Table 3.
Characteristics of studies included in the systematic review: exposure, outcomes and quality assessment.
| Studies | Description of exposure | Measure of substance use | Increased substance use | Decreased substance use | No change | Quality assessmenta |
|---|---|---|---|---|---|---|
| Ahmed et al. (2020) | Full lockdown implemented with restricted transportation related to COVID-19 pandemic | AUDIT | Overall, hazardous drinking increased to 29.1%, harmful drinking increased to 9.5% and alcohol dependency reached to 1.6%. | Not reported | Not reported | Fair |
| Alomo et al. (2020) | Social isolation related to COVID-19 pandemic | Self-reported increase or decrease in alcohol use | 13% reported increases in alcohol use. | Not reported | Not reported | Poor |
| Alpers et al. (2021) | Social distancing, closure of schools, cultural and fitness facilities, related to COVID-19 pandemic | AUDIT-C | 13% increased alcohol use; 54% reported hazardous drinking. | 23% decreased alcohol use. | 64% did not change their alcohol use. | Good |
| Ammar et al. (2020) | Public health measures during COVID-19 including lockdown, closed gyms, no group gatherings, curfews and increased social distancing | Diet questionnaire including self-reported increase or decrease of drinking alcohol "out of control" | Not reported | Binge alcohol drinking decreased: 10.1–5.4% sometimes, 1.8–1.2% most of the time and 0.4% vs 0.2% always drank alcohol "out of control." | Not reported | Poor |
| Barbosa et al. (2020) | COVID-19 stay-at-home orders | Self-reported alcohol use behavior | 29% increased their average drinks per day; average drinks per day increased by 10%; 20% increase of those exceeding drinking limits; and 21% increase in binge drinking in April 2020 compared with February 2020. | Not reported | Not reported | Fair |
| Bartoszek et al. (2020) | Home confinement related to COVID-19 pandemic | Self-reported change in alcohol use since home confinement | 11.9% increased their alcohol use. | None | 38.6% reported no change; 49.5% reported no alcohol use. | Poor |
| Błaszczyk-Bębenek et al. (2020) | Home confinement related to COVID-19 pandemic | Frequency of alcohol use (never, 1–3 times a month, once a week, few times a week, once a day and few times a day) before and after home confinement | Alcohol was consumed more frequently during social isolation. | Not reported | Not reported | Poor |
| Boschuetz et al. (2020) | Social isolation, stay-at-home orders and social distancing related to COVID-19 pandemic | AUDIT-C | Increase in frequency, quantity consumed per day, and frequency consumed before 5 PM. Overall AUDIT scores increased from a median value of 3–4 (Statistically significant only among women). | Abstinence increased from 6.1% to 12.5%; binge drinking (>6 drinks) reduced from 45% to 30%. | Not reported | Good |
| Callinan et al. (2020) | Social distancing and isolation measures related to COVID-19 pandemic | AUDIT | 23.5% increased their AUDIT score. | 48.2% decreased their AUDIT score; mean score decreased from 8.16 to 7.33. | All groups significantly decrease their harmful drinking except for women aged 35 and older. | Good |
| Callinan et al. (2021) | Social distancing related to COVID-19 pandemic | Self-reported frequency, amount and location of alcohol use. Respondents categorized into low-risk (< 2 drinks per day), risky (2–4.99) or high risk (5 or more drinks per day). | 15% moved into a higher risk category. | 15.4% of respondents reported moving into a lower risk category. High-risk drinkers who drank 90% or more alcohol at home reported decreasing their use and were the only group who had less home alcohol use during the lockdown. | Overall, the mean number of drinks per day did not change. 69.5% remained in the same risk category. | Good |
| Chodkiewicz et al. (2020) | Enforcement of the COVID-19 public health measures which included lockdown, business shutdowns, and school closures | AUDIT; Self-reported recreational or designer drugs use | 13.8% increased alcohol use and 1.4% increased drug use. | 17.4% reduced alcohol use and 1.1% reduced drug use. | 27.8% already did not use alcohol and 93.7% did not use drugs. | Good |
| Constant et al. (2020) | Physical distancing, quarantine, school closures and banning gatherings related to COVID-19 pandemic | Self-reported alcohol use behavior | 14.8% of regular drinkers increased alcohol use. | 21.1% of regular drinkers decreased alcohol use. | Not reported | Fair |
| Czeisler et al. (2020) | COVID-19 physical distancing and stay-at-home orders | Self-reported initiation or increase of substance use to cope with stress | 13.3% reported increasing substance use to cope with stress or emotions related to COVID-19. | Not reported | Not reported | Fair |
| Czeisler et al. (2020) | COVID-19 physical distancing and stay-at-home orders | Self-reported increase of substance use | 15.1% reported increases in substance use. | Not reported | Not reported | Fair |
