key: cord-0723344-akar9kma
authors: Clay, James M; Parker, Matthew O
title: Alcohol use and misuse during the COVID-19 pandemic: a potential public health crisis?
date: 2020-04-08
journal: Lancet Public Health
DOI: 10.1016/s2468-2667(20)30088-8
sha: 8736b209fc2e1f779542423d2c03c6ac89f4b3e7
doc_id: 723344
cord_uid: akar9kma

nan

Stress is a prominent risk factor for the onset and maintenance of alcohol misuse. For example, chronic alcohol use results in neuroadaptations in stress and reward pathways, which lead to dysfunctional hypothalamic pituitary adrenocortical and sympathetic adrenomedullary axes, characterised by dysregulation of the cortisol response and deficits in emotional regulation. 2 In turn, these neuroadaptations lead to increased cravings for alcohol in response to stress. The effects of long-term social isolation on stress levels, including increased neuroendocrine responses and stress reactivity, have been described in non-human animals. 3 However, the ongoing lockdowns across many countries are unique and little is known of the effects on the general population of chronic isolation (with respect to health and wellbeing) in these circumstances A risk factor for the onset and maintenance of alcohol misuse and alcohol use disorder is trait impulsivity (ie, the tendency to take risks or act without adequate forethought or reflection). Impulsivity can moderate stress-induced consumption of alcohol 4 and is also associated with relapse in addicted individuals. 5 Thus, this period of isolation might lead to a spike in alcohol misuse, relapse, and potentially, development of alcohol use disorder in at-risk individuals, therefore placing further strain on addiction and drug and alcohol services, and the health service in general, during and after the pandemic.

Most governments, including the UK Government, have responded to the COVID-19 pandemic by advising the public to remain indoors, avoid unnecessary social contact, to protect themselves and health-care systems, and to save lives. We suggest that, as well as this important public health advice, governments should give public health warnings about excessive alcohol consumption during isolation to protect vulnerable individuals.

We declare no competing interests.

Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Geneva: World Health Organization

Stress, dysregulation of drug reward pathways, and the transition to drug dependence

Effect of social isolation on stress-related behavioural and neuroendocrine state in the rat

The role of stress-reactivity, stress-recovery and risky decision-making in psychosocial stress-induced alcohol consumption in social drinkers

Genetic influences on impulsivity, risk taking, stress responsivity and vulnerability to drug abuse and addiction