Pandemic spike in healthcare visits due to alcohol equal for individuals with or without history of alcohol problems

31/01/2023

Relative increases in healthcare visits due to alcohol during the COVID-19 pandemic were the same for individuals with and without a history of alcohol problems, according to a new study using ICES data.

Public health concerns about alcohol use and harms related to drinking escalated during the pandemic, as surveys and alcohol sales data suggested an increase in alcohol consumption. Data from the start of the pandemic also found a spike in hospitalizations related to alcohol, although it is unclear whether these harms were concentrated in individuals who had pre-existing problems with alcohol use.

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“A number of studies have found that Canadians on average purchased and drank alcohol during COVID-19 at greater rates than normal,” says lead author and ICES Trainee Daniel Myran, who is also a family physician and Canadian Institutes for Health Research Fellow at The Ottawa Hospital. “Our data highlights substantial increases in healthcare visits in Ontario directly caused by alcohol and suggests that we are already seeing negative health consequences.”

This study comes as recent guidelines for low-risk alcohol drinking show that each additional standard drink per week radically increases the risk of alcohol-related consequences such as cancer, heart disease, and stroke.

Published in the Canadian Journal of Public Health, the researchers conducted cross-sectional analyses of health administrative data to identify individuals with and without one or more health service encounters (outpatient visits, ED visits, and hospitalizations) due to alcohol in past the two years.

The data showed that:

Overall, during the first 15 months of the pandemic, there was a 22% increase in outpatient visits for severe alcohol use, a 15% decline in ED visits due to alcohol, and a 6% increase in hospitalizations due to alcohol
The relative increases in healthcare visits due to alcohol during COVID-19 were the same for individuals with and without a pre-pandemic history of alcohol problems.
The largest increases in alcohol-related health visits were outpatient visits.

“Surprisingly, we found that increases were fairly universal for people who had and had not received healthcare for alcohol pre-pandemic. This suggests that the pandemic both worsened alcohol use and harms for people already really struggling with alcohol use and led to increases in first-time issues with alcohol,” says Dr. Myran.

The researchers suggest that the increase in outpatient visits could be related to improved access to treatment and reduced stigma of seeking care, after the widespread rollout of virtual care during the pandemic.

The findings underscore the need for public health strategies that promote population-level changes in alcohol use behaviours across the entire population, in addition to strategies that target higher-risk drinkers.

“Our findings suggest that continuing to offer virtual care services may help improve access for individuals struggling with their alcohol use who historically have faced substantial barriers to treatment,” says Dr. Myran.

The study, “Changes in health service use due to alcohol during the COVID-19 pandemic among individuals with and without pre-existing alcohol-related medical diagnoses” was published in the Canadian Journal of Public Health.

Author block: Myran D, Friesen EL, Pugliese M, Milani C, Kurdyak P, Saraswat M, Tanuseputro P.

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario

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