Changes in alcohol consumption during the COVID-19 pandemic: exploring gender differences and the role of emotional distress. / Modifications de la consommation d'alcool pendant la pandémie de COVID-19 : exploration des différences selon le genre et du rôle de la détresse émotionnelle.

INTRODUCTION: Restrictions to do with the COVID-19 pandemic have had substantial unintended consequences on Canadians' alcohol consumption patterns, including increased emotional distress and its potential impact on alcohol use. This study examines 1) changes in adults' alcohol consumption during the COVID-19 pandemic in New Brunswick and Nova Scotia; 2) whether drinking more frequently during the pandemic is associated with increased feelings of stress, loneliness and hopelessness; and 3) whether gender moderates this relationship. METHODS: Participants were drawn from a cross-sectional survey of 2000 adults. Adjusted multinomial regression models were used to assess the association between drinking frequency and increased feelings of stress, loneliness and hopelessness. Additional analyses were stratified by gender. RESULTS: About 12% of respondents reported drinking more frequently after the start of the COVID-19 pandemic, and 25%-40% reported increased emotional distress. Increased feelings of stress (odds ratio [OR] = 1.99; 95% confidence interval [CI]: 1.35-2.93), loneliness (OR = 1.79; 95% CI: 1.22-2.61) and hopelessness (OR = 1.98; 95% CI: 1.21-3.23) were all associated with drinking more frequently during the pandemic. While women respondents reported higher rates of emotional distress, significant associations with increased drinking frequency were only observed among men in gender-stratified analyses. CONCLUSION: Individuals who report increased feelings of stress, loneliness and hopelessness during the COVID-19 pandemic were more likely to report increased drinking frequency; however, these associations were only significant for men in stratified analyses. Understanding how the pandemic is associated with mental health and drinking may inform alcohol control policies and public health interventions to minimize alcohol-related harm.

Cannabis Legalization and Detection of Tetrahydrocannabinol in Injured Drivers.

BACKGROUND: The effect of cannabis legalization in Canada (in October 2018) on the prevalence of injured drivers testing positive for tetrahydrocannabinol (THC) is unclear. METHODS: We studied drivers treated after a motor vehicle collision in four British Columbia trauma centers, with data from January 2013 through March 2020. We included moderately injured drivers (those whose condition warranted blood tests as part of clinical assessment) for whom excess blood remained after clinical testing was complete. Blood was analyzed at the provincial toxicology center. The primary outcomes were a THC level greater than 0, a THC level of at least 2 ng per milliliter (Canadian legal limit), and a THC level of at least 5 ng per milliliter. The secondary outcomes were a THC level of at least 2.5 ng per milliliter plus a blood alcohol level of at least 0.05%; a blood alcohol level greater than 0; and a blood alcohol level of at least 0.08%. We calculated the prevalence of all outcomes before and after legalization. We obtained adjusted prevalence ratios using log-binomial regression to model the association between substance prevalence and legalization after adjustment for relevant covariates. RESULTS: During the study period, 4339 drivers (3550 before legalization and 789 after legalization) met the inclusion criteria. Before legalization, a THC level greater than 0 was detected in 9.2% of drivers, a THC level of at least 2 ng per milliliter in 3.8%, and a THC level of at least 5 ng per milliliter in 1.1%. After legalization, the values were 17.9%, 8.6%, and 3.5%, respectively. After legalization, there was an increased prevalence of drivers with a THC level greater than 0 (adjusted prevalence ratio, 1.33; 95% confidence interval [CI], 1.05 to 1.68), a THC level of at least 2 ng per milliliter (adjusted prevalence ratio, 2.29; 95% CI, 1.52 to 3.45), and a THC level of at least 5 ng per milliliter (adjusted prevalence ratio, 2.05; 95% CI, 1.00 to 4.18). The largest increases in a THC level of at least 2 ng per milliliter were among drivers 50 years of age or older (adjusted prevalence ratio, 5.18; 95% CI, 2.49 to 10.78) and among male drivers (adjusted prevalence ratio, 2.44; 95% CI, 1.60 to 3.74). There were no significant changes in the prevalence of drivers testing positive for alcohol. CONCLUSIONS: After cannabis legalization, the prevalence of moderately injured drivers with a THC level of at least 2 ng per milliliter in participating British Columbia trauma centers more than doubled. The increase was largest among older drivers and male drivers. (Funded by the Canadian Institutes of Health Research.).

Alcohol access and purchasing behaviour during COVID-19 pandemic restrictions: An exploration of sociodemographic, health and psychosocial correlates in two Canadian provinces.

INTRODUCTION: Alcohol access has changed in Canada during the COVID-19 pandemic. This study compares the use of two novel purchasing modes (via delivery and in excess/stockpiling) to traditional, in-person purchasing to determine if their use is associated with sociodemographic and psychosocial characteristics, perceived COVID-19 health risk or consumption frequency. METHODS: We draw on cross-sectional survey data from 2000 residents of the Canadian provinces of Nova Scotia and New Brunswick, ages 19 years and older that were administered online and by telephone. Associations between purchasing modes and sociodemographic and psychosocial characteristics, perceived COVID-19 health risk or consumption frequency were assessed using logistic regression. RESULTS: About 70% of people who drink purchased in-person, 17% used delivery and 30% purchased in excess/stockpiled. Sociodemographic and psychosocial attributes varied among those at increased odds of using each purchasing mode. Those at higher COVID-19 health risk were at higher odds of getting alcohol delivered. Increased drinking frequency was associated with alcohol delivery and purchasing in excess/stockpiling. DISCUSSION AND CONCLUSIONS: This study highlights the need for increased public health considerations regarding changes to alcohol regulations. Alcohol delivery and purchasing in excess/stockpiling is positively associated with heavier drinking. Drinkers at higher COVID-19 health risk were more likely to purchase online for delivery, which suggests novel purchasing modes may serve a partial public health function.