Alcohol Abuse Before, During and After The Pandemic In The UK: Risk Factors, Statistics, Solutions

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Before the 2020 pandemic, the UK was a country of binge drinkers. In 2016, the Chief Medical Officer released an analysis paper showing 24% of adults in England and Scotland regularly consume alcohol over the low-risk guidelines.

In 2018, that number jumped to 27%, announcing a natural growth in the culture of excess drinking. However, as the pandemic forced the nation inside and away from communities, those who drank alcohol regularly continued this excessive drinking despite the reduced cultural gatherings. 

This article details the statistics before, during and after the pandemic to showcase the trends and concerns.

There are also tips to identify alcohol dependence, and methods to manage the addiction.

UK Based Statistics

uk based statistics

Published in July 2021, Public Health England released a paper called “Alcohol consumption and harm during the COVID-19 pandemic”. In this paper, the results show trends in the consumption of alcohol and how these changes have harmed the country. It only focuses on the diseases and illnesses caused after the pandemic, therefore requiring other data to show a full history.

Here is a breakdown of the alcohol sales, hospital admittances and deaths throughout each time period. The Public Health England paper is used as the main source, however gaps in the timeline are filled using peer reviewed papers, or other governmental sources.

Alcohol Sales

To monitor alcohol sales, data needs to be pulled from supermarkets, off licences, online stores, pubs and restaurants. 

Before the pandemic, a large percentage of alcohol was consumed in pubs and nightclubs. In 2019, 28% of alcohol across Great Britain was sold through clubs, pubs, restaurants and cafes. The remaining 72% was bought in stores.

In 2020, the country spent an extra £25,000 million on alcohol, despite the pubs and restaurants being closed. This meant that supermarkets and off licences were keeping the country in stock. However, this larger spending growth can also be put down to a rise in inflation

The total amount of alcohol sold during the pandemic was similar to pre-pandemic times. This conveys that people were drinking in their homes more, but not drinking more in total. 

During the first year of Covid-19, wine and spirits (duty-paid) had increased by +8.9% for wine and +7.3% for spirits. However, cider and beer sales decreased. At -16.8% for cider and -14% for beer.

After the pandemic, the rise in alcohol sales continued. Beer recovered from its dip and increased sales by 22%, while spirits continued to climb at a steady pace of 7%.

This corresponds with the reopening of pubs and restaurants. However, as these figures show, the nation continued its drinking habits during the pandemic, created a new at-home drinking culture, and then returned to pub culture. 

The return to community drinking did not slow down or reduce at-home drinking, thereby adding another layer to Britain’s drinking culture.

Alcohol Abuse Hospital Admittance

Alcohol abuse causes multiple medical conditions. These are included but not limited to, high blood pressure, cancer (specifically, liver, breast, throat and mouth), liver damage and depression.

In 2015, 41,161 adults in Scotland were admitted to hospital for alcohol-related illnesses. 27% of those admitted were through alcohol injuries, the remaining 73% were through medical issues such as cancer, strokes or heart attacks.

In 2020, this number dramatically increased to 976,425 hospital admission connected to alcohol. This is an increase of 1,815 per 100,000 people.

Between 2015 and 2020, there was another change in data. Using rum as an example, the number of casual, moderate and heavy drinkers stayed consistent until 2020 – the year of the pandemic. During this time, casual drinkers kept the same drinking habits and moderate drinkers slowed down. But the number of heavy drinkers dramatically increased. 

From this change, the following can be deduced. Although the UK was consuming the same amount of alcohol before the pandemic and during the pandemic, the gap between heavy drinking and barely drinking grew wider. The middle ground was gone.

This means alcohol abuse increased during the pandemic.

In 2021, there was a reduction in hospital admissions. Only 814,595 admissions were connected to alcohol, reducing the rate to 1,500 per 100,000 admittance.

Buying Groups

Data analysts from the government studied the type of people buying alcohol during the pandemic. They split the adult buyers of alcohol into 5 groups of equal size, based on their purchasing level for the 2 years prior to Covid-19. 

The group who bought the most, had an increase of 14% in 2020 to 2021, from 2019 to 2020. Collectively buying an additional 5.3 million litres extra during the pandemic. 

