In an attempt to control the 2019 coronavirus disease (COVID-19) pandemic, governments across the world have implemented distancing measures during the search for medical countermeasures, resulting in millions of people being isolated for long periods.
Alcohol misuse is one of the leading causes of preventable mortality, contributing annually to about 3 million deaths worldwide. In some individuals, long term, excessive alcohol misuse might escalate into an alcohol use disorder. The potential public health effects of long-term isolation on alcohol use and misuse are unknown.
Stress is a prominent risk factor for the onset and maintenance of alcohol misuse. For example, chronic alcohol use results in neuroadaptations in stress and reward pathways, which lead to dysfunctional hypothalamic pituitary adrenocortical and sympathetic adrenomedullary axes, characterised by dysregulation of the cortisol response and deficits in emotional regulation.
In turn, these neuroadaptations lead to increased cravings for alcohol in response to stress. The effects of long-term social isolation on stress levels, including increased neuroendocrine responses and stress reactivity, have been described in non-human animals. However, the ongoing lockdowns across many countries are unique and little is known of the effects on the general population of chronic isolation (with respect to health and wellbeing) in these circumstances.
James M. Clay, Matthew O. Parker – The Lancet – April 8, 2020.
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