Impacts of changes in alcohol consumption patterns during the first 2020 COVID-19 restrictions for people with and without mental health and neurodevelopmental conditions: A cross sectional study in 13 countries

Background: The initial period of COVID-19-related restrictions affected substance use in some population groups. We explored how changes in alcohol use at the beginning of the pandemic impacted the health and wellbeing of people with and without mental health and neurodevelopmental conditions.

Methods: Data came from the Global Drug Survey Special Edition on COVID-19 conducted in May-June 2020. Measured were; changes in drinking compared to February 2020 (pre-COVID-19 restrictions), reasons for changes, and impact on physical health, mental health, relationships, finances, work/study, and enjoyment. This study included 38,141 respondents (median age = 32 IQR 25-45; 51.9% cis man; 47.8% cis woman; 1.2% trans/non-binary; 30.2% with mental health and neurodevelopmental conditions e.g. depression 20.0%, anxiety 16.3%, ADHD 3.8%, PTSD 3.3%).

Results: A third (35.3%) of respondents with mental health and neurodevelopmental conditions and 17.8% without mental health and neurodevelopmental conditions indicated that increased drinking affected their mental health negatively (p<.001); 44.2% of respondents with mental health and neurodevelopmental conditions compared to 32.6% without mental health and neurodevelopmental conditions said it affected their physical health negatively (p<.001). Reduced drinking was associated with better mental health among a fifth (21.1%) of respondents with mental health and neurodevelopmental conditions and 14.4% without mental health and neurodevelopmental conditions (p<.001). Age, relationship status, living arrangements, employment, coping and distress were significant predictors of increases in drinking.

Conclusion: Among people with mental health and neurodevelopmental conditions, reduced alcohol consumption was associated with better mental health, while the negative effects of increased drinking were more pronounced when compared to people without mental health and neurodevelopmental conditions. When supporting people in reducing alcohol consumption during uncertain times, people with mental health and neurodevelopmental conditions may need additional support, alongside those experiencing greater levels of distress. Disclosure of interest statement: ARW is founder and CEO of Global Drug Survey. The remaining authors have no conflict of interest to declare. No pharmaceutical grants were received in the development of this study.