Alcohol-related deaths and hospitalizations increased significantly during pandemic

Alcohol-related deaths increased 18% during the pandemic, as did hospitalizations related to alcohol use, according to new research in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.241146.

In the early part of the pandemic, retail alcohol sales volume in Canada increased by 2% (2020/21 v. 2019), the highest increase in 10 years, despite few international visitors. More than 1 in 4 people (26%) reported drinking more, and 18% reported heavy drinking (defined as ≥ 5 drinks for men, ≥ 4 for women in a single sitting). 

To understand the effect of changing patterns of alcohol use during the pandemic, researchers looked at deaths and hospitalizations between 2016 and 2022, comparing a prepandemic period and a pandemic period. They found that deaths from alcohol use increased about 18% over the 3-year period, with higher increases mainly in 2020 and 2021 (about 24%), resulting in 1600 more deaths than expected. Alcohol-related hospitalizations also increased 8% over the pandemic period studied, with higher increases (about 14%) in 2020/21.

"The 1596 excess deaths and 7142 excess hospitalizations fully attributable to alcohol we observed in Canada during the pandemic period that we studied speak to the substantial harms of increased alcohol consumption that can occur given circumstances and availability, and speak to the need for robust interventions," writes Dr. Yipu Shi, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, with coauthors.

There were regional variations, with the highest increases in deaths in the Prairie provinces (28%) and in British Columbia (24%), excess rates 3 times higher than in Ontario and the Atlantic provinces, and 6–7 times higher than in Quebec. Hospitalizations were also higher in the Prairies and especially in the territories. Younger adults had the highest increases in both excess deaths (age 25–44 yr) and hospitalizations (age 15–44 yr).

Deaths and hospitalizations were largely due to alcoholic liver disease (ALD) and alcohol use disorder (AUD). As increases in hospitalizations were 3 times higher in females, the authors suggest this could be an early warning of future liver-related disease in this group.

These findings echo those from other countries, including the United States, which had a 29% increase in alcohol-related deaths (2020/21), and Europe (18%).

Increased alcohol consumption may have been driven by stress, boredom, deteriorating mental health, and other factors, including easier access to alcohol.

"Our findings highlight the importance of timely interventions to prevent high-risk drinking from developing into AUD or ALD. A comprehensive approach to preventing and managing high-risk drinking, AUD, and ALD in the aftermath of the pandemic should comprise both public health and clinical management interventions," the authors conclude.