Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the US | Infectious Diseases | JAMA Network Open | JAMA Network
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    1 Comment for this article
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    Awareness is a start, action comes next
    Eileen Barrett, MD, MPH | University of New Mexico
    I read this article with interest, including the recommendation that health systems may need to provide education about increased alcohol use. I agree that education of patients, clinicians, and communities is indicated, but would also recommend strongly health systems strengthen the mental health care infrastructure and work with elected officials on public health strategies, and that individual clinicians become familiar with treatment for excess alcohol use.

    The Centers for Disease Control and Prevention recommends enforcing existing laws to curtail the sale of alcohol to underage individuals; building coalitions between schools, public health agencies, health care and others to reduce
    excessive alcohol use; increasing taxes on alcohol; limiting the hours when alcohol can be purchased; and limiting quantities of purchases in the same day. These steps are effective in many states and municipalities to reduce unhealthy alcohol use, and should be adopted widely. These steps, in partnership with expanding access to mental health care, can help reduce harm to individuals during COVID and beyond.

    Additionally, all clinicians should understand alcohol and other substance use disorders as chronic illnesses rather than personal failings and should seek to treat these patients just as we treat others with chronic illnesses: with evidence-based medicine. A meta-analysis by Kranzler and Soyka published August 28, 2018 in JAMA Psychiatry evaluated all drugs studied for alcohol use disorder used on- or off-label (including disulfiram, naltrexone, acamprosate, topiramate, gabapentin, baclofen, and others). This paper concluded that acamprosate and naltrexone are the very effective albeit underutilized in reducing excess alcohol use. These medications are generic, safe, and effective, and all clinicians with a longitudinal relationship with patients should become more familiar with their use and prescribe them to patients with alcohol misuse.
    CONFLICT OF INTEREST: None Reported
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    Research Letter
    Substance Use and Addiction
    September 29, 2020

    Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the US

    Author Affiliations
    • 1RAND Corporation, Santa Monica, California
    • 2Indiana University School of Public Health, Bloomington, Indiana
    JAMA Netw Open. 2020;3(9):e2022942. doi:10.1001/jamanetworkopen.2020.22942

    As stay-at-home orders began in some US states as a mitigation strategy for coronavirus disease 2019 (COVID-19) transmission, Nielsen reported a 54% increase in national sales of alcohol for the week ending March 21, 2020, compared with 1 year before; online sales increased 262% from 2019.1 Three weeks later, the World Health Organization warned that alcohol use during the pandemic may potentially exacerbate health concerns and risk-taking behaviors.2 This study examines individual-level changes in alcohol use and consequences associated with alcohol use in US adults, as well as demographic disparities, from before to during the COVID-19 pandemic.

    In this survey study, data were collected using the RAND Corporation American Life Panel (ALP), a nationally representative, probability-sampled panel of 6000 participants age 18 years or more who speak English or Spanish; data are weighted to match a range of national demographic characteristics.3 Panel members provide informed consent annually online. All procedures were approved by the RAND Corporation Human Subjects Protection Committee. A sample of 2615 ALP members ages 30 to 80 years was invited to participate in the baseline survey (wave 1), which was closed after 6 weeks (April 29-June 9, 2019) with 1771 completions. Wave 2 data were collected from May 28 to June 16, 2020, several months after widespread implementation of COVID-19–associated social distancing. This study followed the American Association for Public Opinion Research (AAPOR) reporting guideline for survey studies.

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