However, when adding all 5 groups together, 12,607,408 additional litres of alcohol were purchased in the first year of the pandemic. In comparison to the year prior, this was the largest purchasing quantity accounted for, creating a 42% increase, and the two largest buying groups accounted for 68% of the increase. 

Altogether, the data that was collected from this insight reported a polarisation of alcohol consumption. 

Combined with the research from Alcohol Change, the evidence shows that 47% of people who used to drink once a week cut down their consumption or stopped completely. Only 18% of drinkers found they were increasing their consumption. However, from the government-produced data, the increase was substantial, turning moderate drinkers into high-risk heavy drinkers.

50% of those who stated they were drinking more, already consumed 5 units or more a day.

This shows that the pandemic put those at risk of becoming heavy drinkers, into the heavy drinking category. While, those who were already drinking more than the recommended 2 units a day maximum, were pushed further into alcohol abuse.

After the pandemic, a YouGov survey (October 2021) showed that 18.1% of adults in England continued this high drinking culture. They were either increasing into a high-risk category or increasing inside the high-risk category of drinking levels. For comparison, before the pandemic in February 2020, these levels were 12.4%, and in October 2019 they were 11.9% – remaining fairly consistent. 

The 6% jump means an additional 2 million people became high-risk drinkers during the pandemic.

Alcohol-Related Deaths

Findings from these reviews show that there was an increase in the heightened risk level of alcohol consumption from 2020 to 2021. However, post-2021 these levels gradually returned to normal.

This suggests that it was the ‘lockdown’ in itself that saw this alcohol consumption rise. 

From March 2020 to March 2021 there was an increase of 59% in people who reported they drink at a high-risk level. It was calculated to be over 50 units a week for a man and over 35 units per week for a woman.

The increase in alcohol consumption during Covid-19 also saw a rise in alcohol-related deaths. 

Fatalities relating to alcohol rose by 20% in 2020, going from 5,819 in a year in 2019, to 6,983 in a year in 2020. Alcohol can cause multiple different life-threatening diseases, liver disease being the most prominent. 

Alcoholic liver disease rates rose, accounting for around 80% of all the deaths that occurred in 2020. 

Between 2018 and 2019, there was a rise of only 3% in the cases of alcohol liver disease fatalities. However, from 2019 to 2020, this same disease rose in cases by 21%. 

This shows that alcohol-related hospitalisation was already on the rise, however, the pandemic pushed the issue into acceleration. 

Because many of the NHS services turned patients away unless there was an emergency (giving more time to COVID patients and reducing transmission), one theory for the rapid increase is due to a lack of support. 

During the pandemic, the NHS’s mental health advice was to sleep well, stay connected, and work out. Almost every link is related to COVID, and not mental health facilities.

Hoping to avoid COVID and scared of burdening the NHS, a new culture of avoiding health care was emerging. The NHS urged the public to seek help for urgent care, however, this added to the pressure of claiming your care is urgent. This led to millions of people managing their alcoholism without help.

Who Is At A Higher Risk?

Alcohol-related deaths aren’t just from liver disease. There are other physical diseases which are caused by alcohol, such as heart attacks and strokes.  

Mental health disorders are also influenced or caused by alcohol, leading to deaths if left unchecked. 

Deaths from a rise in behavioural and mental disorders, due to alcohol, saw a sharp increase from 2019 to 2020 at 10.8%. From 2018 to 2019 this was only a 1% increase. However, hospital admissions were much lower. 

It is wise to not forget alcohol poisoning either, which was at a 15% increase in the years 2019 and 2020. The year prior had seen a decrease at 4%. 

33% of the deaths caused by alcohol-related circumstances were from people in deprived areas of the country. 

Finding correlations through geographical locations, instead of financial, there is a trend showing the North East as the area of highest risk. North Eastern towns and cities saw a peak of 28.4 deaths out of every 100,000 in the population, during July 2020. 

This rate is higher by 80% than the rate seen in both 2018 and 2019, combined.

It is important to understand the significance of how alcohol can cause death. It is unknown to most that liver disease, which is caused by alcohol, is actually the 5th most prominent cause of premature death in the United Kingdom. 

Alcohol-Related Deaths Increased Sharply During 2020

alcohol related deaths increased sharply during 2020

Britain is well known, across the world, for its drinking culture. However, the lockdown drinking habits that were developed have the potential to bring about fatal consequences. 

