Shifts in alcohol consumption during the COVID-19 pandemic: early indications from Australia

Differential change in alcohol consumption during the COVID-19 pandemic: the role of loneliness, socialization, and mental well-being

Introduction

The COVID-19 pandemic led to a surge in mental health issues and psychological distress, disruption to work/studying conditions, and social isolation particularly among young adults. Changes in these factors are differentially associated with alcohol use. Moreover, the relationship between these factors are bidirectional and may have fluctuated throughout the different phases of the pandemic. However, studies focusing on young adults had conflicting results, short follow-up periods, and lacked comprehensive data to describe underlying mechanisms.

Methods

1067 young adults participated in repetitive measures termed wave 4 (2021) of the Survey of Adolescent Life in Västmanland Cohort "SALVe" Cohort. Of these, 889 also completed pre-pandemic measurements termed wave 3 (2018). Participants completed the Alcohol Use Disorders Identification Test (AUDIT) to evaluate alcohol consumption and harmful use. Cross-sectional associations between perceived changes in alcohol use and shift in individual, mental health, and work environment factors were examined using Chi-square tests. Logistic regression was utilized to identify pre-pandemic predictors of harmful consumption during the pandemic.

Results

Harmful consumption decreased only in females following the COVID-19 pandemic. Participants who reported increased feelings of depression, anxiety, and loneliness were more likely to increase their alcohol use. Interestingly, the subgroup who felt less lonely and met their friends more often, as well as those who continued working/studying from their regular workplace also had an increased likelihood of higher consumption. Only pre-pandemic ADHD and delinquency symptoms predicted harmful alcohol consumption following the pandemic.

Conclusion

Females reduced harmful alcohol consumption during the COVID-19 pandemic. While those who suffered the burden of social isolation and distress were more likely to increase their alcohol use, young adults who felt less lonely and met their friends more often also had a similar outcome. The relationship between loneliness and alcohol consumption among young adults is influenced by the social factors that may be facilitated by drinking.

Lingering Effects of COVID-19 Stressors on Mental Health and Alcohol Use in Middle Aged to Older Adults

Background

Older adults have faced not only health threats but grave mental health challenges since the emergence of the Coronavirus disease 2019 (COVID-19) pandemic. Using factor analysis, this study is the first to identify the underlying dimensions of COVID-19-related stressors, then examine the relationship between these factors and mental health and alcohol use/misuse longitudinally in a middle aged to older adult sample in the United States.

Methods

As part of a long-term follow-up study, 921 survey participants completed measures of COVID-related stressors, psychological distress, and alcohol use/misuse in a 2020 survey. An exploratory factor analysis was conducted to examine the dimensionality of COVID-related stress. Regression models were utilized to examine relationships between the extracted factors and depression, anxiety, and alcohol-related outcomes measured approximately one year later, in 2021.

Results

Four dimensions of COVID-19 stressors were extracted, including 1) jobs, finances and loss of routine; 2) practical difficulties; 3) social worries and challenges; and 4) supply shortages. Practical difficulties were associated with higher depression at follow-up, while jobs, finances and loss of routine were associated with past 12 month frequency of intoxication at follow-up.

Conclusions

Challenges from the pandemic may have longer-term implications for mental health in older adults past the acute phase of the pandemic. It is important to allocate sufficient attention and resources to the prevention of late life depression and mental health as policymakers and health professionals continue to deal with the pandemic and future variants of the virus.

Population Subgroups at Risk of Unhealthy Changes in Food and Beverage Consumption During COVID-19 Lockdowns

BACKGROUND

Understanding health behaviour changes during the COVID-19 pandemic can assist in developing strategies to promote healthy lifestyles at such times. The aim of this exploratory study was to examine whether the frequency of consuming unhealthy foods and beverages changed during lockdown and whether certain population subgroups were more likely to make such changes.

METHOD

An online survey was administered to a national sample of 4022 Australian adults (51% female, mean age 48 years). Generalised linear models with generalised estimating equations were used to identify whether demographic characteristics (age, gender, education, presence of children in the household, number of people in the household) and beliefs related to COVID-19 were associated with changes in the frequency of consuming alcohol, sweet snacks, salty snacks, and sugary beverages from pre to during lockdown.

RESULTS

Overall, the frequency of consuming the four assessed unhealthy products did not change during lockdown. However, being male and having children at home were consistently associated with unhealthy changes, whereas believing that alcohol or unhealthy diets would exacerbate COVID-19 severity was linked to a decreased frequency of consuming these products respectively. Age, education, and living with more people were also associated with changes in the frequency of consuming some product categories.

CONCLUSION

During lockdown, certain population subgroups appeared to be at increased risk of more frequent consumption of unhealthy foods and beverages. Believing certain consumption habits are linked to adverse health impacts of COVID was found to reduce frequency of consumption of related products, presenting a potential focus for future public health actions.

Risk factors for increased alcohol consumption among young adults during COVID-19

Objective: This study explored correlates of increased alcohol use among a predominantly low-socioeconomic status student population at two time points during the COVID-19 pandemic. Participants: Participants were students enrolled in at least one course at a City University of New York (CUNY) campus. Methods: Demographic characteristics, stressor endorsements, probable diagnoses, and alcohol use endorsement, were collected via self-report surveys in April and July 2020. Frequencies and multivariable logistic regressions were computed to assess for prevalence and odds of increased alcohol consumption. Results: High cumulative stress was significantly related to increased alcohol use in both April and July 2020. A greater number of specific stressors was associated with increased alcohol use in April as compared to July. Probable diagnoses of depression and anxiety were associated with higher odds of alcohol consumption at both time points. Conclusion: Findings highlight the importance of stress and mental health on increases in alcohol use for public university students.

How did COVID-19 restrictions impact alcohol consumption in Australia? A longitudinal study

INTRODUCTION

The state of Victoria experienced more stringent public health measures than other Australian states during the COVID-19 pandemic. This study investigated how these public health measures impacted: (i) total alcohol consumption; (ii) location-specific consumption; and (iii) consumption among different pre-pandemic drinking groups, in Victoria compared to the rest of Australia during the first year of the pandemic.

METHOD

A longitudinal study with six survey waves was conducted between April and December 2020. A total of 775 adults completed data on alcohol use, including detailed consumption location information. Based on their 2019 consumption, participants were classified into low, moderate or high-risk groups. Data were analysed descriptively.

RESULTS

There was no difference in total alcohol consumption from 2019 levels among Victorians and those from the other Australian states when Victoria was the only state in lockdown. Location-specific consumption was relatively similar for Victoria and the rest of Australia, with an increase in home drinking, and a decrease in consumption in someone else's home, licensed premises and public spaces during lockdown compared with 2019. Participants in the high-risk group reported a reduction of two standard drinks per day in November 2020 compared with 2019. In contrast, consumption remained relatively stable for participants in the low and moderate-risk groups once accounting for regression to the mean.

DISCUSSION AND CONCLUSION

Contrary to expectations, restrictions on licensed premises appeared to impact high-risk drinkers more than low and moderate-risk drinkers. Reducing availability of on-premise alcohol may be an effective way to reduce consumption in heavier drinkers.

