How Pandemic Stress Fueled America’s Growing Alcohol Problem

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Man COVID Pandemic Alcohol — A new study finds that heavy drinking among American adults increased more than 20% during the peak of the COVID-19 pandemic and continued for the following two years.

A USC study shows a significant rise in alcohol consumption during the COVID-19 pandemic that persisted into 2022.

This increase was seen across most demographics with adults aged 40-49 experiencing the most notable surge. The ongoing high rates of alcohol use pose serious public health risks, highlighting the need for increased screening and intervention efforts.

Alcohol use in the United States rose significantly during the COVID-19 pandemic and stayed high even after the pandemic officially ended. This is according to a large, nationally representative study by Keck Medicine of USC, published on November 12 in the Annals of Internal Medicine.

Between 2018 (pre-pandemic) and 2020 (pandemic peak), heavy drinking among Americans increased by 20%, while general alcohol use rose by 4%. By 2022, these higher levels of alcohol use persisted.

Demographic Analysis of Increased Alcohol Consumption

The increase was widespread, affecting all age groups, genders, races, ethnicities, and regions, except for Native Americans and Asian Americans. Adults aged 40-49 showed the highest rise in heavy alcohol use.

“These numbers reflect an alarming public health issue that could result in severe health consequences for far too many people,” said Brian P. Lee, MD, MAS, a hepatologist and liver transplant specialist with Keck Medicine of USC and principal investigator of the study. “Our results suggest men and women under 50 are at special risk.”

Brian Lee — Dr. Brian P. Lee, MD, MAS, is a hepatologist and liver transplant specialist with Keck Medicine of USC and principal investigator of the study. Credit: Dr. Brian P. Lee, MD, MAS

Health Impacts of Rising Alcohol Use

Excessive alcohol use is one of the leading preventable causes of illness and death in the United States, as reported by the Centers for Disease Control and Prevention (CDC). According to Dr. Lee, alcohol accounts for half of all liver-related deaths and is now the top cause of liver transplants due to alcohol-related cirrhosis.

To reach their conclusions, researchers studied data from the National Health Interview Survey, one of the largest and most comprehensive health surveys in the country. The survey collected alcohol use information as well as demographic and socioeconomic data for more than 24,000 adults age 18 or older. They compared 2018 with 2020 alcohol use numbers, then 2018 with 2022.

Pandemic and Post-Pandemic Drinking Behaviors

While the U.S. Department of Health and Human Services announced the official end of the pandemic in May 2023, the study defined the year 2022 as post-pandemic, as behaviors were beginning to return to normal.

Adults were characterized as having any alcohol use or heavy alcohol use within one year of the survey, and researchers calculated the rate of both measures of alcohol use. Heavy drinking was defined as greater than or equal to five drinks a day or 15 drinks a week for men, and greater than or equal to four drinks a day or eight drinks a week for women.

The study did not analyze why there was an increase in alcohol consumption between 2018 to 2022, but Lee hypothesizes that pandemic stress may have caused drinking to become more normalized. He further speculates that the effects of the pandemic, including disruptions to school and work, may have driven the increases in alcohol use in adults ages 40-49.

Lee hopes the study will bring more awareness to the issue. “We encourage health care providers to offer more screenings for harmful drinking as well as interventions for at-risk populations,” he said.

For more on this study, see Why We’re Drinking More: The Pandemic’s Lasting Effect on Alcohol.

Reference: “Trends in Alcohol Use After the COVID-19 Pandemic: A National Cross-Sectional Study” by Divya Ayyala-Somayajula, MD, Jennifer L. Dodge, MPH, Adam M. Leventhal, PhD, Norah A. Terrault, MD, MPH, and Brian P. Lee, MD, MAS, 12 November 2024, Annals of Internal Medicine.
DOI: 10.7326/ANNALS-24-02157

Divya Ayyala-Somayajula, MD, from Thomas Jefferson University in Philadelphia, was lead author of the study.

Jennifer Dodge, MPH, an associate professor of research medicine and population and public health science at the Keck School of Medicine of USC, Adam Leventhal, PhD, professor of population and public health sciences at the Keck School and director of the USC Institute for Addiction Science, and Norah Terrault, MD, a Keck Medicine gastroenterologist and division chief of gastroenterology and liver diseases at the Keck School, were also study authors.