- In a new study, researchers found that inpatient consultations for alcohol-related liver and gastrointestinal (GI) diseases increased during the COVID-19 lockdown and remained high during the reopening.
- They found the proportion of consultations for alcohol-related disease rose by roughly 60 percent.
- People who said their alcohol consumption had increased were more likely to report symptoms of anxiety or depression associated with COVID-19.
Over the past 16 months, healthcare and public health professionals have devoted much attention and plenty of resources to managing COVID-19.
SARS-CoV-2 diagnoses may represent the most visible health consequence of the pandemic. However, COVID-19 cases are not the only toll the pandemic is taking on physical or mental health.
In a study to be presented at Digestive Disease Week 2021, researchers from Rhode Island have found that inpatient consultations for alcohol-related liver and gastrointestinal (GI) diseases increased during the state’s lockdown phase and remained high during the reopening.
“When we went into lockdown, many people experienced significant negative impacts, such as social isolation, job loss, and an increase in anxiety and depression,” the lead author of the study, Dr. Waihong Chung, said in a press release.
“These experiences may have led people to increase their alcohol consumption, which could explain why we are seeing a surge in the volume of consultations for alcohol-related diseases,” he continued.
Chung is a research fellow for the Division of Gastroenterology at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. He's scheduled to present the findings of his study on May 21.
Alcohol-related consults increased during lockdown
To assess the burden of alcohol-associated diseases, Chung and his fellow researchers conducted an audit of inpatient GI consultations at Rhode Island hospitals during the state’s lockdown and reopening phases.
They found that during the state's lockdown, the total number of GI consultations dropped by 27 percent.
However, the proportion of consultations for alcohol-related disease rose by roughly 60 percent.
This included consults for alcohol-related hepatitis, cirrhosis, gastritis, and pancreatitis.
During the reopening phase, the total number of GI consults returned to prepandemic levels. The proportion of alcohol-related consults remained highly elevated — at a level nearly 79% higher than in 2019.
“It's similar here in the New York area,” Dr. Thomas D. Schiano, the director of the adult liver transplantation program at the Recanati/Miller Transplantation Institute in New York City, told Healthline.
“We have a large liver transplant program here, and we’re transferring enormous numbers of patients who have decompensated liver disease, who have alcoholic hepatitis,” he said.
Some Americans have been drinking more
The new findings from Rhode Island add to a growing body of research showing that alcohol consumption and related diseases have increased among a proportion of Americans during the pandemic.
“COVID-19 morbidity, mortality, and severity are important, that's clear. But we’ve lost sight of another hidden pandemic — that's an epidemic of alcohol use, substance use, and mental health issues,” said Ralph DiClemente, PhD, professor of Social and Behavioral Sciences at the New York University School of Global Public Health.
When DiClemente and co-investigators conducted a nationwide survey of alcohol use among adults in the United States, about 20 percent of respondents said they were drinking less during the pandemic than they did before.
Nearly 30 percent of respondents said they were drinking more during the pandemic.
Women and people under the age of 40 were more likely to say their alcohol consumption had increased.
People who said their alcohol consumption had increased were more likely to report symptoms of anxiety or depression associated with COVID-19.
“We identified high levels of anxiety and depression, and one way that people may be dealing with those mental states is alcohol,” said DiClemente. “Alcohol, I think, is symptomatic of a much deeper issue.”
Financial strain, emotional stress, isolation
DiClemente said that multiple factors may have contributed to increased anxiety, depression and alcohol use during the pandemic — including job loss, financial strain, emotional stress, and social isolation.
“Many people have been unemployed during the pandemic, concerned about how they're going to survive and take care of their family,” he said.
“Many people have experienced COVID-19 illness deaths in their family,” he continued. “And on top of that, many people experienced loneliness and isolation.”
People with alcohol use disorder have also faced barriers to accessing treatment programs and social support for managing the condition during the pandemic.
“Not being able to see their doctor, not being able to go to [Alcoholics Anonymous], not being able to see friends — all of these create a cascade of further strife and stress,” said Schiano.
Many healthcare professionals and substance use programs have been offering telehealth services while in-person services have been shuttered. However, some people may find telehealth services poorly suited to their needs.
“You need that sort of close personal touch when you're dealing with these types of alcohol issues,” Schiano said.
Reaching out for support
To address the mental health effects of the pandemic, DiClemente said that doctors need to screen patients for changes in alcohol use and other signs of mental health challenges.
“What we need is for physicians to screen patients as they routinely come in,” he said.
“We don't want to wait until we get to the end of that trajectory, where people are severely impacted by alcohol use. We need to identify people early, when they’re just starting to ramp up alcohol use, so we can intervene more effectively,” he continued.
Schiano noted that many healthcare professionals and treatment centers are seeing more patients in person again, as the pandemic is being brought under control.
He encourages people who are concerned about their alcohol use to reach out for support.
“I think that they should reach out to family, friends, and physicians if they feel they have an alcohol problem. The physicians are here, they're looking to help,” he said.
“If they feel they have a liver problem, reach out to a gastroenterologist or hepatologist,” he added. Early diagnosis and treatment of liver disease is important for improving patients' outlook.