Exploring the Impact of COVID-19 on Ulcerative Colitis Patients: A Lifestyle Perspective

Background and Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 is the new coronavirus that caused the coronavirus disease 2019 (COVID-19) outbreak. Studies have increasingly reported the involvement of organs outside the respiratory system, including the gastrointestinal tract. Data on the association between COVID-19 and ulcerative colitis (UC) are lacking. Materials and Methods: In this one-centre cross-sectional study, 49 patients with UC from the Riga East Clinical University Hospital outpatient clinic were included from June 2021 to December 2021. The patients were divided into two groups according to their history of a confirmed positive or negative COVID-19 status. Data on their lifestyle, diet, and medications and the food supplements used by the patients were collected during interviews and analysed using the R 4.2.1 software. Results: Out of 49 patients, 33 (63.3%) were male and 13 (36.7%) were female, with a mean age of 32.33 ± 8.6 years. Fourteen patients (28.6%) had a confirmed COVID-19 infection in the last year. The most common COVID-19-related symptoms were a fever and rhinorrhoea. A third of patients followed the inflammatory bowel disease diet (16; 32.7%); out of these patients, 12 (34.3%) did not contract COVID-19 (OR: 0.78 (0.18; 2.98), p > 0.05). In the COVID-19-positive group, the majority of patients did not use vitamin D (11; 79% vs. 3; 21%, (OR: 0.38 (0.07; 1.51), p = 0.28) or probiotics (11; 78.6% vs. 3; 21.4%, OR: 1.33 (0.23; 6.28), p = 0.7). In the COVID-19-positive group, most patients did not smoke (12; 85.7% vs. 2; 14.3%, p = 0.475) and did not use alcohol (9; 64.3% vs. 5; 35.7%, OR: 0.63 (0.16; 2.57), p = 0.5). Most of the patients who participated in sports activities were COVID-negative (18; 51.4% vs. 6; 42.9%, p = 0.82). Conclusions: There were no statistically significant differences in the use of food supplements, probiotics, or vitamins; the lifestyle habits; or the COVID-19 status in patients with UC.

Mental health self-care during the COVID-19 pandemic: a prospective cohort study in Australia

INTRODUCTION

Pandemic public health measures have affected mental health for many people. We sought to determine how people were managing their mental health concerns during the pandemic, and to identify worker characteristics where actions were more common.

METHODS

A prospective cohort of 1646 Australians, who were in paid employment prior to the pandemic, completed a survey during 27 April- 26 July 2020 on changes in work, health, and actions taken to manage their mental health concerns. Descriptive statistics were calculated to determine actions taken to manage mental health concerns during the prior month, such as lifestyle changes, exercise, use of online resources, and talking to others. Regression models identify worker characteristics where actions were more common.

RESULTS

Lifestyle changes were the most frequently reported action to manage mental health concerns (78%), and were more common for women (OR = 2.33, 95%CI=[1.82, 3.03]), and people experiencing recent work loss (OR = 1.54, 95%CI=[1.04, 2.28]). Overall, mental health self-care was more common for people experiencing psychological distress, or with pre-existing mental conditions. Talking to friends about mental health, and making changes to diet and exercise, was more common for women and those aged 18-24 years. Psychological distress was a significant indicator for consulting with health professionals.

CONCLUSION

Actions to manage mental health concerns during the pandemic were common, as were conversations with friends or family members. During economic crises, support and services should focus on reducing barriers to formal mental health care, particularly for people who less commonly seek help, and those experiencing moderate to high levels of psychological distress.

Navigating the Shifts: Retrospective Analysis of Alcohol Consumption and its Predictors Across Pre-Pandemic, Lockdown, and Post-Pandemic Eras in Poland

BACKGROUND Alcohol consumption is a serious health risk that affects both physical and mental health. It is one of the major risk factors in the development of non-communicable diseases. The aim of this study was to perform a retrospective analysis of alcohol consumption patterns, determine of predictors of alcohol addiction, and attempt to distinguish and compare the profiles of participants differentiated in terms of their preferences in the pre-pandemic, lockdown, and post-pandemic periods. MATERIAL AND METHODS A retrospective study was conducted with a computer-assisted web interview on a representative sample of Polish citizens. Primary outcomes were sociodemographic and COVID-19-related variables, preferences regarding the type and location of consumed alcohol, reasons for drinking, severity of addiction symptoms, loneliness, quality of life, and health level. RESULTS During the lockdown period, the percentage of people declaring abstinence increased, as well as people who, according to the Alcohol Use Disorders Identification Test (AUDIT) cut-off points, could be diagnosed with probable alcohol dependence. The strongest predictors of the severity of addiction symptoms were preferences regarding the type and place of alcohol consumption, with a high percentage of explained variance (>50%). The analysis of profiles differentiated in terms of the preferred type of alcohol consumed allowed for the identification of 7 different profiles, which differed in terms of AUDIT score, loneliness, quality of life, and level of health. CONCLUSIONS Patterns of alcohol consumption changed during the pandemic. Alcohol-related preferences are important from the public health perspective.

Web-Based Cognitive Bias Modification Program for Young People With Social Anxiety and Hazardous Alcohol Use: Feasibility, Acceptability, and Preliminary Efficacy Study

BACKGROUND

Interpretation bias modification (IBM) and approach bias modification (ApBM) cognitive retraining interventions can be efficacious adjunctive treatments for improving social anxiety and alcohol use problems. However, previous trials have not examined the combination of these interventions in a young, comorbid sample.

OBJECTIVE

This study aims to describe the feasibility, acceptability, and preliminary efficacy of a web-based IBM+ApBM program for young adults with social anxiety and hazardous alcohol use ("Re-Train Your Brain") when delivered in conjunction with treatment as usual (TAU).

METHODS

The study involved a 3-arm randomized controlled pilot trial in which treatment-seeking young adults (aged 18-30 y) with co-occurring social anxiety and hazardous alcohol use were randomized to receive (1) the "integrated" Re-Train Your Brain program, where each session included both IBM and ApBM (50:50 ratio), plus TAU (35/100, 35%); (2) the "alternating" Re-Train Your Brain program, where each session focused on IBM or ApBM in an alternating pattern, plus TAU (32/100, 32%); or (3) TAU only (33/100, 33%). Primary outcomes included feasibility and acceptability, and secondary efficacy outcomes included changes in cognitive biases, social anxiety symptoms, and alcohol use. Assessments were conducted at baseline, after the intervention period (6 weeks after baseline), and 12 weeks after baseline.

RESULTS

Both Re-Train Your Brain program formats were feasible and acceptable for young adults. When coupled with TAU, both integrated and alternating programs resulted in greater self-reported improvements than TAU only in anxiety interpretation biases (at the 6-week follow-up; Cohen d=0.80 and Cohen d=0.89) and comorbid interpretation biases (at the 12-week follow-up; Cohen d=1.53 and Cohen d=1.67). In addition, the alternating group reported larger improvements over the control group in generalized social anxiety symptoms (at the 12-week follow-up; Cohen d=0.83) and alcohol cravings (at the 6-week follow-up; Cohen d=0.81). There were null effects on all other variables and no differences between the intervention groups in efficacy outcomes.

CONCLUSIONS

Should these findings be replicated in a larger randomized controlled trial, Re-Train Your Brain has the potential to be a scalable, low-cost, and non-labor-intensive adjunct intervention for targeting interpretation and comorbidity biases as well as generalized anxiety and alcohol-related outcomes in the real world.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12620001273976; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364131.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/28667.

The impact of COVID-19 on alcohol sales and consumption in the United States: A retrospective, observational analysis

Understanding the COVID-19 pandemic's effect on alcohol sales and consumption is critical in mitigating alcohol abuse and morbidity. We sought to determine how the onset of the COVID-19 pandemic and changes in viral incidence affected alcohol sales and consumption in the United States. We conducted a retrospective observational analysis regressing National Institute on Alcohol Abuse and Alcoholism (NIAAA) alcohol sales data and Behavioral Risk Factor Surveillance System (BRFSS) survey data for 14 states for 2017 to 2020 with COVID-19 incidence in 2020 in the United States. The onset of the pandemic was associated with higher monthly alcohol sales per capita of 1.99 standard drinks (95% Confidence Interval: 0.63 to 3.34, p = 0.007). Increases of one COVID-19 case per 100 were associated with lower monthly alcohol sales per capita of 2.98 standard drinks (95% CI: -4.47 to -1.48, p = 0.001) as well as broad decreases in alcohol consumption, notably 0.17 fewer days per month with alcohol use (95% CI: -0.31 to -0.23, p = 0.008) and 0.14 fewer days per month of binge drinking (95% CI: -0.23 to -0.052, p < 0.001). The COVID-19 pandemic is associated with increased monthly average alcohol purchases, but higher viral incidence is linked to lower alcohol purchases and consumption. Continued monitoring is needed to mitigate the effects of higher population alcohol use during the pandemic.