In 2020, deaths influenced by alcohol increased by 18.6% in comparison to previous years. This marked the highest increase in alcohol deaths since records came into being. 

In the 12 months of the pandemic year, there were 8,974 deaths caused by alcohol. This number was at an increase of more than 1,000 from the year before. 

This increase is the highest from one year to the next that the UK has ever seen. The record for alcohol deaths began in 2001. 

Before this, deaths relative to alcohol consumption had remained somewhat stable for 7 years, however, the 2020 pandemic year killed this trend. 

Separating by country, Scotland had 21.5 alcohol-specific deaths per 100,000 people. England had 13.0, Wales had 13.9 and Northern Ireland had 19.6. These increases are roughly 35% higher than in 2019.

As pubs, clubs and restaurants shut, home drinking soared, and off-licence alcohol sales went up. This saw spirits sales increase by 26% and beer sales rise 31% from 2019 in off-licences alone. 

Around 8/10 deaths in this time were relative to alcoholic liver disease. Despite how cirrhosis (related to alcohol) can take 10 years or more to develop, the pandemic sped up the time scale fatalities. Often due to the recent consumption of alcohol. 

What Are The Signs Of Alcohol Dependence?

what are the signs of alcohol dependence

In 2019 104,880 people were treated for alcoholism, while in 2020 that number only increased to 107,428 despite the larger percentage jump for the population. 

Alcohol dependence is a type of alcoholism, where a person may need the drug to help them sleep, get through the day, talk to others or feel happy. 

Behavioural And Social Signs

There are several signs that give away an alcohol dependency. They are as follows:

  • Being secretive or lying to oneself or others when the topic of alcohol consumption is brought up. 
  • Excessive or heavy drinking alone.
  • Drinking heavily or binge drinking.
  • Being avoidant towards loved ones.
  • Becoming disinterested in hobbies, activities and other aspects of life which may have once held importance. 
  • Consuming alcohol at times which are inappropriate. I.e. in the mornings. 
  • Becoming withdrawn from home and work life. 
  • Still drinking alcohol even when it has an effect on work life, social life, and home/ relationships.

Physical Signs

Not only are there signs in behaviour and social interactions, but also in the physical being. Let us investigate these: 

  • The discovery of an increased tolerance towards alcohol. Thus resulting in a requirement to drink even more to feel ‘tipsy’, ‘drunk’, or satisfied.
  • A decrease in the care for hygiene and one’s physical looks. 
  • Disturbed sleep and sleep patterns or the emergence of insomnia.
  • Sweating even when not physically exerted. 
  • Headaches.
  • Fatigue/ lethargy.
  • Gaining or losing weight as appetite changes.
  • Symptoms of withdrawal if alcohol has not been consumed for a significant amount of time.

Common Symptoms

There are some common signs that a person is likely to be abusing alcohol as well, even if not dependent on alcohol. A person can be abusing alcohol without being an alcoholic or alcohol dependent. It is important to recognize these signs early, to prevent progression of the abuse.

Here are some signs to look out for: 

  • Excuses for indulgence. E.g. to relax, deal with stress, etc. 
  • Isolation and distance from friends/family. 
  • Memory loss.
  • Secretive about drinking.
  • Hangovers when not drinking.
  • Mood swings or irritable moods.
  • Choosing to drink over responsibilities. 
  • Changing social group or appearance. 

One issue may fuel another, which can lead to more problems down the line.

General Risk Factors

general risk factors

All genders and ages are subject to these risk factors. Men and women, young and old, all can be more at risk depending on certain factors. Genetics and lifestyle factors are the common denominators that will contribute to a heightened risk.

During the pandemic, low triggering issues became high triggers. For example, loneliness can cause depression, which can lead alcohol-dependent individuals to turn to alcohol. During the pandemic, people couldn’t avoid loneliness making this low-risk trigger into a high trigger. 

Below are more factors specific to the Pandemic era.

Pandemic Risks

The Pandemic increased the risk factors for excess of alcohol consumption in adults around the UK. One of the highest influencing factors of risk in alcohol misuse is stress. 

Stress was on the rise during the 2020 pandemic. From the year of 2020, Covid-19 forced many people towards new challenges which were often stressful and overwhelming. 

