Alcohol use behavior, policy, and treatment in the age of COVID-19 - - PowerPoint PPT Presentation

Alcohol use behavior, policy, and treatment in the age of COVID-19

A webinar and Facebook Live event from the PTTC Network Coordinating Office September 22, 2020

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PTTC Network

Today’s Presenters

Julia Sherman

Wisconsin Alcohol Policy Project, University of Wisconsin Law School julia.sherman@wisc.edu

• Dr. Denis M. McCarthy

Professor of Psychology and Associate Chair for Research, Department of Psychological Sciences, University of Missouri mccarthydm@missouri.edu

Kamilla L. Venner, Ph.D.

Assistant Professor Department of Psychology, University of New Mexico kamilla@unm.edu

COVID and Drinking

Changes in Consumption

• Alcohol is the most accessible impairing drug

(but…cannabis)

• In March, Neilsen reported a 55% increase in

alcohol sales

• Overall 5% increase in sales in March and April
• Sales down 5% in May

Changes in Consumption

• BacTrack published data on BAC changes pre-

and post-lockdown

• In March, there were significant changes in
• Average BAC in most States
• Drinking days of the week (shift from weekend to

weekday)

• https://www.bactrack.com/pages/coronavirus-covid-19-causing-dramatic-shift-

alcohol-drinking-habits-americans-lockdown \

• Biased sample of drinkers

Changes in Consumption

• Emerging U-shaped curve in drinking changes
• Small group showing large increases in drinking
• Others decreased drinking
• Unclear what distinguishes the groups
• Women & Black adults more likely to increase

COVID and Drinking

• Curated database of COVID papers
• https://www.addictionjournal.org/index.php/newsroo

m/news

• Changes in locations and motives for drinking
• Increases in solitary and at-home consumption
• Increases domestic violence, child neglect

COVID and Drinking Motives

• Alcohol is both stimulating and sedating
• Drinking to celebrate or socialize (stimulation)
• Drinking to cope with negative affect/stress (sedation)
• Motives can alter effects and consequences
• Increased drinking to cope with stress, negative

affect, boredom

• Not effective, more likely to lead to negative

consequences

How Drinking Alters COVID Risk

Drinking and COVID

• Alcohol reduces immune response
• May increase risk or severity of infection
• Increases risk for lung problems from COVID

Drinking and COVID

• Alcohol reduces vigilance & behavioral control
• Harder to maintain social distancing
• Mask wearing and physical distancing are not

established behaviors

• Require higher level of cognitive control
• Can lead to unintentional “risk taking”

Drinking and COVID

• Alcohol alters judgment and risk perception
• COVID changes risk of some behaviors
• Driving alternatives have different “costs”
• Strategies for safe drinking need to change

Cannabis and COVID

• Approaching alcohol in accessibility
• Less clear data on changes in cannabis use
• Like alcohol, can be used to cope
• Effect on depression/anxiety not clear

Policy Changes

Julia Sherman Wisconsin Alcohol Policy Project

Availability o

• f A

Alcohol

When alcohol becomes more available, problems follow: Immediate problems: disorderly conduct, noise, property damage, neighborhood disruption. Long term problems: alcohol is a causal factor in 7 different cancers, number of outlets increases the number of ACES recorded for area youth.

Changing A Alcohol Poli

• licie

ies

Make the temporary permanent

• Mixed drinks to go
• Home delivery of alcohol

Changes in law or rule

• Expanded footprints “licensed premises” or

“licensed area”

• Home delivery of alcohol authorized
• Reinterpretation of existing law/rules
• Growlers in Wisconsin

Issues ues w with h Home e Del elivery

• Drafts assign all liability for

underage/intoxicated person sales to delivery service, not retailer.

• Limit to on-premises licensees or

allow off-premises.

• Limit days and times for delivery.
• Community opt-in/opt out? Delivery

radius?

• Limited to sealed containers?
• Enforcement protocols are

developing, untested.

Concer erns ns w with C h Click ck & Collect ct A Alco coho hol

• May impact licensed footprint
• How to ID intoxicated

customers.

• Underage purchasers
• Lack of enforcement protocols
• r meaningful sanctions for:
• Online ordering
• Home delivery
• Curbside/Click & Collect

Mixed drinks t to g go

• Before the pandemic only Florida & Mississippi

allowed.

• During the pandemic – 33 states and D.C.

allowed, some sunset.