The Involvement of Age, Gender, and Personality Variables in Alcohol Consumption during the Start of the COVID-19 Pandemic in Romanian University Students

This study aimed to explore the age, gender, and personality variables involved in alcohol consumption (AC) at the start of the COVID-19 pandemic in Romania among 210 bachelor's and master's students aged between 19 and 25 years. The results of the Freiburg Personality Inventory-Revised and the Alcohol Use Disorders Identification Test were examined using a logistic model and cluster analysis. The prevalence of problematic AC was relatively low (10.5%). The risk of males being part of the problematic AC cluster was 5.223 times higher than that of females (p < 0.001). Increasing age was associated with a decrease in the risk of belonging to the problematic cluster by a factor of 0.733 (p = 0.001). Increasing scores on the Frankness and Somatic Complaints personality scales were associated with a decreased risk of belonging to the problematic cluster of AC, with factors of 0.738 (95% CI, 0.643 to 0.848), Wald χ²(1) = 18.424, and p < 0.001 and 0.901 (95% CI, 0.813 to 0.999), Wald χ²(1) = 3.925, and p = 0.048, respectively. More action to prevent AC is needed in men, especially in those at the beginning of their university studies. It is necessary to intervene to decrease the interest in making a good impression (low scores on the Frankness Scale) so as to increase healthy autonomy using critical thinking and find a balance between the internal and external loci of control. Students from faculties with profiles that deal with health and its promotion are less vulnerable to problematic alcohol consumption, even if they have a withdrawn, pessimistic personality (low scores on Somatic Complaints).

Impacts of COVID-19 on alcohol use among help-seeking adults

The coronavirus (COVID-19) pandemic has been associated with both increased and decreased alcohol use. Authors explored reasons for increased and decreased alcohol use since the COVID-19 lockdown (March 2020) in a sample of help-seeking adults (HSA) participating in a remote-based alcohol reduction text-messaging intervention in the USA. At the time of recruitment, the HSA in this study were interested in reducing rather than stopping their alcohol consumption. An optional self-report questionnaire was completed by 324 participants (mean age 41.6 ± 10.2 years; 71.5% female; 83.9% White) in February 2021. Survey questions assessed sociodemographic factors, social stressors (quarantine conditions, employment status, changes to daily routine), and drinking patterns. Authors fit two ordinal logistic regression models: one for increased drinking and one for decreased drinking, as functions of the potential predictors and control variables. Most participants (n = 281; 87.0%) reported drinking more than usual since COVID-19 lockdown began. The most common self-reported reasons for drinking more were increased stress/anxiety (74.7%), boredom (69.4%), and spending more time at home (65.5%) whereas reasons for drinking less were less socializing (33.7%) and worrying about how alcohol would impact the immune system (31.5%). Identifying as female, severity of changes to daily routine, and increased access to alcohol were significantly associated with drinking more than usual. These data suggest that the general consequences of the pandemic in the general population (e.g., boredom) led to greater alcohol use among help-seeking adults attempting to reduce their drinking. Identifying these factors may help create more targeted interventions during public health crises.

Investigating the effects of emotion dysregulation and repetitive negative thinking on alcohol hangover anxiety and depression

INTRODUCTION

Underlying factors associated with alcohol hangover psychological symptoms, such as anxiety and depression, have not been identified. Emotion dysregulation and repetitive negative thinking (RNT) are transdiagnostic factors associated with psychopathology, including non-hangover anxiety and depression. The current study prospectively examined the role of emotion dysregulation on subsequent alcohol hangover anxiety and depression symptoms, as well as the moderating role of RNT on this relation among university students.

METHODS

One hundred thirty-six participants completed baseline assessments of emotion dysregulation (DERS-16) and non-hangover anxiety and depression (DASS-21). Thirty-nine participants reported experiencing alcohol hangover at 2-week follow up and completed assessments of RNT (PTQ) and hangover anxiety and depression (modified DASS-21). Two independent regression-based moderation analyses were conducted to examine the relation of baseline emotion dysregulation, 2-week follow-up RNT, and hangover anxiety and depression symptoms after accounting for baseline non-hangover anxiety and depression symptoms.

RESULTS

Among those experiencing alcohol hangover (n = 39), emotion dysregulation and RNT were not associated with hangover related anxiety beyond non-hangover anxiety. Emotion dysregulation significantly predicted hangover depression but was rendered non-significant by the addition of RNT, which was significantly associated with hangover depression. RNT moderated the emotion dysregulation-hangover depression relation such that emotion dysregulation was not associated with future hangover depression at low levels of RNT but was positively associated with hangover depression at moderate to high levels of RNT.

CONCLUSION

Results provide preliminary support for the role of emotion dysregulation and RNT in hangover depression severity.

Alcohol Use, Anxiety and Depression among French Grandes Écoles Engineering Students during the COVID-19 Pandemic

In French Grandes Écoles, heavy alcohol consumption seems to be generalized and largely tolerated, leading to particular concerns about Alcohol Use Disorder and harmful alcohol practices among students. The COVID-19 pandemic led to increased psychological difficulties, and two coexisting scenarios seemed to emerge regarding alcohol consumption: A decrease in alcohol consumption linked to the absence of festive events, and an increase in solitary alcohol consumption to cope with lockdowns. The aim of this exploratory study is to investigate the evolution of alcohol consumption, consumption motives and the relationship of these factors to the anxiety and the depression of French Grandes Écoles students during the COVID-19 pandemic, depending on their residential status. After the last lockdown, 353 students completed a questionnaire measuring alcohol consumption, motivation to drink, anxiety and depression during and after the COVID-19 period. Although students confined to campus were more likely to increase their alcohol use, they also presented higher well-being scores than those who lived off campus. A significant proportion of students were aware of their increased alcohol use due to the COVID-19 pandemic, and the motives attributed to their increased consumption highlight the need for vigilance and specialized support facilities.

Severe Alcohol Withdrawal in an Adolescent Male

Ethanol remains one of the most frequently abused agents by adolescents, exceeding all others except for vaping nicotine, and use is rising. With increased ethanol use comes a greater risk for dependence and potential for alcohol withdrawal syndromes (AWS). Pediatric AWS is extremely rare and poorly characterized in the literature. Pediatric acute care practitioners may have limited exposure to AWS. We report the case of a 16-year-old male with a history of polysubstance abuse who presented with mild AWS and progressed rapidly to delirium tremens. His withdrawal was initially refractory to high dose benzodiazepine therapy but responded well to phenobarbital. This case highlights how rapidly and dangerously AWS can progress if not aggressively treated. Given the rise in adolescent alcohol use and potential for life threatening symptoms, practitioners, especially in acute care specialties such as emergency medicine, critical care, and hospital medicine, would benefit from additional familiarity with AWS diagnoses and management strategies.

Alcohol use among Australian parents during the COVID-19 pandemic - April-2020 to May 2021

AIMS

This study examined the trajectory of alcohol use frequency among parents from April-2020 to May-2021 during the COVID-19 pandemic in the state of Victoria, Australia (who experienced one of the longest lockdowns in the world), compared to parents from the other states of Australia (who experienced relatively fewer restrictions). We further examined the extent to which baseline demographic factors were associated with changes in alcohol use trajectories among parents.

METHOD

Data were from the COVID-19 Pandemic Adjustment Survey (2,261 parents of children 0-18 years). Alcohol use frequency was assessed over 13 waves. Baseline demographic predictors included parent gender, age, speaking a language other than English, number of children, partnership status, education, employment, and income.

RESULTS

Overall, alcohol trajectories declined over time. Victorian parents, in comparison to parents from other states, reported a smaller reduction in alcohol use frequency across 2020, with a more notable decline during 2021. Female/other gender, speaking a language other than English at home, unemployment, and lower income (Victoria only) were associated with alcohol trajectories of less frequent use, and older age was associated with a trajectory of more frequent use.

