Study shows link between alcohol sales and alcohol-related hospital admissions during COVID-19 pandemic
When the COVID-19 pandemic was declared five years ago, social distancing, restrictions on gathering and uncertainty abounded. So did stockpiling purchases like canned food, toilet paper and, as a new study from researchers at Sunnybrook Health Sciences Centre and University of Toronto shows, alcohol. In Ontario, as alcohol sales rose steadily in the first 24 months of the pandemic, so too did overall alcohol-related emergency department (ED) visits and hospital admissions.
The findings, published in NEJM Evidence this week, point to a trend towards a significant increase in alcohol use and alcohol-related harms in the first two years of the pandemic, and the potential for persistent, long-term negative health outcomes for years to come.
“We studied alcohol sales in Ontario from March 2020 to 2022 and compared it to the years before the pandemic, and we found that alcohol sales were higher during the pandemic,” says Dr. Wid Yaseen, a clinical fellow in General Internal Medicine at Sunnybrook and lead author on the study.
“We then also looked at alcohol-related harms, like hospital visits to the emergency department, admissions and deaths from alcohol toxicity, and we found that there were higher rates of all of these alcohol-related harms.”
In the first year of the pandemic alone, alcohol sales in Ontario increased by more than half a billion dollars, equating to approximately $1.5 million in excess alcohol purchasing each day across the province.
“We know that data on alcohol purchasing is a reliable surrogate for people’s use,” Dr. Jonathan Zipursky, study senior author and clinician-scientist at Sunnybrook, explains. As a general internist, he recalls noticing an uptick in the number of patients he’d see for alcohol-related health concerns over the course of the pandemic.
“We often care for patients who have alcohol withdrawal or other medical effects from alcohol-use disorder,” he says. “But we were seeing more patients coming in with uncontrolled alcohol use and alcohol withdrawal.”
The research picks up from a study published in 2021 that shows the same increases in alcohol purchasing, but with a marginal decrease in alcohol-related emergency visits in the first four months of the pandemic.
“In the beginning of the pandemic, people were anxious about seeking medical care. Several months later, as we entered the summer, we went back up to baseline, if not higher,” Dr. Zipursky says.
Using data on alcohol-related ED visits and hospital admissions compiled from the Ontario Ministry of Health and alcohol sales information from the Liquor Control Board of Ontario (LCBO), the research team compared the March 2020 to February 2022 period with the four-year pre-pandemic period preceding it. In addition to a significant increase in alcohol sales, the research team saw a seven per cent increase in alcohol-related ED visits over the first two years of the pandemic, as well as a 21 per cent increase in alcohol-related hospital admissions and 33 per cent increase in alcohol toxicity deaths.
Beyond the measurable outcomes of alcohol use during the pandemic, the researchers have expressed concern over the risks of long-term alcohol use, such as alcohol use disorder, organ damage and certain cancers, which may only become evident after a number of years of increased alcohol use.
“It's important for people to have a check-in with their primary care provider, to review their health and their pattern of alcohol use,” Dr. Yaseen says.
“This is a concerning two-year window where we saw increases in alcohol purchasing, increases in alcohol-associated harms, and don’t know what is going to happen in the future,” Dr. Zipursky adds.
“People need to know that there are services available if they are suffering. There are addictions medicine clinics here at Sunnybrook, around the city and province to reach out to if their alcohol intake is more than it should be.”
If you are seeking support, the Sunnybrook Rapid Access Addiction Medicine (RAAM) Clinic is a non-urgent and short-term service that supports patients with a history of alcohol or drug use seeking addictions treatment for the first time, or who have recently relapsed and are not connected with any treatment service.
