Alcohol and Substance Use

Increased stress can lead to increases in alcohol and substance use. If you or someone you care about is starting to use alcohol or other substances, or is increasing their use during the COVID-19 pandemic, here are a few suggestions that may help:

• Contact your healthcare provider.
• Locate virtual treatmentexternal icon and recovery programs pdf icon[244 KB, 3 pages]external icon.
• Medication-assisted treatmentexternal icon for alcohol or opioid use disorders may be an option.
• Take medicine as prescribed and continue your therapy, treatment, or support appointments (in person or through telehealth services) when possible.
• Call the National Drug and Alcohol Treatment Referral Routing Service (1-800-662-HELP) to speak with someone about an alcohol or substance use problem.

What you can do

• Consider healthier options for stress and coping such as exercise, meditation, or reaching out to friends and family.   

What states and communities can do

Support evidence-based prevention of excessive drinking. Greater availability and accessibility of alcohol is linked with excessive alcohol drinking. Many states and communities are providing additional options for delivery and takeaway of alcoholic beverages. The Community Preventive Services Task Forceexternal icon recommends limiting the availability of alcohol to lower excessive alcohol use and its impacts. It also recommends enforcing laws that prohibit sales to minors, which may be difficult with home delivery of alcohol.  

What healthcare providers can do

• Screen all adult patients for excessive drinking.
• Advise patients who screen positive for drinking too much to drink less (and refer people who might have an alcohol use disorder to specialized treatment).
• Screen all adults for substance use and refer people who might have a substance use disorder to specialized treatment.

Basics of excessive alcohol use

Drinking too much can be harmful to your health. Most people who drink excessively are not alcoholics or alcohol dependent. Excessive alcohol use includes binge drinking, which is defined as five or more drinks on an occasion (within two or three hours) for men, and four or more drinks on an occasion (within two or three hours) for women. Other forms of excessive alcohol use include heavy drinking (15 or more drinks a week for men, eight or more drinks a week for women), and any drinking by pregnant people or people younger than 21 years. Excessive alcohol use leads to more than 95,000 deaths each year in the United States.

Excessive alcohol use increases the risk for violence, injuries, and motor vehicle crashes. It can also increase the risk of long-term health issues such as liver disease, cancer, heart disease, stroke, high blood pressure, and birth defects.

• Drinking alcohol:
  • May increase anxiety, depression, or other mental health.
  • Increases the risk of family problems and violence.
  • May alter your thoughts, judgment, and decision-making.
  • Worsens sleep quality, which makes it more difficult to deal with stress.
• To reduce the risk of alcohol-related harms, the 2020-2025 Dietary Guidelines for Americansexternal icon recommends that adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed. The Dietary Guidelines do not recommend anyone start drinking for any reason.
• There are some people who should not drink any alcohol, including those who are:
  • Younger than age 21.
  • Pregnant or may be pregnant.
  • Driving, planning to drive, or participating in other activities requiring skill, coordination, and alertness.
  • Taking certain over-the-counter or prescription medications.
  • Experiencing certain medical conditions.
  • Recovering from alcoholism or are unable to control the amount they drink.
• Make sure you can practice recommended social distancing if you consider visiting bars, nightclubs, and other locations where people gather and drink alcohol.

Drinking alcohol and COVID-19 

• Drinking alcohol does not protect you from COVID-19.
• Drinking alcohol weakens your body’s ability to fight infections, increasing the risk of complications and making it harder to get better if you are sick.
• Alcohol use can increase the risk of acute respiratory distress syndrome and pneumonia, which are sometimes associated with COVID-19.

Basics of substance use

• Stress during a pandemic can contribute to increased use of prescription medications, non-prescription medications, illegal drugs, or a return to use after remission.
• Anyone who uses opioids or illegal drugs can become addicted to them.
• Different drugs can have different adverse effects. For example, taking too many opioids can stop a person’s breathing—leading to death.

Substance use and COVID-19

• The response to the COVID-19 pandemic may result in disruptions to treatment and harm reduction service providers used by persons with a substance use or substance use disorder.
• In-person treatmentexternal icon options for substance use or substance use disorder might not be available, leading to risk of:
  • Untreated substance useexternal icon or substance use disorder.
  • Return to substance use for people not currently using or in remission.
• Syringe service programs (SSP) may be closed or have restricted hours, limiting access to:
  • Clean syringes.
  • Safe disposal of used syringes.
  • Testing for HIV and Hepatitis C.
  • Access to care and treatment for SUD and infectious diseases.
• The illicit drug supply might be disrupted, or people might not be able to obtain drugs because of social distancing, potentially leading to risk of:
  • Withdrawal for people with physical dependence.
  • Contaminated drug products or people using drugs they are not used to, which might increase risk of overdose or other adverse reactions
• Social distancing guidance and stay-at-home orders may lead to higher numbers of people using substances alone, without others around to administer naloxone, perform life-saving measures, or call for help in case of overdose.
• Bystanders to an overdose might be reluctant to administer naloxone or perform CPR or other life-saving measures because of fear of COVID-19 exposure.
• People may be afraid to seek medical attention in the Emergency Department (ED) or from other healthcare professionals for fear of infection.