CONCLUSIONS

Results suggest subtle difference in alcohol trajectories reflecting COVID-19 restrictions, when comparing Victoria and other states in Australia. Socioeconomically advantaged groups were most at risk for elevated trajectories of alcohol use frequency. Population level support may beneficial to reduce drinking behaviours.

The Psychological Impact of the COVID-19 Pandemic on Alcohol Abuse and Drunkorexia Behaviors in Young Adults

The COVID-19 outbreak negatively affected young adults' psychological well-being, increasing their stress levels and symptoms of anxiety and depression, and potentially triggering health-risk behaviors. The present study was aimed at investigating the psychological impact of the COVID-19 pandemic on alcohol abuse and drunkorexia behaviors among young adults living in Italy. Participants were 370 emerging adults (63% women, 37% men; Mage = 21.00, SDage = 2.96, range: 18-30) who were recruited through an online survey between November 2021 and March 2022. Participants completed measures of alcohol abuse, drunkorexia behaviors, negative life experiences, and post-traumatic symptoms related to the COVID-19 outbreak. The results showed that the emotional impact and negative life experiences associated with the pandemic predicted both alcohol abuse and drunkorexia behaviors, albeit in different ways. Specifically, the number of negative life experiences during the pandemic and the tendency to avoid COVID-19-related negative thoughts positively predicted alcohol abuse; and the presence of intrusive thoughts associated with the pandemic significantly predicted the frequency of drunkorexia behaviors. Implications for research and clinical practice are discussed.

Impact of COVID-19 on alcohol use disorder recovery: A qualitative study

In March 2020, restrictions on in-person gatherings were introduced due to the coronavirus disease (COVID-19) pandemic, requiring alcohol use disorder (AUD) recovery resources to migrate to virtual platforms. This study investigated how these restrictions impacted recovery attempts and explored participant experiences with virtual resources using a qualitative approach. Participants attempting recovery from AUD (N = 62; Mage = 48.2; F = 53.2%; 71% White) completed virtual semistructured interviews from July 2020 to August 2020 on their experience during the COVID-19 lockdown, impacts on recovery, and experiences with online resources. Interviews were recorded, transcribed, and analyzed using a thematic coding process. Three overarching themes were identified: Effect on Recovery, Virtual Recovery Resources, and Effect on General Life. Within each overarching theme, lower order parent themes and subthemes reflected varied participant experiences. Specifically, one group of participants cited negative impacts due to COVID-19, a second group reported positive impacts, and a third group reported experiencing both positive and negative impacts. Participants reported both positive and negative experiences with virtual resources, identifying suggestions for improvement and other resources. Findings suggest that while individuals in AUD recovery experienced significant hardships, a proportion experienced positive impacts as well, and the positive and negative consequences were not mutually exclusive. Additionally, the results highlight the limitations of existing virtual resources. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The changing face of maxillofacial trauma during the 2020 COVID-19 lockdowns in Melbourne, Australia

PURPOSE

To compare the incidence, aetiology, and patterns of maxillofacial fracture presentations during the various stages of the 2020 Melbourne COVID-19 lockdown restrictions to periods outside lockdown in 2019 and 2020.

METHODS

This is a retrospective study of 344 subjects. The patterns of facial trauma presentations to a tertiary hospital in metropolitan Melbourne during the 2020 COVID-19 restrictions were compared to periods with no restrictions over 22 months from March 2019 to December 2020.

RESULTS

The incidence of maxillofacial fractures decreased by 28% during lockdown (0.41 vs. 0.57 injuries/day, P = 0.0003). Falls overtook interpersonal violence as the leading cause of fractures (44% of lockdown presentations vs. 25.7% of presentations outside lockdown, P = 0.002), while sporting injuries dropped drastically (4% vs. 17.1%, P = 0.005). Lockdowns saw an increase in the proportion of female patients (40% vs. 26.8%, P = 0.03) and a fivefold increase in proportion of domestic violence-related fractures (6.7% vs. 1.1%, P = 0.006). Alcohol-related injuries decreased significantly (11% vs. 21%, P = 0.03).

CONCLUSIONS

While restrictions reduced rates of interpersonal violence and alcohol-related maxillofacial trauma, there was a higher proportion of injuries to females, increased falls, and domestic violence-related injuries.

Examining the relationship between alcohol consumption, psychological distress and COVID-19 related circumstances: An Australian longitudinal study in the first year of the pandemic

OBJECTIVE

The aim of this study is to examine the relationship between alcohol consumption, psychological distress and COVID-19 related circumstances (being in lockdown, working from home, providing home-schooling and being furloughed) over the first eight months of the pandemic in Australia.

METHOD

A longitudinal study with six survey waves over eight months with a convenience sample of 770 participants. Participants were aged 18 or over, lived in Australia and consumed alcohol at least monthly. Demographic data was obtained in the first wave. Data on alcohol consumption, psychological distress (Kessler 10), and COVID-19 related circumstances (being in lockdown, working from home, providing home-schooling and being furloughed) were obtained in each survey wave.

RESULTS

Results from the fixed-effect bivariate regression analyses show that participants reported greater alcohol consumption when they had high psychological distress compared to when they had low psychological distress. Meanwhile, participants reported greater alcohol consumption when they worked from home compared to when they did not work from home. Participants also reported greater alcohol consumption when they provided home-schooling compared with when they did not provide home-schooling. The fixed-effect panel multivariable regression analyses indicated a longitudinal relationship between higher psychological distress and providing home-schooling on increased alcohol consumption.

CONCLUSION

Broader drinking trends during the COVID-19 pandemic typically indicate increases and decreases in drinking among different members of the population. This study demonstrates that in Australia, it was those who experienced psychological distress and specific impacts of COVID-19 restrictions that were more likely to increase their drinking.

Trends in Substance Use and Abuse During COVID-19 Among the General Population

BACKGROUND

COVID-19 pandemic has brought many public health issues, including substance use and abuse. Individuals abusing substances are vulnerable to severe infections caused by SARS-CoV-2 virus as well as impairment of the immune system, mental health, and physical health. Despite considerable efforts to minimize and prevent substance use, the use of tobacco, alcohol, and illicit substances is ever increasing resulting in morbidity and mortality which significantly leads to socio-economic costs.

METHODS

A quantitative review of the literature searched in PubMed and Google Scholar databases yielded a total of 1416 studies among which 27 cross-sectional studies, conducted on the general population of 15 and above years of age, were selected based on the eligibility criteria.

FINDINGS

A sample of 1,021,118 individuals were investigated in this study. The most commonly used substances were marijuana (100%), methadone (69.86%), and large cigar (60%). A total of 26 substances were reported to have been used during pandemic, 13 of which showed trends in usage (increased/decreased/no change). Of the total sample, 45.89% were males, 54.14% females, and 1.28% others.

CONCLUSION

Everyone and anyone is susceptible to alcohol, tobacco, and other substance use and abuse at different stages of their lives. Therefore, the need for effective preventive strategies is critical in community efforts to combat substance abuse. Combined efforts from local and global stakeholders will lead to curbing the issue of substance use and abuse worldwide.

Suicide rates during the COVID-19 pandemic in Japan from April 2020 to December 2021

This study estimated the excess suicidal mortality during the COVID-19 pandemic in Japan. A Poisson regression model was used to assess the association between unemployment rates, expenditure for alcohol, eating out, and suicide, from January 2008 to March 2020. The excess suicidal mortality was assessed by applying the identified model to data from April 2020 to December 2021. The number of estimated excess deaths during COVID-19 was 3397 in men and 2390 in women. COVID-19 may have caused unprecedented psychological distress among people, owing to restricted social gatherings and prolonged uncertainties.

Factors associated with changing alcohol consumption during the first UK lockdown

Background

In response to COVID-19 there have been lockdowns and restrictions to hospitality services. Drinking behaviours often change in response to traumatic events and changes in the drinking environment, and this is influenced by a range of factors. This study explores self-reported changes in alcohol consumption in the third month of the UK lockdown, associations with socio-demographics factors and with COVID-19-related concerns, and mental health and wellbeing.

