The COVID-19 pandemic has exacerbated a significant public health concern in Canada as alcohol-related deaths and hospitalizations soared. In 2017, alcohol was already a contributing factor to 18,000 deaths and 105,000 hospitalizations. However, the pandemic's onset marked a troubling escalation. Alcohol-related deaths increased by 24%, while hospitalizations saw a 14% rise. The pandemic period highlighted the need for urgent interventions to address the growing alcohol-related harms in Canadian society.
Alcoholic Liver Disease (ALD) emerged as the leading cause of excess mortality and hospitalizations during the pandemic, recording a 22% increase in mortality and a 23% rise in hospitalizations. By region, the Prairie provinces and British Columbia experienced the most significant increases in alcohol-related deaths, at 28.1% and 24.2%, respectively. These alarming trends necessitate a multifaceted response to mitigate the adverse effects of alcohol use.
The demographic breakdown reveals that younger adults bore the brunt of these increases. Those aged 25-44 years witnessed a staggering 55.4% rise in mortality, while individuals aged 15-44 years saw the highest surge in excess hospitalizations. This pattern is further mirrored in retail behavior, as 26% of Canadian adults reported increased alcohol consumption, with 18% engaging in heavy drinking during the pandemic. Retail alcohol sales volume jumped by 2.1% in 2020, marking the largest increase in over ten years.
“Our findings highlight the importance of timely interventions to prevent high-risk drinking from developing into AUD or ALD, both of which demonstrated rising trends before the pandemic and continued at increasing rates during the pandemic,” – Shi
The research underscores the necessity of addressing alcohol-related harms through public health interventions, policies, and appropriate healthcare services. Shi noted that these measures are crucial to prevent high-risk drinking from evolving into more severe conditions like Alcohol Use Disorder (AUD) or ALD.
“Addressing alcohol-related harms may require a multifaceted approach involving public health interventions, alcohol policy and regulation, and appropriate health services.” – Shi
Healthcare providers play a pivotal role in this battle against alcohol misuse. There are significant gaps in care for individuals with AUD, with many patients not receiving evidence-based treatments such as medically managed withdrawal or anticraving medications.
“Research has consistently shown major gaps in care for individuals with AUD, with most patients not receiving evidence-based treatments such as medically managed withdrawal or anticraving medications,” – Shi
Routine screening for alcohol use by healthcare providers is essential. Providers should offer treatment or referrals based on their expertise. Even those with heavy but not disordered drinking could benefit from brief counseling about the adverse health effects of alcohol use.
“Healthcare providers should routinely screen alcohol use and offer treatment or referrals based on their expertise. Individuals with heavy but not disordered drinking may also benefit from brief counseling about the adverse health effects of alcohol use.” – Shi
The study further highlights that all these deaths were preventable. Jürgen Rehm argued that hundreds of deaths and hospitalizations could have been avoided if alcohol had not been designated as an essential good and if control policies had not been relaxed during the pandemic.
“All of these deaths are 100% preventable, and hundreds of deaths and hospitalizations could have been prevented in these 2 years alone if alcohol had not been given the status of an essential good and if alcohol control policies had not been loosened, such as by allowing more home deliveries and widening [alcohol] availability outside of lockdowns,” – Jürgen Rehm
Rehm emphasized the need for more stringent alcohol control policies and better preparation among healthcare providers to handle increased service demand.
“Alcohol control policies should have been adapted, but also healthcare providers should have been better prepared for more service demand,” – Jürgen Rehm
Seasonal patterns also emerged during this period, with an increase in hospitalizations during summer months compared to winter. Between April 2020 and December 2022, alcohol-related deaths rose by 17.6%, with a particularly sharp increase of 24% in 2020 and 2021. These figures equated to an additional 1,596 excess deaths over three years.
While some harms have returned to baseline levels post-pandemic, this research serves as a stark reminder of ongoing challenges.
“Alcohol use was already a major health and societal burden before the pandemic. While harms have returned to baseline, this study is a crucial reminder that much more needs to be done, both from a policy and healthcare perspective, to reduce alcohol-related harms,” – Daniel Myran
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