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Alcohol-related health care visits spiked during pandemic in Ontario: study

A new Ontario study suggests there was a spike in health-care visits related to alcohol during the pandemic, both among people with a history of problems with drinking as well as those confronting issues for the first time.
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A new Ontario study suggests there was a spike in health-care visits related to alcohol during the pandemic, both among people with a history of problems with drinking as well as those confronting issues for the first time.

The study, which used data from research institute ICES, shows a 22 per cent jump in visits to physicians including family doctors, psychiatrists and addiction medicine specialists.

Lead author and Ottawa Hospital family physician Dr. Daniel Myran said the data, collected between March 2020 and May 2021, also show a six per cent increase in hospitalizations.

“These are people who are being hospitalized with alcohol dependence or withdrawal. Or seizures or problems like that,” he said. “Or they’ve drunk enough that you’ve eroded the lining of your stomach, or you’ve given yourself pancreatitis.”

At the same time, there was a 15 per cent drop in alcohol-related emergency-room visits, likely because people generally stopped going to ERs for fear of catching COVID-19 or overwhelming an already stretched health-care system, Myran said.

Much of the rise in out-of-hospital care was done virtually, and that suggests those services should be bolstered to help improve access for people struggling with alcohol use, said Myran, a researcher at ICES.

“It could be that people who before would have never sought care or would have been delayed in seeking care found that the change in virtual care delivery was easier to access. So that becomes a question of, is maintaining or improving access to virtual care for alcohol and substance use an important piece of the policy puzzle?”

The study, published this week in the Canadian Journal of Public Health, suggests pandemic-related stress caused a rise in alcohol-related health problems for those who did not have any pre-existing issues, as well as those who had already been dealing with alcohol use disorder but lacked access to in-patient addiction treatment services, Myran said.

Increased availability of alcohol during the pandemic while other services were shut down may have influenced people to drink more, and for some people that behaviour will persist, he said.

“You had rules before against the home delivery of alcohol that have been rolled back. And in many cases those are here to stay.”

However, new guidance on alcohol use by the Canadian Centre on Substance Use and Addiction could help some people to consider their level of consumption due to evidence about alcohol-related cancer and heart disease with increased use, Myran said.

The CCSA’s guidance says no amount of alcohol is safe, and low-risk consumption amounts to two standard drinks per day.

“I hope the guidance is part of a broader conversation about harms from alcohol,” Myran said. “I think it has certainly fostered increased awareness.”

Getting help for alcohol use disorder may be fraught with barriers for some people, especially if they do not have a family doctor, he said.

“Compounding that, there’s a problem of access to addiction services and treatment, which are hard to access for a variety of reasons.”

“I see this clinically, that you have people looking for help with addiction and detox from alcohol. If they’re a case where they need medical management, it’s not always possible to start treatment immediately. And that’s a shame. We should have improved access to treatment, but the services are available. It can just take time.”

Data released by Statistics Canada in February 2022 says liquor authorities sold the equivalent of 9.7 standard alcohol beverages a week per Canadian of legal drinking age in 2020/2021. That was up by just over two per cent from a year earlier.

“Overall, $25.5 billion worth of alcoholic beverages were sold in the fiscal year ended March 31, 2021, up 4.2 per cent from a year earlier. This was the largest sales increase in over a decade. Most of the liquor authorities attributed this growth to the pandemic and its impact on purchasing habits,” the agency said in a release.

It has conducted a series of online surveys since the beginning of the pandemic, including one in the last week of January 2021 that asked about changes in alcohol consumption.

Among Canadians who had previously consumed alcohol, 24 per cent believed their use had increased, compared with before the pandemic, Statistics Canada said in a March 2021 release.

“Those who had increased their alcohol consumption during the pandemic were most likely to report frequent heavy drinking,” it said, adding 36 per cent of respondents had five or more drinks on one occasion at least once a week in the previous 30 days.

Respondents to a survey in March and April 2020 cited boredom, stress and isolation as factors for their higher consumption of alcohol.

At the provincial level, Ontario had the greatest increase in reported alcohol consumption, at 30 per cent, following by the Prairie provinces, at 27 per cent.