Methods

The COVID-19 Psychological Wellbeing Study was a longitudinal, online, three-wave survey of 1958 UK adults. Data were collected during the first UK lockdown; wave 1 launched 23 March 2020, wave 2 was 1 month after and wave 3 2 months after completion of wave 1A hierarchical multinomial regression model was estimated to investigate factors associated with changes in perceived alcohol consumption in the third month of the lockdown.

Results

The majority of participants reported changes in drinking (62%) with over one-third indicating increased consumption. Student status and worries about the financial implications of COVID-19 were associated with lower odds of decreased alcohol consumption. Those with above average income and those with children in the household had lower odds of increased alcohol consumption, while younger adults had higher odds of increased alcohol consumption.

Conclusions

This study adds to the growing body of research showing changes in alcohol consumption behaviours during the COVID-19 lockdown restrictions, and identifies risk and protective factors which can aid in targeting intervention at those most in need of support.

Use of illicit drugs, alcohol and tobacco in Spain and Portugal during the COVID-19 crisis in 2020 as measured by wastewater-based epidemiology

The COVID-19 pandemic spread rapidly worldwide in the year 2020, which was initially restrained by drastic mobility restrictions. In this work, we investigated the use of illicit drugs (amphetamine, methamphetamine, ecstasy, cocaine and cannabis), and licit substances of abuse (alcohol and tobacco) during the earlier months (March-July 2020) of the pandemic restrictions in four Spanish (Bilbao and its metropolitan area, Vitoria-Gasteiz, Castellón and Santiago de Compostela) and two Portuguese (Porto and Vila do Conde) locations by wastewater-based epidemiology (WBE). The results show that no methamphetamine was detected in any of the locations monitored, while amphetamine use was only detectable in the two locations from the Basque Country (Bilbao and its metropolitan area and Vitoria-Gasteiz), with high estimated average usage rates (700-930 mg day-1 1000 inhabitant-1). The remaining substances were detected in all the investigated catchment areas. In general, no remarkable changes were found in population normalized loads compared to former years, except for cocaine (i.e. its main metabolite, benzoylecgonine). For this drug, a notable decrease in use was discernible in Castellón, while its usage in Porto and Santiago de Compostela seemed to continue in a rising trend, already initiated in former years. Furthermore, two events of ecstasy (3,4-methylenedioxymethamphetamine, MDMA) dumping in the sewage network were confirmed by enantiomeric analysis, one in Santiago de Compostela just prior the lockdown and the second one in the Bilbao and its metropolitan area in July after relieving the more stringent measures. The latter could also be associated with a police intervention. The comparison of WBE with (web) survey data, which do not provide information at a local level, points towards contradictory conclusions for some of the substances, thereby highlighting the need for stable WBE networks capable of near real-time monitoring drug use.

Changes in the clustering of health-related behaviors during the COVID-19 pandemic: examining predictors using latent transition analysis

The COVID-19 pandemic has had a significant impact on daily life, affecting both physical and mental health. Changes arising from the pandemic may longitudinally impact health-related behaviors (HRB). As different HRBs co-occur, in this study, we explore how six HRBs - alcohol (past-week and binge-drinking), tobacco, marijuana, benzodiazepine use, and unhealthy food consumption - were grouped and changed over time during the COVID-19 pandemic. A sample of 1038 university students and staff (18 to 73 years old) of two universities completed an online psychometrically adequate survey regarding their recalled HRB (T0, pre-COVID-19 pandemic) and the impact of COVID-19 on their behaviors during July (T1) and November (T2). Latent Transition Analysis (LTA) was used to identify HRB cluster membership and how clusters changed across T0, T1, and T2. Four clusters emerged, but remained mainly stable over time: ‘Lower risk’ (65.2–80%), ‘Smokers and drinkers’ (1.5–0.01%), ‘Binge-drinkers and marijuana users’ (27.6–13.9%), and ‘Smokers and binge-drinkers’ (5.6–5.8%). Participants who moved from one cluster to another lowered their HRB across time, migrating from the ‘Binge-drinkers and marijuana users’ cluster to ‘Lower risk’. Participants in this cluster were characterized as less affected economically by the COVID-19 pandemic, with lower reported stress levels, anxiety, depression, and loneliness than the other clusters. Our results provide evidence of how HRBs clustered together and transitioned longitudinally during the COVID-19 pandemic. HRB clustering across time offers a valuable piece of information for the tailoring of interventions to improve HRB.

Changes in activity locations during the COVID-19 pandemic and associations with depression, anxiety, loneliness, and alcohol use

INTRODUCTION

Restrictions and guidelines to limit the spread of COVID-19 caused considerable and rapid changes to individuals' daily routines. This study examines how activity locations changed during the COVID-19 pandemic and associated social distancing restrictions, and whether these changes were associated with depression, anxiety, loneliness, and alcohol use.

METHODS

A web-based survey was conducted early in the COVID-19 pandemic (May-June 2020) in Allegheny County (Pittsburgh), Pennsylvania. Participants (n = 265) reported visits to activity locations in the last 30 days and retrospectively for February 2020 (pre-pandemic). A principal components analysis was conducted to assess change in utilization of activity locations. Component scores of changes to activity locations were compared by sociodemographics. Poisson and zero-inflated negative binomial models were used to examine the relationship between component scores and pandemic depression symptoms, anxiety symptoms, loneliness, and drinking days.

RESULTS

Five distinct principal components of activity location changes were identified. The first component, characterizing broad reductions in activity locations during the early phases of the pandemic, was associated with increased depression and loneliness.

CONCLUSIONS

Results indicate non-uniform shifts in routine activities during the pandemic and highlight the importance of understanding how changes to the social environment affect individuals' psychological wellbeing and alcohol use.

Psychological distress and its association with intake of sugar-sweetened beverages, discretionary foods, and alcohol, in women during COVID-19, in Australia

Objectives

This study aimed to explore psychological distress, lifestyle, and demographic factors, as well as their relationship to discretionary choices in women of reproductive age during the coronavirus disease 2019 pandemic in Australia.

Methods

Reproductive-aged women (18–50 y) in Australia participated in a national online survey. Psychological distress score (using a validated 10-item Kessler Psychological Distress Scale questionnaire) was the primary exposure of interest, and key outcomes were frequencies of discretionary choices (sugar-sweetened beverages [SSBs], alcohol, and discretionary foods). Sociodemographic and physical activity data were also collected. Logistic regression was used to report adjusted odds ratio (aOR) and 95% confidence interval to predict SSBs (less than weekly; most days/daily), total discretionary foods (none/<2 times/d; ≥3 times/d), and alcohol use (never/less than monthly; most weeks/daily).

Results

A total of 1005 women were included in the study, of whom 40% had a high level of psychological distress. Women with high psychological distress (aOR: 1.96; 95% CI, 1.32–2.91) and those who gained weight during the pandemic (aOR: 1.71; 95% CI, 1.10–2.65) were more likely to consume discretionary foods ≥3 times/d. There was no association between psychological distress and SSB intake or alcohol; however, Australian, New Zealander, or Pacific Islander background (aOR: 1.68; 95% CI, 1.21–2.33) and more hours of sitting time (aOR: 1.88; 95% CI, 1.07–3.29) were associated with SSB consumption on most days/daily. Older age (aOR: 1.70; 95% CI, 1.00–2.89), higher household income (aOR: 1.44; 95% CI, 1.08–1.92), and moderate or high physical activity (aOR: 1.75; 95% CI, 1.10–2.80) were associated with alcohol intake on most weeks/daily.

Conclusions

Public health messaging to promote healthy eating should take into account the effect of psychological distress on health behavior. Messages aimed at maintaining a positive relationship between food intake and mental wellbeing, particularly among vulnerable groups, are warranted.

The impact of changes in COVID-19 lockdown restrictions on alcohol consumption and drinking occasion characteristics in Scotland and England in 2020: an interrupted time-series analysis

BACKGROUND AND AIMS

Early evidence suggests that COVID-19 lockdown restrictions affect alcohol consumption. However, existing studies lack data on how drinking practices changed as restrictions disrupted people's work, family life and socializing routines. We examined changes in consumption and drinking occasion characteristics during three periods of changing restrictions in Scotland/England.

