Substance Use Blog Series: Alcohol and COVID-19
Today’s post is about increase in alcohol consumption during the COVID-19 pandemic. This post will share data that is available so far, factors that have been contributing to increased urges to drink, and some tips for how to manage these increased urges. We are all coping with unprecedented stress in one way or another, but to varying degrees depending on our circumstances. We want to acknowledge right off the bat that it absolutely makes sense for many of us to be craving relief from the different types of stress that come with COVID-19. We want to normalize that response, while offering other tools for coping with this stress for anybody who is concerned about their increasing drinking and wants to change it. If you are curious, you can read more about how substance use urges interact with stress here.
Statistics
The Canadian Centre on Substance Use and Addiction presented two webinars on this topic mainly keeping policy in mind, and provided the following information.
- Since COVID-19 has started, 90% of people have reported drinking as much or more often than they did previously, and 20% of people reported drinking more often consistently.
- General substance use and mental health struggle rates have been increasing since the onset of COVID.
- Alcohol sales between March and November 2020 are up by 7.7% when compared to 2019.
- When the pandemic began, the World Health Organization recommended that regulations related to alcohol use should either restrict along with other non-essential services, or “not relax,” citing the generally successful implementation of this plan in South Africa which resulted in a dramatic decrease in unnatural deaths, assaults, and accidents [1].
- It went the other direction however, with alcohol becoming more accessible than before. An example of these regulations being relaxed is how restaurants are now permitted to include cocktails or other alcoholic beverages as part of delivered meals.
It is worth mentioning that while this recommendation was made to try mitigating risks associated with rising alcohol use and has been successful in other regions, suddenly restricting access to alcohol could be a risk in itself as it could be dangerous to those who are physically dependent on alcohol.
- It went the other direction however, with alcohol becoming more accessible than before. An example of these regulations being relaxed is how restaurants are now permitted to include cocktails or other alcoholic beverages as part of delivered meals.
These increases in alcohol use also have other affects in light of COVID; in the short-term, alcohol increases susceptibility to respiratory infections, and is associated with recent increases in intentional injuries such as domestic violence and self-harm. These statistics are all Canada specific, and globally, alcohol contributes to 20% of injury and 11.5% of non-injury related emergency room visits [2].
Why we may be turning to alcohol more
Some studies run by the Canadian Centre on Substance Use and Addiction have looked at factors contributing to these increases in alcohol use.
In one of these studies based on self-reports, 51% of people said they were drinking more often because of the lack of a regular schedule, 49% stated it was due to boredom, and 44% said it was due to stress.
In a study investigating the relation between COVID 19 related distress and substance use, they found that 54.4% of people reported a significant psychological impact in a way that relates to increased substance use.
It is not surprising that people are looking for relief and some way to mitigate the sudden changes and discomfort, and this post is meant to provide information regarding the way these numbers have risen, not to express any shame toward anybody who has been using substances more often. We are dealing with some incredibly difficult times and are all trying to cope in our own ways. While acknowledging this, these numbers are definitely cause for concern however, especially for as long as these predictive factors (lack of schedule, boredom, and stress) continue.
Substance use and life circumstances
Exploring the relationship between life circumstances and substance use rates and patterns is not new. Gabor Maté is a doctor who works with people experiencing substance use concerns and has done many talks that are available online on this subject.
He writes that “all drugs – and all behaviours of addiction, substance-dependent or not, whether to gambling, sex, the internet or cocaine – either soothe pain directly or distract from it. Hence my mantra: The first question is not “Why the addiction? But “Why the pain?”” [3]
It can be easy to address substance use challenges from a habitual or scientific perspective where the focus is only on managing symptoms, but that is never the whole story. It is a very important part of the story, but life circumstances always play a role in any struggle, and in the case of substance use, often involves self-medicating for something else that is going on. We are going to explore this topic more in future blog posts, but we are mentioning it here mainly to validate the felt desire to self-medicate. It is understandable to feel overwhelmed and want relief. That’s why we are going to talk about some tools for managing a newfound desire to self-medicate, for the sake of exploring other methods of managing pain and discomfort.
