Spike in Alcohol Withdrawal Seen in Hospitalized Patients During Pandemic, Study Finds

The analysis of patient records confirms reports of booming alcohol sales and tax collections, and could be a warning of more hospitalizations to come once the economy fully reopens.

A study from Delaware’s largest health system offers a hint of what hospitals could be facing as more workplaces reopen—a spike in patients hospitalized for alcohol withdrawal.

Data from ChristianaCare, published this week in JAMA Network Open, found a 34% increase in alcohol withdrawal rates among hospitalized patients during the pandemic. The researchers said they believe their study is the first to directly link the pandemic to alcohol withdrawal in hospitalized patients.

They examined records for patients hospitalized for alcohol withdrawal from January 1, 2018, and September 22, 2020. The study evaluated three groups of patients: 340 who were treated before Delaware’s stay-at-home order on March 25, 2020, 231 were treated during the lockdown period, and 507 treated after the order was lifted June 1, 2020.

Not only was the hospitalization rate far higher in 2020 than in 2018 and 2019, but there was a noticeable spike in cases in the last two weeks of the stay at home order, when cases rose 84%.

“There has been concern that pandemic-associated stress, restrictions and reduced access to recovery supports would result in more alcohol consumption, increasing the risk that some will develop or worsen alcohol use disorders, but it has been difficult to measure these impacts,” said Terry Horton, M.D., ChristianaCare’s chief of addiction medicine and senior author on the research letter.

Alcohol withdrawal occurs when a person who has been drinking heavily suddenly stops or significantly reduces alcohol intake. While symptoms can vary widely, they may include headaches, anxiety, nausea, seizures, or hallucinations. In severe cases, withdrawal can be deadly. Medications can treat physical symptoms and hospital admission may be required.

While indoor dining in restaurants has been shut down or limited, most parts of the United States did not close liquor stores or limit hours over fears of triggering alcohol withdrawal. In fact, many stores developed alcohol delivery services to ease patrons’ worries about contracting the disease.

The World Health Organization recommended limiting the availability of alcohol during the pandemic to prevent excessive consumption during a period of stress. The WHO noted that its use could increase susceptibility to contracting the coronavirus.

Stress caused by the pandemic, including uncertainty job situations and the lack of social contact has fueled a rise in both alcohol use and smoking, confirmed by news reports around the country of surging state alcohol tax collections and online alcohol retail sales.

Last month, the American Medical Association took note of the 54% boom in alcohol sales a year ago this month, as lockdowns began. New Jersey and New York—the original centers of the US pandemic—have reported increaes 30% and 25% in alcohol sales tax collections, respectively. And despite a different approach to pandemic response—Governor Tate Reeves reopened earlier and lifted the mandate this week—Mississippi matched its Northeast counterparts with a 30% increase in alcohol sales taxes for 2020.

“Our findings are relevant nationally and serve as a clarion call to alert other hospital systems to the increased need to screen for and treat alcohol use withdrawal and to refer patients for ongoing alcohol treatment,” said Horton.