DESIGN

Interrupted time-series analysis of repeat cross-sectional market research data (assessing step-level changes).

SETTING

Scotland/England, January 2009-December 2020.

PARTICIPANTS

Scotland: 41 507 adult drinkers; England: 253 148 adult drinkers.

MEASUREMENTS

Three intervention points: March 2020 lockdown, July 2020 easing of restrictions and October 2020 re-introduction of some restrictions.

PRIMARY OUTCOME

mean units consumed per week (total/off-trade/on-trade; 1 unit = 8 g ethanol).

SECONDARY OUTCOMES

drinking > 14 units per week, heavy drinking, drinking days per week, solitary drinking, drinking with family/partners, drinking with friends/colleagues, own-home drinking, drinking in someone else's home and drinking start times.

FINDINGS

In Scotland, March 2020's lockdown was associated with a 2.32 [95% confidence interval (CI) = 0.61, 4.02] increase in off-trade (i.e. shop-bought) units per week, a -2.84 (95% CI = -3.63, -2.06) decrease in on-trade (i.e. licensed venues) units per week, but no statistically significant change in total units per week. July 2020's easing of restrictions was associated with a 1.33 (95% CI = 0.05, 2.62) increase in on-trade units per week, but no statistically significant total/off-trade consumption changes. October 2020's re-introduction of some restrictions was not associated with statistically significant consumption changes. Results for England were broadly similar. Lockdown restrictions were also associated with later drinking start times, fewer occasions in someone else's home and with friends/colleagues, more own-home drinking and (in Scotland only) more solitary drinking.

CONCLUSIONS

Reductions in on-trade alcohol consumption following COVID-19 lockdown restrictions in Scotland/England in 2020 were mainly offset by increased own-home drinking. This largely persisted in periods of greater/lesser restrictions. The shift towards off-trade drinking involved significant changes in the characteristics of drinking occasions.

Alcohol use, sleep, and depression among family caregivers in the time of COVID-19

The COVID-19 pandemic has substantially altered daily life around the world, resulting in significant impacts on health behaviors. The additional burdens imposed by family caregiving (i.e., providing unpaid care for children and/or adults) may further exacerbate negative effects of the pandemic on health and health behaviors, including increased alcohol consumption, poor sleep, and increased depressive symptoms. The current study examined this possibility. Participants (N = 320, mean age = 35.11 years) completed an online questionnaire assessing alcohol use, sleep, and depression during the COVID-19 pandemic (June–August 2020) and retrospectively assessed the same health behaviors in the months prior to the pandemic. Insomnia severity increased, sleep quality decreased, and depressive symptoms increased for both caregivers and non-caregivers during the pandemic (p < 0.001). By contrast, alcohol consumption increased among caregivers only (p < 0.05). Further, increased alcohol use was associated with decreased sleep quality and increased insomnia symptoms among caregivers, but not non-caregivers. While additional longitudinal research is warranted in this population, our findings offer important insight on self-reported changes in alcohol consumption, sleep patterns, and mood among family caregivers during the COVID-19 pandemic.

Double shifts, double trouble: Alcohol as a problematic panacea for working mothers

Alcohol consumption among midlife women has become an area of research focus. We suggest it is important to examine the social roles that many midlife women take on - specifically working mothers. Working mothers balance both employment and the unequal burden of caring/domestic duties, leading to 'double shifts' of paid and unpaid labor. This creates unique stresses that may impact their drinking. This is particularly important as a growing number of mothers re-enter the workforce after childbirth. In this commentary, we suggest that working mothers' drinking tends to be overlooked or even endorsed as a means of managing the gendered stresses they face - stresses which have been exacerbated during the pandemic. We highlight the dearth of literature focusing on the drinking patterns, practices, and motives of working mothers and argue that gendered expectations placed on working mothers may be an increasingly important social determinant of health among this group.

Testing both affordability-availability and psychological-coping mechanisms underlying changes in alcohol use during the COVID-19 pandemic

Two theoretical perspectives have been proffered to explain changes in alcohol use during the pandemic: the ‘affordability-availability’ mechanism (i.e., drinking decreases due to changes in physical availability and/or reduced disposable income) and the ‘psychological-coping’ mechanism (i.e., drinking increases as adults attempt to cope with pandemic-related distress). We tested these alternative perspectives via longitudinal analyses of the COVID-19 Psychological Consortium (C19PRC) Study data (spanning three timepoints during March to July 2020). Respondents provided data on psychological measures (e.g., anxiety, depression, posttraumatic stress, paranoia, extraversion, neuroticism, death anxiety, COVID-19 anxiety, intolerance of uncertainty, resilience), changes in socio-economic circumstances (e.g., income loss, reduced working hours), drinking motives, solitary drinking, and ‘at-risk’ drinking (assessed using a modified version of the AUDIT-C). Structural equation modelling was used to determine (i) whether ‘at-risk’ drinking during the pandemic differed from that recalled before the pandemic, (ii) dimensions of drinking motives and the psychosocial correlates of these dimensions, (iii) if increased alcohol consumption was predicted by drinking motives, solitary drinking, and socio-economic changes. The proportion of adults who recalled engaging in ‘at-risk’ drinking decreased significantly from 35.9% pre-pandemic to 32.0% during the pandemic. Drinking to cope was uniquely predicted by experiences of anxiety and/or depression and low resilience levels. Income loss or reduced working hours were not associated with coping, social enhancement, or conformity drinking motives, nor changes in drinking during lockdown. In the earliest stage of the pandemic, psychological-coping mechanisms may have been a stronger driver to changes in adults’ alcohol use than ‘affordability-availability’ alone.

Patterns of Alcohol Use Among Italian Young Adults Before and During a COVID-19 Lockdown: A Latent Class Analysis Study

Two not mutually exclusive theories explain the effects of the COVID-19 pandemic on alcohol use. The Availability hypothesis contends that reduced opportunities to drink due to the closure of outlets and consumption sites should lead to decreases in alcohol use, whereas the Stress and Coping hypothesis argues that those exposed to stressful situations may increase drinking. The primary aim of this study was to examine changes—separately by gender—in the prevalence of drinking patterns among Italian young adults (18–34 years) before and during a COVID-19 lockdown. Study design was a repeated cross-sectional study, whereby data collected in 2015 and 2020 from nationally representative samples were analyzed. Latent class analysis identified five, fully invariant for women and partially invariant for men, drinking pattern classes among both cohorts: current non-drinkers (CND), weekend risky (WRD) and weekend non-risky drinkers (WnRD), daily non-risky (DnRD) and daily risky drinkers (DRD). In support of the Availability hypothesis, increases in abstaining and moderate drinking women and men were observed from 2015 to 2020. Concomitantly, among men only there were also increases in the prevalence of patterns characterized by risky drinking, coping drinking motives and related harm (Stress and Coping hypothesis). The pandemic and the three-tier lockdown imposed by the Italian government likely reduced overall alcohol use in the general population who drink moderately. However, there was a substantial increase in the prevalence of a small but significant group of men who drank daily and heavily to cope. Outreach and prevention efforts should target primarily this group, but also consider the opportunities that the exceptional circumstances of a quarantine offer to any individuals to reshape their lifestyle and health-related behaviors.

COVID-19 testing decisions and behaviours in two Australian cities

Issue addressed

High levels of testing are crucial for minimising the spread of COVID‐19. The aim of this study is to investigate what prevents people from getting a COVID‐19 test when they are experiencing respiratory symptoms.

Methods

Semi‐structured, qualitative interviews were conducted with 14 purposively sampled adults between 20 November 2020 and 3 March 2021 in two capital cities of Australia and analysed thematically. The analysis included people who reported having respiratory symptoms but who did not undergo a COVID‐19 test.

Results

Participants appraised risks of having COVID‐19, of infecting others or being infected whilst attending a testing site. They often weighed these appraisals against practical considerations of knowing where and how to get tested, inconvenience or financial loss.