• Many required concurrent food sale.
• Some states allowed 3rd party delivery

(DoorDash)

• Michigan allows through 2025

Concerns A About M Mixed D Drinks T To-Go

Problem Solutions/Mitigation

• Require food purchase with

alcohol sales

• Require a seal and define it
• Define when and where drinks

may be consumed

• Strength
• Amount of alcohol will vary
• Not sealed by manufacturer

tampering is possible

• Public safety
• Drinking in cars
• Underage drinking

Options

• Add and enforce sunset dates
• Create meaningful sanctions

including suspension or loss of license

• Fund the creation/testing of

enforcement protocols

• Fund enforcement by the

appropriate agencies

Fram amin ing t the e Issue ue: Thi his s is a abo bout ut healt ealth & & saf afety, no not busi business

• There is no “healthy” level of drinking –
• nly low-risk drinking.
• Communities see small businesses closing –

hospitality industry hard hit.

• Save the Bars Movement – license fees

and tax abatement proposals

• We know that expanding the availability of

alcohol increases alcohol consumption.

• Unintended consequence, avoid blame.
• Expand sympathy to all hard-hit

businesses.

• Change the commoditization
• f alcohol.

An Opportu tunity to y to Red educe ce D Dens ensity

• Some licensees will close

permanently.

• Map & measure now to

assess outlet density .

• Relicense carefully based
• n vision & mapping.

COVID and Treatment with American Indian/ Alaska Native clients

Kamilla L. Venner, Ph.D. Assistant Professor of Psychology University of New Mexico

FCOI Disclosure

 I have a financial conflict of interest (FCOI) management plan at the

University of New Mexico due to providing training and consultation in evidence-based treatments for fee

Overview

 AI/AN health inequities in COVID-19 prevalence  Challenges to SUD Treatment

 Reservations severely restricted (on lock down)  Technological challenges  Increased social isolation and stress

 Facilitators of SUD Treatment  Summary

Age-adjusted mortality by race

New Mexico AI/AN COVID-19 mortality

COVID-19 related increases mental health problems

 Increase substance use  Increase in misuse of medications to treat opioid use

disorder

 Increase in overdose death  Increase in suicidal behaviors  Increase in anxiety and depression

Why COVID related health inequities?

 Not because of race  Social Determinants of Health

 Historical Trauma and Colonization  Boarding Schools  Poverty, Unemployment  Quality of education  Housing – multigenerational, cannot isolate one person from others in

home

 Neighborhood factors (e.g., safety, safe roads, lighting, distance to

hospitals)

 Reservation- lack of clean water sources, lack of running water  Access to culturally safe medical care (IHS severely underfunded)

AI/AN Strengths

 High rates of alcohol and drug abstinence  People have resolved substance use disorder  Cultural Identity  Spirituality  Traditional Ceremonies  Community connectedness

SUD Outpatient Treatment Programs: Challenges

 Many outpatient and inpatient programs closed since

March of 2020

 No in-person sessions (intake, group or individual counseling)  Patients go in to quickly and safely sign consent to treat forms

 Phone contact

 Often focused on basic level needs, food, utilities, services, COVID

testing

 Technological Challenges

 Counselors and patients limited in access to broadband providers  Little familiarity with virtual telehealth options  Lack of client privacy at home

 Counselor and staff fears of contracting COVID if offer in-

person treatment

Traditional Healing

 Community ceremonies can lead to spread of COVID-19  Recommendations

 Self-prayer  Self-smudging  Healers use phone or video  Virtual dances

 https://www.mprnews.org/story/2020/03/17/every-step-you-

take-is-prayer-as-coronavirus-spreads-women-lead-virtual- dance-for- healing?utm_content=buffer81478&utm_medium=social&utm_ source=twitter.com&utm_campaign=buffer

COVID-19 related SUD Treatment: Opportunities

 Technology and virtual sessions

 Overcome stigma  Increase outreach and engagement  Overcome transportation problems

 Free phone app

 https://www.addictionpolicy.org/post/free-app-to-

support-people-in-recovery-during-covid-19-outbreak

 On-line recovery groups

https://www.intherooms.com/home/covid-19-resources/ AA online meetings

Summary

 AI/AN populations disproportionately impacted by COVID-

19 morbidity and mortality

 SUD treatment programs experiencing many challenges

 Shut down since March  Challenges with technology for virtual outpatient counseling  Many clients not getting treatment services

 Opportunities

 Increase outreach and engagement with virtual services  Decrease burden on client  Use Traditional healing and practices safely

Tsin ‘aen (Thank you)

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