We would like to link you to this post which provides substance use resources in Delta, this post which provides detox resources, and this post which provides youth resources. The following tips may be helpful to everybody, but are not meant for individuals who are severely struggling and need immediate help. If you do, there are supports available, and if you are unsure how to navigate all these resources, call the Substance Use Services team at Deltassist and we can help narrow down the process. Reach us at (604) 594-3455, ext. 108.
The Replacement Technique
If you have found yourself drinking more in order to cope with the pain and discomfort involved with COVID-19, simply cutting yourself off of alcohol and doing nothing else is unlikely to get to the root of the problem, and you may end up disappointed.
If you think about it, you are drinking in order to meet some kind of need. It is not only a developing chemical dependency, because if it was, there would be no reason to start in the first place. The following reflection questions are based on a technique described by Darien Thira in a Community Wellness & Healing workshop called “From Wound to Wellness” [4]. This technique is not specific to alcohol, although I describe it that way here to maintain relevance, and I have added some COVID-19 specific points based on what has already been explored in this post.
The writer of this technique conceptualizes misuse of substances as a way to feel better, and as a source of self-worth as well as an attempt to live a worthwhile life.
It is important to acknowledge these roots of developing alcohol use, and to find a replacement behaviour that also addresses the need alcohol has been meeting, but one that better serves your ongoing wellness. Start by taking these steps:
1. Identify the purpose the problem behaviour is serving.
– When you pour that first drink, what is the motivation beyond simply “chemically craving a buzz”?
– These may line up with the Canadian studies’ results we went through earlier. The purpose may be to alleviate boredom, cope with stress, or fill the time in a schedule that is unfamiliarly inconsistent. Other common purposes can be: a distraction from felt purposelessness, or a felt sense of accompaniment. Take note of what purpose is underlying your emerging alcohol use.
2. Identify the advantages and disadvantages of the problem behaviour
– First explore the benefits of the behaviour, then the cons. Jumping to the cons immediately may bring up feelings of shame which could interfere in the process. Benefits will likely be related to the purpose of the behaviour, such as an escape from a feeling of a purposelessness, a sense of enjoyment in place of boredom, or soothing for the stress of uncertainty regarding the future. After acknowledging the advantages, approach the cons in a non-judgmental way. Consider why it is a problem for you, and how it has impacted you in a negative way. Again, the goal is not to berate yourself for ending up in this spot, but to take note of the ways drinking is not serving you or is taking up space that could be filled with more sustainable, and enriching activities.
3. Identify a replacement behaviour that has less disadvantages and/or more advantages.
– Find a behaviour that meets the same need alcohol has, or that serves a similar purpose. If going by the examples above, feeling less alone could be replaced by finding a new group to meet with who shares your values (Psst, meetup.com is great for this), choosing to develop a connection with nature, or focusing on your spirituality if that is part of your identity. Distraction from felt purposelessness could be replaced with finding a way to contribute to your community, or engaging in cultural practices that foster a sense of purpose.
Of course some of these replacement possibilities contain barriers due to COVID-19, and there is no magic fix for this. That is why it’s important to be creative when thinking of replacement behaviours and focus on aspects of enrichment that you do have control over.
It’s also important to acknowledge your own feelings of grief while practicing this technique, and know that the replacement behaviours likely won’t have the same immediate affect as alcohol. When facing frustration associated with this, it may be important to remind yourself of the sustainable nature of the replacement behaviours in the long run that will contribute to your wellness in more meaningful ways than relying primarily on alcohol.
The Canadian Institute for Substance Use Research have put together this infographic which includes more tips for Safer Drinking during COVID-19:
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[1] Reuter, H., Jenkins, L. S., Jong. M. D., Reid, S., & Vonk, M. (2020). Prohibiting alcohol sales during the coronavirus disease 2019 pandemic has positive effects on health services in South Africa. Afr J Prim Health Care Fam Med, 12(1): 2528. [2] Stockwell, T., Andraesson, S., Cherpitel, C., Chikritzhs, T., Dangardt, F., Holder, H., Naimi, T.,& Sherk, A. (2020). The burden of alcohol on health care during COVID-19. Drug and Alcohol Review. [3] Maté, G. (2008). In the realm of hungry ghosts: Close encounters with addiction. Toronto: Knopf Canada. [4] Thira, D. (2018). From wound to wellness: Community wellness & healing workshop participant manual. Darien Thira Consulting. www.thira.ca
