The COVID-19 pandemic triggered a substantial increase in alcohol use — and alcohol use disorders (AUD) have yet to return to pre-pandemic levels, according to Jessica L. Mellinger, MD, MSc, assistant professor at Michigan Medicine at the University of Michigan, who spoke on the topic during Digestive Disease Week^® (DDW) 2022.

“Alcohol use disorders had been on the rise prior to the pandemic,” said Dr. Mellinger. “In early 2020, alcohol purchases and consumption increased by about 25% across the United States. For hepatologists, this means that AUD must be top of mind for all our patients. We must continue to be vigilant and routinely screen for problem alcohol use.”

Increases in alcohol consumption were seen across all demographics. But some evidence indicates that women were disproportionately affected, whether due to biological differences or to differences in the social stressors that the pandemic added to women’s lives.

The pandemic also impacted the way many patients with AUD receive care. It accelerated the use of telemedicine, which enabled physicians to reach more patients.

“Virtual care has emerged as a potential silver lining of the pandemic. Rapid changes in laws and regulations that previously limited reimbursement for virtual visits now allow us to provide alcohol treatment to patients who otherwise would struggle to travel to our hospitals and clinics.  It has brought alcohol treatment to many who would otherwise not have it.  The move to virtual care shows no signs of stopping and is here to stay, which is good for patients.”

Dr. Mellinger stressed that curbing the increase in AUD requires action at all levels — from individuals and organizations to systemic policy changes. She outlined steps that hepatologists can take to curtail problem alcohol use in their patients.

• Routinely screen all patients using the Alcohol Use Disorders Identification Test (AUDIT). This can be automated by incorporating AUDIT into the electronic medical record.
• Include biomarkers in your practice to help detect alcohol use that patients may have a hard time talking about.
• Engage in respectful, compassionate discussions with patients about their alcohol use.
• Incorporate motivational interviewing principles into your conversations with patients. These methods can help you help your patients make changes to their alcohol use or connect with alcohol use treatment.

“Organizations should work to integrate alcohol use treatment and medical care, especially hepatology care, for patients with advanced AUD.  In hepatology, with the rise in alcoholic liver disease during the pandemic, integrated care holds the potential to improve outcomes.”

Dr. Mellinger gave the oral presentation, “Impact from alcohol use disorder in the United States, going forward after the pandemic” on Monday, May 23, at 2 p.m. PDT.