Conclusions

Clear public health messages communicating the importance of testing, even when symptoms are minor, may improve testing rates. Increasing the accessibility of testing centres, such as having them at transport hubs is important, as is providing adequate information about testing locations and queue lengths.

So what?

The findings of our study suggest that more needs to be done to encourage people to get tested for COVID‐19, especially when symptoms are minor. Clear communication about the importance of testing, along with easily accessible testing clinics, and financial support for those concerned about financial impacts may improve testing rates.

Changes in alcohol use during COVID-19 and associations with contextual and individual difference variables: A systematic review and meta-analysis

OBJECTIVE

The present study meta-analyzed studies examining changes in alcohol consumption during the coronavirus disease (COVID-19) pandemic and systematically reviewed contextual and individual difference factors related to these changes.

METHOD

Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol, studies were gathered via PsycINFO, PubMed/MEDLINE, and preprint databases (published April 29, 2021) that examined individual-level changes in consumption during the initial COVID-19 mitigation measures (before October 2020). Next, sample proportion increases and decreases in consumption, in addition to mean change in consumption variables from pre- to during-COVID, were meta-analyzed, and contextual and individual difference variables related to consumption changes during the pandemic were summarized.

RESULTS

One hundred and twenty-eight studies provided data from 58 countries (M n = 3,876; Mdn n = 1,092; aggregate sample n = 492,235). The average mean change in alcohol consumption was nonsignificant (Cohen's d = -0.01, p = .68); however, meta-analysis revealed that 23% of participants reported increases in consumption and 23% reported decreases. These changes were moderated by per capita gross domestic product and country. Narrative synthesis revealed multiple predictors of increased drinking, including contextual changes (e.g., children at home, income loss, working remotely), individual difference variables (being female, a young-to-middle aged adult, or Black), and mental health/alcohol-related risk factors (e.g., depression).

CONCLUSIONS

The identified factors associated with increased alcohol consumption should be considered in planning behavioral health services during future crisis events that abruptly alter everyday environments in ways that increase stress and decrease access to naturally occurring rewards. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self-Assured and Sober: The Relationship Between Maternal Parenting Sense of Competence, Stress, and Alcohol Use

Alcohol misuse is widespread, creating serious health and parenting harms. It is important to explore the motivations behind why people drink and the modifiable factors determining severity of the behavior. While alcohol-related research has historically focused on men, the closing gender gap in alcohol consumption highlights a need for targeted research on women. Parenting stress is a commonly reported motivation for maternal drinking. Likewise, parenting stress is associated with parenting sense of competence. However, there is no research connecting parenting sense of competence with alcohol use directly, nor indirectly via moderation of the alcohol and parenting stress relationship. The current study explored these associations and investigated the potential moderation through a questionnaire completed by a sample of 406 mothers. There were significant correlations between all factors, however, parenting sense of competence was not a significant moderator of the parenting stress and alcohol use relationship. Specifically, as a mother's parenting stress increases, her confidence in the parenting role tends to decline and she is more likely to misuse alcohol. Despite this, variation in parenting sense of competence among women was not significantly correlated with one's likelihood to drink when coping with stress. Further exploration of these relationships is required, with replication of the current study following the COVID-19 pandemic.

Cannabis use during the early COVID-19 pandemic: Use patterns, predictors, and subjective experiences

BACKGROUND

Even in the early stages, global crises such as the COVID-19 pandemic lead to serious dislocations of social life, secondary adjustment reactions to external restrictions and individual concerns. Coping mechanisms may also include dysfunctional strategies like an increase of drug use. Considering the wide-spread use of cannabis, the aim of this study was to elucidate the interplay of social restrictions, psychopathology, concerns related to the pandemic in addition to the users' experiences, motivations and consumption quantities during the early COVID-19 pandemic. It was presumed that cannabis intake would increase during the early phase of the crisis and that consumption quantities would be related to corona-related restrictions, concerns as well as subjective substance effects and psychopathology.

MATERIALS AND METHODS

As part of an international, cross-sectional, internet-based survey (N = 5,049) available in five languages, consumption quantities and patterns of cannabis use in the early phase of the pandemic from April to August 2020 were examined. Participants retrospectively rated restrictions and concerns related to the pandemic, motives of cannabis use prior to and during 1 month the pandemic, and subjective consumption effects.

RESULTS

Cannabis use behavior showed no significant differences when consumption quantities prior and during 1 month after the COVID-19 outbreak were compared. Higher quantities of cannabis intake prior and during 1 month of the pandemic as well as more corona-related concern were associated with an increased perception of positive effects of cannabis during the pandemic. Predictors of its use during 1 month of pandemic were higher pre-pandemic consumption quantity, older age, quarantinization, a lesser degree of being affected by negative effects of the pandemic and a stronger subjective experience of corona-related positive effects of cannabis. Comparisons of the motives for cannabis intake in the pre-pandemic versus the pandemic period showed that all rationales for consumption were reported less frequently, except boredom.

CONCLUSION

Frequencies of cannabis intake remained relatively stable in the early pandemic phase. Risk factors for increased use seem related to habitual consumption patterns that become more prominent under quarantinization. The use of cannabis as a dysfunctional coping strategy might not be amenable via self-report and should therefore receive special attention in clinical contexts.

Longitudinal Assessment of Alcohol Consumption throughout the First COVID-19 Lockdown: Contribution of Age and Pre-Pandemic Drinking Patterns

INTRODUCTION

The COVID-19 outbreak and the related lockdown measures have raised concerns regarding mental health, including alcohol misuse. Preliminary studies investigated alcohol consumption at the early stages of lockdown, but no longitudinal data regarding its evolution during and after the first lockdown are currently available.

METHODS

We investigated changes in alcohol consumption among a convenience sample of 1,693 French-speaking Belgian adults using a 3-stage longitudinal online survey. All participants reported their consumption at different stages of lockdown: before lockdown onset (retrospectively, T0), at 2 different times during lockdown (T1 and T2), and after lockdown offset (T3). We also measured socio-demographic variables and the harmfulness of drinking patterns before lockdown.

RESULTS

A mixed model with negative binomial distribution indicated that participants decreased their alcohol consumption after lockdown onset and returned to their initial alcohol consumption after lockdown offset. Younger individuals (18-30 years old) were more likely to decrease their consumption during the lockdown period (T1 and T2) than the periods preceding or following lockdown (T0 and T3), especially if they presented hazardous or problematic drinking patterns before lockdown. We only observed a rebound effect after lockdown offset among young moderate drinkers. All participants kept stable their alcohol consumption during lockdown (T1 and T2).

CONCLUSIONS

Lockdown onset and offset constitute key periods for alcohol consumption changes during the COVID-19 crisis, particularly in youth and in individuals with hazardous or problematic drinking patterns.

Changes in Youth Mental Health, Psychological Wellbeing, and Substance Use During the COVID-19 Pandemic: A Rapid Review

Since the onset of the COVID-19 pandemic, researchers around the world have made efforts to assess its impact on youth mental health; however, the breadth of this topic has impeded a clear assessment of pandemic outcomes. This study aimed to address this gap by reviewing changes in youth (age ≤ 25) mental health, psychological wellbeing, substance use, and the use or delivery of relevant services during the pandemic. PubMed and Embase were searched in May 2021 to conduct a rapid review of the literature. The results encompass 156 primary publications and are reported using a narrative synthesis. Studies of mental health (n = 122) and psychological wellbeing (n = 28) generally indicated poor outcomes in many settings. Publications regarding substance use (n = 41) noted overall declines or unchanged patterns. Studies of service delivery (n = 12) indicated a generally positive reception for helplines and telehealth, although some youth experienced difficulties accessing services. The findings indicate negative impacts of the pandemic on youth mental health, with mixed results for substance use. Services must support marginalized youth who lack access to telehealth.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40894-022-00185-6.

