Heavy drinking was a chronic symptom of the pandemic lockdown, and many have yet to cork it.
A Keck Medicine of USC study published in November found that heavy alcohol use among Americans rose by 20 percent from 2018 to the height of the pandemic in 2020. By 2022, the increases were sustained, according to the research.
According to the Centers for Disease Control and Prevention, more than 6,750 Ohioans, on average, die each year from excessive drinking. In addition, about 20 percent of Ohio adults report they binge drink, which is greater than 17 percent nationwide. In Michigan, nearly 6,000 die each year.
The most stark data comes from the World Health Organization, which cited 2.6 million deaths worldwide were attributable to alcohol abuse disorder in 2019. Some experts are saying that number has now surpassed 3 million.
Branden Smith, a clinical social worker and senior director of recovery services at the Zepf Center in Toledo, said drinking of alcohol became a coping mechanism for many during the pandemic lockdown.
“It was a way for people to cope with the stress from the pandemic. And it was socially acceptable,” he said. “You used to be able to get margaritas delivered to your door.”
For many, social supports, including 12-step meetings where a community of people help one another overcome addiction, collapsed during the pandemic lockdown. While telehealth and Zoom meetings filled the vacuum for some, others, who were not digital natives, slipped. Meanwhile, alcohol sales in the United States increased by 34 percent at that time, according to a researcher at the Washington University School of Medicine.
“Some people were not working,” said Mr. Smith, noting that, at that point, many lost their community and their purpose.
Mr. Smith said the pandemic was deeply distressing for many.
“It was a trauma, and we are still trying to figure out how it is affecting us,” said Mr. Smith, who defined trauma as an external event that is bigger than a person’s internal resources and external support. “It was a new environment and required new coping skills.”
Amid all that, drugs and alcohol are a kind of coping skill, according to Mr. Smith. When the use becomes uncontrolled is when problems arise.
“Addiction is a chronic, progressive, and eventually fatal disease,” he said. “As in any disease, it is better to catch it earlier.”
During the pandemic lockdown, many medical conditions, including cancer screenings, did not get addressed. Today, people are continuing to get help, said Mr. Smith, who saw a cultural shift happen.
“Mental health lost some of its stigma,” he said.
Delayed treatment
While many mental health experts have noted this national permutation, a study conducted by researchers at Washington University School of Medicine in St. Louis found that fewer than one in 10 ever get treatment for drinking.
Published in 2021, the study involved data from more than 200,000 people with and without alcohol problems. About 8 percent met the criteria for alcohol use disorder. Of those, 81 percent had been to a doctor, hospital, or clinic during the previous year. Twelve percent of those reported they were advised to cut down on their drinking, 5 percent were offered information about treatment options, and 6 percent received treatment.
“Some primary care doctors may not feel comfortable telling patients they should cut down on drinking, prescribing medication to help them cut back, or referring them to treatment because they don’t specialize in treating alcohol misuse; but the result is that many people who need treatment aren’t getting it,” said senior author Dr. Laura Jean Bierut, an alumni endowed professor of psychiatry, at Washington University.
“We used to see the same thing with smoking, but when physicians became educated about smoking and learned that many of their patients wanted to quit or cut back, doctors began offering more treatment, and more people were able to quit,” she said. “We think the same thing may be possible with alcohol.”
Seeking help
Among treatments that could be prescribed are the FDA-approved medications naltrexone, acamprosate, and disulfiram, as well as psychotherapy and mutual-aid approaches, such as the 12-step program used by Alcoholics Anonymous.
“Alcohol use disorder is a chronic disease, but compared to other chronic diseases, it’s wildly untreated,” Dr. Bierut said. “For example, two-thirds of patients with HIV and 94 percent of patients with diabetes receive treatment, compared with only 6 percent of people with alcohol use disorder.”
Mr. Smith said there are many treatment facilities, including the Zepf Center, available in Toledo.
“We are not against alcohol,” he said. “Everyone is unique. For some, it may be cutting down. For some, it is abstinence.”
The World Health Organization took a hard-line approach when it issued a statement in 2023 saying no level of alcohol consumption is safe. It pointed to an increased risk for head and neck cancers, breast cancer, and liver cancer.
“We cannot talk about a so-called safe level of alcohol use,” said Dr. Carina Ferreira-Borges, acting unit lead for noncommunicable disease management and regional adviser for alcohol and illicit drugs in the WHO regional office in Europe.
“It doesn’t matter how much you drink — the risk to the drinker’s health starts from the first drop of any alcoholic beverage,” she said. “Although it is well established that alcohol can cause cancer, this fact is not widely known to the public in most countries. We need cancer-related health information messages on labels of alcoholic beverages, following the example of tobacco products.”
In the United States, men should have no more than two drinks per day and women should have no more than one drink per day, according to the Dietary Guidelines for Americans 2020-2025.
Additional treatments for alcohol abuse disorder may be on the horizon.
A new study released this year by researchers at the Case Western Reserve University of Medicine reveals that the popular diabetes and weight-loss drugs Wegovy and Ozempic are linked to reduced incidents and recurrence of alcohol abuse or dependence. Those treated with these drugs and their active ingredient semaglutide saw a 50 percent to 56 percent decrease for the initiation and recurrence of alcohol use disorder in the year following.
“This is very promising news in that we may have a new therapeutic method to treat AUD,” said lead study Rong Xu, a biomedical informatics professor.