Stress is known to have an effect on us, and people often turn to find an outlet for stress. However, a great deal of people do not use healthy coping mechanisms and often turn to alcohol, smoking, drugs, or other negatively impactful forms of coping. 

It is recommended to limit alcohol intake when dealing with stress. Yet, as the pandemic forced the population away from other, healthier, means of coping, such as socializing, long outdoor walks, going to the gym, and so on. People instead turned to means of coping that were more readily available.

pandemic risks

Not only this but becoming socially isolated is well known to have a drastic impact on the risk of misusing alcohol. 

It has been noted that those who have an alcohol disorder or those who have liver disease associated with alcohol had an overall increase in risk factors over the course of the pandemic. 

Health organizations noted that the impact of long-term social isolation over the course of the pandemic and the lockdowns did have an impact on the overall national levels of alcohol consumption. This in turn had an impact on public health.

There is an association between an increase in alcohol use and loneliness in middle-aged to older adults. Since the pandemic saw many people alone, or lonely, these entire age groups in the population were at a higher risk. 

However, it is typically noted that alcohol use creates loneliness, and those with an alcohol use disorder are likely to be lonely as a result of their alcohol misuse, rather than the other way around. 

This means that it is possible that this connotes that as people imbibed in alcohol more during the pandemic, loneliness became more prominent due to excess alcohol consumption, rather than because of it.

Loneliness, such as was seen in the pandemic is also not only tied to alcohol abuse, but it is also tied into low self-esteem and a bad self-image. Having a bad self-image or low self-esteem is also a risk factor for alcohol abuse.

The pandemic was noted by mental health professionals to have an effect on self-esteem too. It left people with a lowered self convince, struggling to find motivation and a poor self-image. 

The nation responded to the mental health repercussions of the pandemic in this sense by increasing mental health aid. Although, this did not come into play until the latter part of the Pandemic. 

Self-esteem became a nationwide well-being issue for a gross number of the population. The fact that a great deal of the time no one knew what to expect the next day increased anxiety, and this caused a poor self-image.

Abusing alcohol is widely known to be closely linked to poor self-esteem. It easily triggers people into drinking and therefore is able to lead to a dependency. People often battle low self-esteem with a bottle. 

Interestingly, there was also a study conducted on a group of undergraduate students in the UK during the pandemic. This study actually showed a decline in alcohol consumption, but an increase in symptoms of depression and a loss of sleep. 

This study looked at how the UK compared to other countries. Germany was one of these countries. They saw 20% of the population decrease their alcohol consumption but 35% increase it. 

It also notes that stress was often perceived to be a catalyst, as the people who had a higher rate of stress often fell into the category of those who increased their alcohol consumption. (Effects of COVID-19 lockdown, on mental health, wellbeing, sleep, and alcohol use in a UK student sample, Evans).

Another study was conducted during this time, this study looked at a significant 22,113 people. It saw 48.1% of these people drinking the same as pre-pandemic, 25.7% drinking less, and 26.2% drinking more. 

Contrary to the popular belief that younger persons tend to drink more, the percentage of people who drank less were often found to be younger. This links heavily with the study done on students, as mentioned above. 

It was also found that those who were drinking more, as per this study were typically stressed about catching the virus, stressed about finances, or had an anxiety disorder.

Another study looked into the demographics of alcohol consumption in the UK, during the pandemic. This study unearthed a significant amount of risk factors. 

It noted that out of 1346 subjects they found more males than females used alcohol. Single people used alcohol more than married, with single people at n=785, but married people were at n=571. 

Socioeconomic status was also important, showing that those at the lowest incomes were likely to drink more. Those below £19.9k per annum made up 285https://bmjopen.bmj.com/content/10/11/e044276 of the drinkers, and those at £20-39k per annum made up 273 of the drinkers. 

The income that saw the lowest alcohol use was $70-99k per annum with less than 150 drinkers. 

These statistics show that income, mental health, and stress are some of the most prevalent risk factors when it comes to the likelihood of overindulging in alcohol during the Covid-19 pandemic.

Psychological Factors – Mental Health Disorders

psychological factors mental health disorders

Those who suffer from psychological trauma and mental illness will be at a greater risk of alcoholism. 60% of people who received alcohol treatment between 2006 and 2016 also needed mental health treatment.

