Alcohol-Related Deaths and Hospitalizations Surged During Pandemic—Could Policy Have Changed the Outcome?

The COVID-19 pandemic disrupted health systems worldwide, but for Dr. Peter Butt, a family physician and addiction specialist, it also led to a surge in patients struggling with alcohol use.

“What we saw was potentially a doubling of the number of people needing alcohol withdrawal management or other services directly attributable to their alcohol use,” said Butt, who co-chaired Canada’s Guidance on Alcohol and Health.

Now, a study published in the Canadian Medical Association Journal confirms what many in the medical community suspected—alcohol-related deaths and hospitalizations spiked significantly during the pandemic.

Between April 2020 and December 2022, deaths directly linked to alcohol rose by 18%, with hospitalizations increasing by 8%. The first two years of the pandemic saw the sharpest increases—deaths were up 24%, and hospitalizations climbed 14%. Researchers estimate that during this period, alcohol contributed to 1,596 excess deaths and 7,142 additional hospitalizations.

Alcohol and Pandemic Stressors

Previous data from Statistics Canada had already hinted at rising alcohol-related deaths during the pandemic, but this new study provides a more comprehensive analysis. Researchers examined long-term trends, demographic breakdowns, and regional differences, even accounting for fluctuations across different pandemic waves.

Study lead Dr. Yipu Shi, a senior epidemiologist at the Public Health Agency of Canada, explained that the findings reflect not just increased alcohol consumption, but also stress, health restrictions, and varying access to medical care.

“Younger adults were the most vulnerable,” Shi noted. Excess alcohol-related deaths were highest among those aged 25 to 44, while young women between 15 and 44 saw the largest spike in hospitalizations.

The study identified alcoholic liver disease—including fatty liver disease, alcoholic hepatitis, and cirrhosis—as the leading cause of both hospitalizations and deaths.

The factors driving this increase included:

• Heightened stress and anxiety due to pandemic-related uncertainty

• Boredom and isolation, leading to increased drinking at home

• Disrupted health care, delaying early intervention for alcohol-related conditions

• Easier access to alcohol, as liquor sales remained unrestricted in most provinces

A ‘Self-Inflicted Wound’?

For some public health experts, the findings raise uncomfortable questions about policy decisions made during the pandemic.

Dr. Tim Naimi, director of the Canadian Institute for Substance Use Research at the University of Victoria, said he was surprised by the magnitude of the increase. He warned that the long-term effects of heightened alcohol use during the pandemic—such as rising cases of alcohol-related cancers—may not yet be fully realized.

“There’s almost a conveyor belt of people with different degrees of liver disease,” he explained. “Some may already have damaged livers but haven’t come to medical attention yet.”

Naimi called some of Canada’s pandemic-era alcohol policies a “self-inflicted wound.”

“Alcohol was declared an essential commodity at the beginning in all 13 provinces and territories,” he said.

Balancing Public Health and Access

Adam Sherk, a senior scientist at the Canadian Centre on Substance Use and Addiction, acknowledged the complexity of the issue.

While keeping liquor stores open may have prevented dangerous withdrawal symptoms in people with severe alcohol dependency, it also contributed to increased alcohol-related harm at a time when hospitals were already overwhelmed.

“It increased the strain on our health-care system,” Sherk said. “Alcohol is responsible for a significant share of emergency room visits, and those were resources we desperately needed during the pandemic.”

For future public health emergencies, Sherk suggests a more measured approach—such as limiting liquor store hours rather than maintaining full access.

“I’m not saying close all alcohol outlets,” he clarified. “But we could find a more balanced approach that better protects public health.”

The Need for Mental Health Support

Dr. Butt argues that the findings highlight a deeper issue: the need for greater investment in mental health services.

“Instead of viewing increased access to alcohol as an essential service during a crisis, we should be prioritizing increased access to mental health care,” he said.

As the pandemic’s effects on public health continue to unfold, researchers hope these findings will inform future policies—ensuring that Canada is better prepared to balance public health concerns with responsible alcohol regulation in times of crisis.