Pennsylvanians have been ordered to isolate at home, and some people are dealing with the stress and boredom with a stiff drink.
Not everyone who has a cocktail when they feel lousy has substance use disorder, but addiction treatment and health policy experts say they’re concerned how the novel coronavirus pandemic and economic downturn are affecting people who do have unhealthy relationships with alcohol.
“People have less income,” said behavioral health economist Michael T. French. “They’re drinking less because they have less money.
Others binge drink more, especially after they’ve lost their jobs. In Pennsylvania more than one million people have filed for unemployment.
Further complicating the situation are government mandates of social distancing. French, a health policy professor at the University of Miami, said this could affect people who otherwise wouldn’t self-medicate with alcohol.
“Isolation for more than a month or two months, that’s going to be real difficult,” he said.
There's evidence to suggest some might already be feeling, or at least anticipating, this stress: Pennsylvanians are buying up alcohol like its toilet paper.
“People were stocking up and looking ahead. And I think we’re kind of worried about what this might mean,” said Mark Fuller, medical director of Allegheny Health Network’s addiction medicine program.
As western Pennsylvanians begin to run out of alcohol, Fuller said he and his staff are bracing for a surge of patients needing immediate detoxification care.
Jennifer Smith, secretary of the state’s Drug and Alcohol Programs, said she was expecting an increase of alcohol-related calls to her department’s emergency services hotline, especially after liquor stores closed. That hasn’t happened yet.
“I think it could be folks are more concerned about physical conditions that they’re experiencing and putting this on the back burner,” said Smith.
In other words, Pennsylvanians might have less bandwidth to address their alcohol use as the crisis created by COVID-19 is more immediate. Also, now that people are spending so much time by themselves, it’s easier to hide problematic habits from friends and family. And there are still plenty of ways to get alcohol, even though brick and mortar liquor stores are closed.
Allegheny Health Network’s Mark Fuller said his medical system has seen a slight increase in patients seeking alcohol addiction-treatment services. Though often, people don’t realize they have a problem until they land unexpectedly in the hospital.
“Like for a heart attack or for [emergency] gallbladder surgery, or for a car wreck," said Fuller. "When they’re in a hospital and isolated from it, often times to their surprise and ours as well, they go into alcohol withdrawal."
Alcohol withdrawal itself can be fatal as it causes multiple organ dysfunction. So people who are hospitalized with COVID-19 are more medically vulnerable if they also have untreated alcohol use disorder.
Dave Lettrich is director of Bridge to the Mountains, a street outreach program based in Pittsburgh. Lettrich’s clients don’t have steady jobs, so accessing large quantities of cheap liquor to prevent withdrawal has become difficult, now that stores’ physical locations are closed.
“I know of people having seizures,” he said. “I know of people who have been in compromised medical states that should have received medical attention [but] choose not to.”
Some people, Lettrich said, have banded together in order to get enough alcohol to stave off withdrawal.
“Then you end up with groups of six or eight or 10 people all staying together in a house that share resources,” he said.
The state closed liquor stores in an effort to increase social distancing. But this has brought some closer together, increasing their risk of coronavirus transmission. Some people are choosing that risk over almost certain alcohol withdrawal.