and liver diseases at the Keck School, were also study authors.
About this AUD and psychology research news
Author: Laura Nuño
Source: USC
Contact: Laura Nuño – USC
Image: The image is credited to Neuroscience News
Original Research: Open access.
“Trends in Alcohol Use After the COVID-19 Pandemic: A National Cross-Sectional Study” by Brian P. Lee et al. Annals of Internal Medicine
Abstract
Trends in Alcohol Use After the COVID-19 Pandemic: A National Cross-Sectional Study
Background: Alcohol is a leading cause of morbidity and mortality in the United States. The COVID-19 pandemic was associated with increases in stress-related drinking and alcohol-related deaths.
Analyses of whether increased alcohol use has persisted since the pandemic and trends among subpopulations could inform public policy and health care initiatives to mitigate alcohol-related morbidity and mortality.
Objective: To determine whether increased alcohol use during the pandemic (2020 vs. 2018) was sustained after the pandemic (2022).
Methods: This was a population-based study using cross-sectional data from serial nationally representative surveys of adults aged 18 years or older who participated in the National Health Interview Survey (NHIS) from 2018 to 2022. The survey uses complex sampling to provide estimates that are representative of the entire U.S. population.
Data were collected on demographic, health, and socioeconomic factors at the family and person levels. The survey was administered by trained interviewers in face-to-face or telephone interviews.
The primary outcomes of this study were prevalence of any alcohol use and heavy alcohol use. Adults were categorized as having any alcohol use or heavy alcohol use within 1 year of the survey per the National Institute on Alcohol Abuse and Alcoholism definition of heavy drinking (≥5 drinks on any day or ≥15 drinks per week for males, and ≥4 drinks on any day or ≥8 drinks per week for females). Prevalence rates per 100 persons and associated 95% CIs were calculated.
We tested for differences in national prevalence of any alcohol use and heavy alcohol use by year (vs. 2018) using logistic regression. The margins command was used to calculate pairwise differences in proportions by year with 95% CIs. NHIS weighting was used for all analyses, which were performed in SAS, version 9.4 (SAS Institute), and Stata MP 17.0 (StataCorp).
All data are publicly available and were deemed to be exempt from review by the Institutional Review Board of the University of Southern California.
Findings: The study included 24 965 respondents from 2018, 30 829 from 2020, and 26 806 from 2022.
Compared with 2018, there were absolute increases in any alcohol use in 2020 (2.69% [95% CI, 1.28% to 4.10%]) and 2022 (2.96% [CI, 1.58% to 4.33%]). Numerical increases in any alcohol use occurred in 2020 and 2022 versus 2018 among all subgroups.
