Dr. Sara McEwen, Executive Director, Governor’s Institute

The COVID-19 pandemic has dramatically increased the prevalence and acuity of substance use disorders (SUD) in North Carolina and the nation. The effect on opioid overdose deaths in North Carolina is well documented: overdose death rates increased 40% between the 12-month period ending 2019 and the 12-month period ending 2020, and preliminary data indicate this trend has only gotten worse. Less well known is the marked increase in excessive alcohol use and related harms during this period.

Excessive alcohol use prior to COVID-19 was already problematic, warranting selection as one of the targeted outcome measures for Healthy North Carolina 2030.

Excessive use includes exceeding weekly drinking limits (> 7 drinks for women/men aged 65+ years and > 14 drinks for men aged < 65), binge drinking (> 3 drinks for women/men aged 65+ years on one occasion and > 4 drinks for men aged < 65 on one occasion), and any drinking in pregnant women and youth under 21. Ninety percent of individuals with excessive use are not alcohol dependent but instead exceed weekly drinking guidelines or engage in binge drinking. Excessive drinking is associated with over 200 diseases and injury related health conditions (including COVID-19 requiring hospitalization or causing death) and places the individual at risk for developing alcohol dependence.

Beginning in Spring 2020 alcohol use in North Carolina and across the nation increased dramatically as stay-at-home orders were instituted. A RAND national study published in 2020 provided evidence of changes in alcohol use and associated consequences. The study documented that compared with 2019 baselines, frequency of alcohol consumption increased 14% overall, and that for adults aged 30–59 years, drinking increased 19%. This same study reported a 41% increase in heavy drinking days for women.

Read the full article in the North Carolina Medical Journal: https://www.ncmedicaljournal.com/content/83/4/280