A new study reveals a 17.6% increase in alcohol-related mortality and an 8.1% rise in hospitalizations from April 2020 to December 2022, with the sharpest increases among younger adults and in Western Canada. Experts call for urgent public health interventions.

Study: Mortality and hospitalizations fully attributable to alcohol use before versus during the COVID-19 pandemic in Canada. Image Credit: Ground Picture/Shutterstock.com

Could the coronavirus disease 2019 (COVID-19) pandemic have fueled an invisible crisis? As COVID-19 upended daily life, alcohol consumption in Canada surged, raising concerns about its long-term consequences.

A recent study published in the Canadian Medical Association Journal investigated the contribution of increased drinking during the pandemic to alcohol-related deaths and hospitalizations, shedding light on how the pandemic altered the landscape of substance use and public health.

Alcohol consumption

Alcohol-related health issues were already a significant public concern in Canada even before the onset of the COVID-19 pandemic. In 2017, alcohol use contributed to approximately 18,000 deaths and over 100,000 hospitalizations.

Research has long established that increases in population-level alcohol consumption can lead to higher rates of alcohol-related harm, including liver disease, poisoning, and dependence.

During the early months of COVID-19, the stress, social isolation, and disrupted routines contributed to increased alcohol use. Retail alcohol sales rose sharply in 2020, marking the largest increase in a decade.

Furthermore, with public health restrictions limiting social drinking in bars and restaurants, at-home consumption became more prevalent.

At the same time, access to healthcare services, including primary care screenings for alcohol use disorders, declined. However, the extent of the pandemic’s impact on alcohol-related hospitalizations and mortality remained hitherto unclear.

About the study

To assess the pandemic’s impact on alcohol-related deaths and hospitalizations, a team of Canadian researchers conducted an interrupted time series analysis using national health data.

They examined mortality and hospitalization records from January 2016 to December 2022, using the national databases for vital statistics and hospital discharge records.

The study focused on people above the age of 15 years and identified various health conditions that were a result of alcohol use, such as alcohol dependence, alcoholic liver disease, and alcohol poisoning.

The researchers employed numerous statistical models to estimate expected monthly rates of alcohol-related deaths and hospitalizations. These models accounted for trends, seasonal variations, and pandemic waves to determine excess rates from April 2020 to December 2022. The analysis compared observed data to projections based on pre-pandemic trends.

The study also explored variations across demographic groups, including age, sex, income level, and geographic region. For socioeconomic status, neighborhood income quintiles based on census data were used.

The pandemic months were categorized into three time periods: T1 (between April and August 2020), T2 (from September 2020 to August 2021), and T3 (from September 2021 to December 2022), corresponding to different COVID-19 waves.

By isolating alcohol-attributable conditions from other health impacts of the pandemic, the study aimed to elucidate the effects of pandemic-associated increased alcohol consumption on the overall health of Canadians.

Major findings

The study found that alcohol-related deaths and hospitalizations significantly increased during the pandemic. Canada recorded a 17.6% rise in alcohol-attributable mortality, with an estimated 1,600 excess deaths during the April 2020 to December 2022 period. Hospitalizations linked to alcohol also rose by 8.1%, translating to more than 7,100 additional hospital admissions.

However, the burden of excess mortality was not evenly distributed across demographics. The sharpest increase in alcohol-related deaths occurred among adults aged 25 to 44, with a staggering 55.4% rise.

Mortality rates were also elevated in the 45–64 age group (19.1%) but showed only a slight increase (2.6%) in those over 65 years. Excess hospitalizations followed a similar pattern, with the highest increase seen in younger adults, particularly among those between the ages of 15 and 24 (20.3%) and 25 and 44 (13.1%).

Regionally, alcohol-related deaths surged the most in the Prairie provinces of Alberta, Manitoba, and Saskatchewan (28.1%), followed by British Columbia (24.2%).

The territories experienced the highest surges in hospitalizations, with a 27.3% increase, followed by the Prairie provinces, which cumulatively saw a 14.6% increase in hospitalizations.

Alcoholic liver disease emerged as the major cause of excess deaths and hospitalizations, with an increase of 22% and 23%, respectively. While alcohol use disorder also contributed to the rise, deaths from alcohol poisoning declined by 10%.

The study also revealed an income disparity in alcohol-related mortality. Although excess deaths ranged from 17% to 21.5% across most income groups, they were lowest among the highest-income individuals (11.7%), suggesting that socioeconomic factors influenced the vulnerability to alcohol-related harm.

These findings highlighted the COVID-19 pandemic’s role in exacerbating alcohol-related health issues and stressed the need for enhanced prevention, education, and treatment strategies to address long-term public health consequences.

Conclusions

To summarize, the results reported that there was a significant and concerning increase in alcohol-related deaths and hospitalizations in Canada during the pandemic, particularly among younger adults and lower-income groups.

Furthermore, with alcoholic liver disease driving much of this surge, urgent interventions are needed to address high-risk drinking and its long-term health impacts.

The team believes that strengthening public health policies and expanding access to treatment will be essential in mitigating the lingering effects of pandemic-induced alcohol consumption.