Covid ‘Cocktail Crisis’ Adds to America’s Serious Drinking Problem

Lockdowns and other pandemic stresses have certainly primed the drinking pump

Americans are drinking more during the Covid-19 pandemic, and even indulging on the job while working from home, adding to an epidemic of alcohol consumption that research shows will only lead to more premature deaths, most notably among middle-aged people.

Excessive alcohol consumption kills more than 93,000 people in the United States every year, shortening the lives of these people by an average of 29 years, according to a new study by the U.S. Centers for Disease Control and Prevention. The research accounts for acute alcohol-related deaths involving such things as violence, car crashes, suicides, accidents, and child abuse.

But 55% of these premature, preventable deaths are from long-term drinking that causes various cancers, liver disease, heart disease, and other health problems. Overall, 71% of these premature deaths are among men, and 56% are people ages 35 to 64.

The study, led by CDC scientist Marissa Esser, PhD, is based on data from 2011 through 2015. The figures are slightly higher than in the previous five-year period.

“A lot of my patients talk about this idea that there’s a hamster wheel constantly going in their head and that alcohol quiets down the hamster wheel. But I’m worried when drinking becomes the routine, go-to solution.”

Likely an undercount

There were substantial differences among states. The researchers recorded 20 alcohol-related deaths per 100,000 people in several states, including New York and New Jersey. A few other states had lower figures but were thought to have “suppressed estimates” of the real totals, the study concludes.

The five states with the highest number of alcohol-related deaths per 100,000 people:

• New Mexico: 52
• Arizona: 37
• Montana: 37
• Oklahoma: 36
• West Virginia: 35

“Effective population-level interventions to reduce excessive drinking are underutilized in states,” Esser said by email.

The study is “important” and its methods “rigorous and valid,” says Frederic Blow, PhD, director of the Addiction Center at the University of Michigan, who was not involved in the study. But the data involved only cases in which alcohol was listed as the primary cause of death on the death certificate. “So it is highly likely that many alcohol-involved deaths were not detected—for example, individuals who died of cardiovascular disease but were also heavy drinkers might not have been counted even though their drinking likely contributed to their heart disease,” Blow says.

Drunk and drunker

It’s no secret Americans overimbibe. Excessive alcohol consumption, along with opioids and suicide, are thought to be responsible for the decline in U.S. life expectancy that began in 2015, after many decades of mostly rising.

Before the pandemic, binge drinking — defined as four drinks for a woman or five for a man in a single two-hour window in the past month — was already on the rise among people over age 50, while being most common in people ages 25 to 34.

And increasingly, scientists question the age-old advice that one or two drinks is good for you, citing many recent studies indicating no amount of alcohol is healthy. Research last year refuted the long-held claim that moderate drinking reduces the risk of stroke, as but one example. Another study finds that when moderate drinkers stop, their mental health improves.

Recently, a committee of health experts proposing changes to the federal Dietary Guidelines for Americans suggested reducing the recommendation for alcoholic beverages to no more than one for men, rather than two, and retaining the suggested limit of one for women. The scientists say if you don’t have a drink one day, that does not mean you should have two the next day.

Covid cocktail crisis

Lockdowns and other pandemic stresses have certainly primed the drinking pump. Data from previous epidemics, including SARS in 2003 and swine flu in 2009, “suggest that social isolation can have a number of negative health effects, including increases in alcohol consumption,” Blow says.

Stress, isolation, and boredom are all potential triggers for alcohol consumption, says Adriane Dela Cruz, MD, an assistant professor in psychiatry at the University of Texas Southwestern Medical Center. “A lot of my patients talk about this idea that there’s a hamster wheel constantly going in their head and that alcohol quiets down the hamster wheel,” she says. “But I’m worried when drinking becomes the routine, go-to solution.”

Which seems to be exactly what’s happening, based on multiple analyses of the first months of the pandemic.

• Overall alcohol sales, including from stores and in bars and restaurants, was roughly 10% to 20% higher in March and April this year compared to the previous three-year average for those months in states that reported data, according to the National Institute on Alcohol Abuse and Alcoholism. Sales of wine and hard liquor rose while beer sales dipped.
• About a third of Americans say they’re drinking more now than before the pandemic, according to a survey released in April by the American Addiction Centers. A similar percentage said that if they work from home, they’re more likely now to drink during working hours.
• The average number of drinks per day increased 27% between February and April, with binge drinking up 26%, according to another survey led by Carolina Barbosa, PhD, of RTI International, a nonprofit research institute. The biggest rise was among people with kids at home versus adults with no children in the house.

“Alcohol use, especially heavy use, weakens the immune system and thus reduces the ability to cope with infectious diseases.”

Stressed-out parents

It’s not hard to imagine the connection between children and parental drinking.

Parents who are stressed about their kids’ distance learning are downing seven more drinks a month than parents who say it does not stress them, according to yet another survey done in May. “These stressed parents are also twice as likely to report binge drinking at least once over the prior month than parents who are not stressed,” write the researchers, University of Maryland psychologist Susan Sonnenschein, PhD, and Elyse Grossman, PhD, of Johns Hopkins Bloomberg School of Public Health.

“Drinking appears to have gone up, perhaps rather substantially,” says Max Griswold, a researcher at the Institute for Health Metrics and Evaluation at the University of Washington whose own research found a strong link between alcohol consumption and the risk for cancer, injuries, and infectious diseases. “In the long run, I can’t imagine this will be good for American health.”

Alcohol-related deaths had been declining in prior years, mostly among younger adults, Griswold points out. If younger people are responsible for the current rise, “then given the addictive nature of alcohol, this could lead to increased drinking in the long run and subsequent increased deaths,” Griswold tells Elemental. “If the increased drinking is among those who already were drinking a modest amount, this might push them to alcohol abuse.”

Strategies to avoid alcohol as a pandemic stress reliever include physical activity, eating and sleeping well, staying in touch with friends and family, and even deep-breathing exercises, according to the American Heart Association. The researchers in the new CDC study say alcohol-related deaths could be reduced via societywide measures, like increasing alcohol taxes and reducing the number of places that sell alcohol.

Alcohol and the coronavirus don’t mix

Experts have, meanwhile, dashed any myth-driven hopes that a good stiff drink might ward off the coronavirus.

Rather, alcohol slows the function of lung cells responsible for clearing out coronavirus particles and reduces production of the immune system’s white blood cells, says David Fiellin, MD, director of the Yale Program in Addiction Medicine.

“Alcohol use, especially heavy use, weakens the immune system and thus reduces the ability to cope with infectious diseases,” the World Health Organization states. Consuming alcohol will not destroy the [corona]virus, and consumption is likely to increase the health risks if a person becomes infected with the virus.”

While increased drinking may play a role in serious Covid-19 cases and deaths, many of the effects, including cancers and liver disease, won’t show up for many years, Griswold notes.

“I have no doubt that for many individuals who increased their drinking during the pandemic, they will continue that higher level of consumption over the longer term,” says Blow, the University of Michigan researcher. “Therefore, we will likely see many more people who drink excessively in need of treatment, and unfortunately many who will die of alcohol-related causes over the coming few years.”

The Substance Abuse and Mental Health Services Administration offers a free, confidential national helpline for anyone struggling with alcohol, or concerned family members, at 1-800-662-HELP (4357).