For example, 46.2% of those with bipolar disorder have had an alcohol-dependent issue in their life. And 63.8% of those who suffer from alcohol addiction also experience clinical depression. This shows that mental health and alcoholism are linked.

As previously explained, mental health facilities were turning away patients, to give more beds to emergency services.

Prior to the pandemic, there weren’t enough beds to care for patients in mental health services. Due to the continued strain on the department and a lack of resources, the mental health of the public caused a spike in alcohol dependence.

Personality Factors

People with low self-esteem, an impulsive nature, and a strong need to be liked often become victims of an alcoholic disorder.

During the pandemic, 5% of people said they either “always” or “often” felt lonely – that’s 2.6 million Britons. During the same time, 30.9% reported being affected by loneliness – that’s 7.4 million.

As loneliness increased those with low self-esteem and a need to be liked, used alcohol to self-medicate. As going outside wasn’t an option, people with an impulsive personality would find a quick distraction in a drink. 

Personal Choice Factors

personal choice factors

Boredom during the pandemic led 30.1% of Britons to drink alcohol. With normal life suspended, millions used alcohol to entertain themselves. However, as the pandemic lasted for over a year, the length of excess drinking led to alcohol dependence.

The physical change in neurochemistry meant that those without an alcohol addiction developed one from overuse.

Drinking History Factors

There is no defining timeline to develop alcoholism. However, the more exposed one is to excessive drinking, the more likely the addiction can develop.

A study by scientists Rudolf Moos and Bernice Moos showed that “natural remission” is normally followed by “a high likelihood of relapse”. This means that, without help, someone with a history of drinking will likely fall back into alcohol abuse.

As the NHS was not able to care for mental health and therefore alcoholic prevention, natural remission was one of the only options for alcoholics. This would inevitably fail, causing life-risking damage and a rise in alcohol-related deaths.

Genetic History Factors

genetic history factors

Though it is not often considered, a child of an alcoholic is more likely to become an alcoholic than a child who is not – even if they are not raised by alcoholics.

In 1990, a study by Gordis, Tabakoff, and Goldman showed that twins and adopted children would take after their alcoholic biological parents, rather than the social connection of their family. Showing that alcoholism is genetic. 

Familial And Environmental Factors

Genetics are not the only influence from family. The way in which a family views alcohol is also an important factor. If a child grows up in an environment in which heavy drinking is practised or normalised then they are likely to become a heavy drinker. 

In some families, heavy drinking may be glamorised, or normalised, and it may even be expected of members of the family

This means that alcohol addiction becomes a part of the social structure, and in an attempt to be a part of the family, alcoholism may bloom.

Being locked in a home with a family who drinks socially, means avoiding drinking can cause disruption in the family dynamic. Making family peer pressure a leading factor in teenagers casually drinking during the pandemic.

Social And Cultural Factors

British culture is deeply tied to drinking. 30% of TV shows include teen drinking, creating a social goal for teenagers. 84% of office events involve binge drinking. And there are 58 pubs per 100,000 people in the UK.

This was seen in 2020, when the public’s biggest outcry was from the multiple closures and reopenings of pubs. 

Due to the pubs closing, withdrawal symptoms became obvious to unassuming drinkers. This either motivated a detox or encouraged excess drinking.

The Overall Effects Of Covid-19 On Alcoholism

the overall effects of covid 19 on alcoholism

In the UK, there was a rise in alcohol abuse during the Covid-19 pandemic, and while the statistics have seen numbers decrease somewhat since the pandemic year, it’s not over yet. 

The nation will be reaping the consequences for years to come. An increase in drinking leads to long-term health conditions, some of which will not necessarily surface for a few years. Thus, the alcohol abuse during the pandemic will come back to haunt the country. 

If someone suffers from an alcohol addiction or dependency, do not feel afraid to ask for help. Get regular health check-ups, and try to kill the reliance, help is out there.

Alcohol is the deadliest drug in the world, the world needs to fight it as hard as it fought Covid-19.

Last Updated: July 21, 2022

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Peter also co-authored the new 6th edition of Drugs In Use by Linda Dodds, writing Chapter 15 on Alcohol Related Liver Disease. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.