Psychoactive substance use, internet use and mental health changes during the COVID-19 lockdown in a French population: A study of gender effect

INTRODUCTION

COVID-19 has enormous impacts on each individual. The goals of our study were (1) to assess the rate of internet and psychoactive substance use, clinical depression and anxiety in a French population during the lockdown (2) to study the role of clinical and socio-demographic variables (especially, gender).

MATERIALS AND METHODS

During lockdown, an online anonymous questionnaire was used to assess socio-demographic and health data, previous psychiatric history, anterior and current internet and psychoactive substance use, current anxiety, depression and suicidal ideation. The associations of socio-demographic, clinical variables with anxiety, depression, internet or psychoactive substance use were examined.

RESULTS

The study included 263 participants (aged 38.1 ± 15.3-197 males and 64 females). During the lockdown, internet use increased in 14.4% of cases, alcohol use in 20.2%, and tobacco use in 6.8%. In contrast, more participants reported a decrease in alcohol, tobacco or illicit drug use (25.9, 24, and 27.8% respectively). Anxiety was reported in 62.4% and depression in 20.2% of cases; 29.7% of participants reported an increase in anxiety and 25.5% an increase in depression. Depression was associated with an increase in internet and tobacco use. Tobacco and alcohol use were positively associated and an increase in use was more frequent in previous users of both substances. Maintaining a daily routine and relationships with family, being self-employed were associated to lower risks of depression and anxiety.

CONCLUSION

Higher rates of internet use, as well as depression and anxiety, were observed during the lockdown. Gender was not a significant associated factor.

A multicentric survey among patients with substance use disorders during the COVID-19 lockdown in India

BACKGROUND

The unprecedented first wave of the COVID-19 pandemic severely impacted mental health services globally. However, the negative impact of such disruptions on people with substance use disorders (SUD) seeking treatment remains unclear. We aim to explore the behaviors adopted by these individuals to overcome the service disruptions.

MATERIALS AND METHODS

We explored the changes related to substance use behavior (quit attempts, withdrawal experienced, treatment-seeking, and risky behaviors), and behavioral changes in response to COVID-19 lockdown. A cross-sectional survey was conducted among 404 people with SUD seeking treatment from seven centers across India. They were assessed by a specially designed structured questionnaire during the first wave (June-September) of the pandemic.

RESULTS

An overwhelming majority experienced withdrawal symptoms, with close to half making quit attempts and seeking treatment during the lockdown. Three-fourth of the sample reported difficulty in accessing treatment services and medications. Patients with opioid use were significantly more likely to think about quitting (χ² = 20.408, P = 0.000), make attempts (χ² = 12.436, P = 0.000), seek treatment (χ ² = 7.536, P = 0.006), and self-medicate for withdrawal symptoms (χ² = 5.885, P = 0.015). In turn, those with alcohol use were more likely to use telepsychiatry services (χ² = 35.143, P = 0.000) and experience stigma by family members (χ² = 29.951, P = 0.000) and neighbors (χ² = 17.725, P = 0.000). Among COVID-19 safety precautions, majority practised wearing masks and social distancing but not others.

CONCLUSION

COVID-19 lockdown led a significant proportion of substance users, especially opioid users, to make quit attempts and seek help. However, these could not be sustained due to difficulty in accessing treatment services. Further, significant proportion failed to adhere to COVID-19 safety precautions.

Maternal Parenting Stress, Disengagement Strategies for Managing Parenting Stress, and Hazardous Alcohol Use among Mothers of Adolescents

Objective: According to the reward- stress dysregulation model of addiction and parenting, parenting stress may play a critical role in the etiology and maintenance of substance misuse. To date, limited work has examined how parenting stress may relate to hazardous alcohol use among mothers of adolescents. The present study examined if parenting stress interacted with maternal stress responses (i.e., disengagement coping, involuntary disengagement stress responses) in relation to maternal hazardous alcohol use. Method: Two hundred and fifty-three mothers (n = 147 hazardous alcohol users; 58% of the sample) of adolescents between the ages of 12 and 16 years participated in the current study. Mothers were recruited using Qualtrics panel services. Mothers reported on their parenting stress, strategies for managing parenting stress, and use of alcohol. Mothers also reported basic demographic information (Mage = 41.10 years, 86.6% identified as white, 81.1% of mothers were married). Interaction analyses were used to test hypotheses. Results: Maternal parenting stress interacted with maternal involuntary disengagement stress responses in relation to maternal hazardous alcohol use, such that at average and high levels of disengagement stress responses, parenting stress was associated with hazardous alcohol use. These results were robust to covariates (i.e., family income, maternal anxiety symptoms, maternal depressive symptoms, general levels of maternal stress, maternal cigarette use). Maternal disengagement coping strategies were not related to maternal hazardous alcohol use. Conclusion: Results suggest that parenting stress and involuntary disengagement stress responses may be associated with hazardous alcohol use among mothers of adolescents.

Impact of Gambling Supply Reduction During COVID-19 Shutdowns on Gambling Problems and Gambling Behaviour in Australia: A National Longitudinal Study

Restricting access to gambling products is one possible harm reduction strategy. We examined whether land-based gambling product supply restrictions during the COVID-19 pandemic impacted gambling problems and gambling engagement. In a three-wave, online, longitudinal study, 462 Australian adults (M_age = 44.94; 87% male) who gambled completed survey measures of demographics, gambling engagement (land-based and online), gambling problems, and psychological distress. Analyses were pre-registered and examined the impacts of restrictions on gambling problems and engagement. During the period of restrictions, there were no significant differences in gambling problems (OR = 0.88 [95%CI 0.55-1.42], p = .610) nor online gambling (B = 4.48 [95%CI-0.40-9.35], p = .071) between states experiencing and not experiencing restrictions. There was a small overall reduction in gambling engagement at 2-(t = 2.03, p = .043) and 5-months (t = 2.37, p = .019) post-restrictions, but no change in gambling problems (t = 1.25, p = .211; t = 1.50, p = .134). Amongst those at moderate-to-high risk of problems at baseline, there were no significant reductions in gambling engagement (t = 0.58, p = .564; t = 1.20, p = .232) or problems (t = 0.92, p = .359; t = 1.53, p = .126) at 2- and 5-months post-restrictions. Findings show only a modest impact of COVID-related supply restrictions on gambling engagement and no impact on gambling problems up to 5 months follow-up. The wide-ranging psychosocial and financial impacts of the pandemic may have overshadowed any potential beneficial effects of the supply restrictions on problem gambling levels. Policies to promote and improve access to problem gambling treatment services are needed even following periods of reduced availability of gambling products.

Changes in the use of alcohol and tobacco in Slovenia during the first wave of the SARS-COV-2 pandemic

Background

In the first months of 2020, the SARS-CoV-2 virus spread all over the world and numerous measures were adopted that had a strong impact on both personal and public life. This contribution explores changes in alcohol and tobacco use during the first months of the COVID-19 pandemic in Slovenia.

Methods

Self-reported changes in alcohol and tobacco use during the first few months of the Covid-19 pandemic were recorded in 495 Slovenian adults, as part of the European Alcohol Use and COVID-19 survey.

Results

About half of the Slovenian sample indicated that the frequency of drinking occasions did not change in the months after the pandemic’s outbreak, while the remainder stated either a decrease (26.0%) or an increase (24.2%). 23.1% reported a decrease and 17.3% an increase in the quantity of alcohol consumed per occasion. Respondents who reported that their overall alcohol consumption decreased were more likely to be male than female and more likely to be younger than middle-aged. Those who reported experiencing at least a substantial level of distress due to financial loss were at a four-times increased risk of reporting an increase in their alcohol consumption compared to individuals who reported no or only some financial distress. Of the 120 people reporting the use of tobacco, almost half indicated an increase in tobacco consumption within the previous month, and about 20% reported a decrease in use. The differences in the results between Slovenia and other European countries are small and the overall pattern suggests that the situation in Slovenia was comparable to other European countries.

Conclusion

As this pandemic continues to evolve, further monitoring is needed to identify the long-term effects of alcohol and tobacco use on public health in relation to the management of COVID-19.