Background

The Covid-19 pandemic, declared in March 2020, has had a profound impact on the lives of people worldwide, particularly on mental health, as lockdowns resulted in lost incomes, health fears, and isolation, all of which are risk factors for increased mental health problems and alcohol use. Alcohol use as a response to stressful life events increases an individual’s risk of developing alcohol problems.1 In addition, it weakens the immune system, which in turn reduces immunity to viral infections such as Covid-19.2,3 Studies carried out earlier in the pandemic indicated that older people were more likely to have increased their alcohol use, with stress and depression cited as reasons for the increase.4,5 A cross-sectional study in Ireland aimed to determine the drinking motives and changes in alcohol use later in the pandemic during the second lockdown, in October–December 2020, along with psychopathological symptoms.6

Methods

The online survey involved 713 adult participants. The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) was used to measure alcohol use and patterns of use, and participants were asked to complete the survey based on what their normal drinking patterns were prior to the pandemic as well as during the last month (during the pandemic). To assess motives for drinking during the lockdown, the Drinking Motives Questionnaire-Revised (DMQ-R) was used, which asked participants to provide reasons for their drinking: enhancement, coping, social facilitation, or conformity motives. The Brief Symptom Inventory (BSI) assessed their level of anxiety, depression, and loneliness due to the Covid-19 situation, while the Global Severity Index (GSI) measured the participant’s distress level. A Likert scale based on the Report on the social implications of Covid-19 in Ireland assessed their perception of the negative impact of Covid-19 distress.7

Results

The mean age of the participants was 35.77 years and the majority were female (68%). Comparing the AUDIT-C scores before and during the pandemic, the data indicated that the majority of participants decreased their alcohol use (65.8%), 19.6% remained unchanged, and 14.6% increased their alcohol use, with no gender differences identified.

Older age was associated with increased alcohol use, and the authors refer to evidence of older age alongside alcohol use weakening the immune system as both increasing the individual’s risk of Covid-19. In fact, the World Health Organization (WHO) specifically recommended that older adults reduce their alcohol intake.8

Drinking to cope with the impact of the pandemic to relieve negative mood/state (also referred to as ‘self-medicating’) was also associated with increased alcohol use. Those who indicated low social facilitation on the DMQ-R, i.e. those who were less likely to report social purposes for drinking prior to the pandemic, were also more likely to consume alcohol during the pandemic. Increased alcohol use as a response to stressful life events has been associated with the development of alcohol-related problems.

The study also reported that those with higher psychopathological symptoms during the Covid-19 lockdown, as measured by the GSI, were more likely to report depression, loneliness, and anxiety attributed to the pandemic. In particular, depression scores and hostility (e.g. anger or frustration), as measured using the BSI, were the strongest predictors of drinking to cope.

Conclusion

The authors conclude by highlighting the vulnerability of older people in a vicious cycle of drinking during the pandemic to reduce anxiety, and yet noting that alcohol has depressogenic effects. This vulnerable group are also at increased risk of Covid-19 and thus are a group that would benefit from interventions aimed at enhancing their coping skills.
 

1    Skrzynski CJ and Creswell KG (2020) Associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives in adolescents and young adults: a systematic review and meta-analysis. Addiction, 115: 1989–2007.

2    Molina PE, Happel KI, Zhang P, et al. (2010) Focus on: alcohol and the immune system. Alcohol Res Health, 33: 97–108.

3    Testino G (2020) Are patients with alcohol use disorders at increased risk for Covid-19 infection? Alcohol Alcohol, 55: 344–346.

4    Boschuetz N, Cheng S, Mei L, et al. (2020) Changes in alcohol use patterns in the United States during COVID-19 pandemic. WMJ, 119: 171–176.

5    Callinan S, Smit K, Mojica-Perez Y, et al. (2021) Shifts in alcohol consumption during the COVID-19 pandemic: early indications from Australia. Addiction, 116(6): 1381–1388.

6    Carbia C, García-Cabrerizo R, Cryan JF, et al. (2022) Associations between mental health, alcohol consumption and drinking motives during COVID-19 second lockdown in Ireland. Alcohol Alcohol, 57(2): 211–218. https://www.drugsandalcohol.ie/35897/

7    Department of the Taoiseach (2020) Report on the social implications of COVID-19 in Ireland. Update 5th June 2020. Dublin: Government of Ireland. https://www.drugsandalcohol.ie/32307/

8    World Health Organization (WHO) (2020) Alcohol and COVID-19: what you need to know. Copenhagen: WHO Regional Office for Europe. https://www.drugsandalcohol.ie/31855/