| Đogaš et al. (2020) | Lockdown, social distancing, and home confinement related to COVID-19 pandemic | Self-reported frequency of weekly alcohol use | Proportion of people who drank 7 drinks or more increased from 16.7% to 18.4%. | Proportion of people who did not drink alcohol increased from 19.1% to 32.1%; who drank occasionally (once per month) decreased from 31.9% to 22.3%; and who drank up to 3 drinks a week decreased from 32.3% to 27.2% | Not reported | Fair |
| Dozois (2021) | COVID-19 physical distancing and isolation measures | Self-reported increase or decrease in alcohol use and cannabis use | 28% increased alcohol use and 29% increase in cannabis use. | Not reported | 56% reported no change in alcohol use and 48% reported no change in cannabis | Fair |
| Every-Palmer et al. (2020) | Stay-at-home orders, school closures and travel bans related to COVID-19 pandemic | Self-reported number of standard drinks of alcohol per day | 22% increased alcohol use. | 18.9% decreased alcohol use. | 59.1% did not change their alcohol use. | Fair |
| Ferrante et al. (2020) | Lock down measures related to COVID-19 pandemic | Self-reported increase or decrease in alcohol use | 17.3% increased their alcohol use. | Not reported | Not reported | Poor |
| Gadermann et al. (2021) | Social isolation, school/childcare closures and employment instability related to COVID-19 pandemic | Self-reported change in alcohol use since home confinement | 27.7% of parents increased their alcohol use compared to 16.1% of those without children at home. | Not reported | Not reported | Poor |
| Garnett et al. (2021) | Social distancing and business closures related to COVID-19 pandemic | Self-reported number of drinks consumed in the past week, and changes in alcohol use | 26.2% reported increasing alcohol use over the past week. | 25.7% reported decreasing alcohol use over the past week. | 48.1% reported alcohol use the same as usual. | Good |
| Glowacz and Schmits (2020) | Self-isolation and social distancing related to COVID-19 pandemic | AUDIT-C; self-reported change in alcohol use | A larger percentage of middle-aged and older people increased their alcohol use. | 18–30-year olds reported significantly less use of alcohol, compared with other age groups. | Half the population did not change their alcohol use during lockdown. | Fair |
| Górnicka et al. (2020) | Isolation, social distancing, and home confinement related to COVID-19 pandemic | Self-reported change in alcohol use since home confinement | 18.1% increased their alcohol use. | 10.7% decreased their alcohol use. | 71.3% did not change their alcohol use. | Poor |
| Grossman et al. (2020) | Shelter-at-home orders related to COVID-19 pandemic | Self-reported change and motivation for alcohol use | 60.1% increased alcohol use compared to pre-COVID. | 12.8% reported that their alcohol use had decreased from pre-post COVID-19. | 27.0% did not change their alcohol use. | Fair |
| Huckle et al. (2020) | Home confinement, social distancing related to COVID-19 pandemic | Typical occasion quantity in the past week and self-reported change in alcohol use since home confinement | 47% of males and 53% of females reported drinking more alcohol during COVID-19 restrictions. | 26% of males and 22% of females reported drinking less alcohol during COVID-19 restrictions. | 28% of males and 25% of females reported drinking the same amount of alcohol. | Fair |
| Jackson et al. (2021) | Stay-at-home orders and social distancing related to COVID-19 pandemic | AUDIT-C and self-reported quit attempts | The prevalence of high-risk drinking (38.3%) was significantly higher during compared with before lockdown (25.1%). | Among high-risk drinkers, the odds of making a serious attempt to reduce alcohol use was 2.16 times higher after lockdown as compared to before lockdown. | Not reported | Good |
| Jacob et al. (2021) | Physical distancing related to COVID-19 pandemic | Self-reported change in alcohol use behavior | 17% increased alcohol use. | Not reported | Not reported | Poor |
| Killgore et al. (2021) | Stay-at-home orders related to COVID-19 pandemic | AUDIT-C | Higher levels of hazardous alcohol use among people in areas with lockdowns. AUDIT scores increased month-by-month for those under lockdown. | Not reported | Not reported | Fair |
| Koopmann et al. (2020) | Quarantining and social isolation related to COVID-19 pandemic | Self-reported changes in alcohol use | 34.7% increased alcohol use. | 19.4% decreased alcohol use. | 37.7% did not change their alcohol use. | Poor |
| Kriaucioniene et al. (2020) | Quarantining related to COVID-19 pandemic | Self-reported changes in alcohol use | 14.2%. increased alcohol use. | 15.9% decreased alcohol use. | 69.9% remained the same as before the COVID-19 quarantine. | Poor |
| López-Bueno et al. (2020) | Quarantining related to COVID-19 pandemic | Self-reported alcohol use | Not reported | Percent of the population that reported alcohol use decreased every week over the first three weeks of confinement (70.5% before, 53.4% week 1, 46.5% week 2% and 43.3% week 3). | Not reported | Poor |
| McKnight-Eily et al. (2021) | COVID-19 social isolation measures | Self-reported changes in substance use | 18.2% increased or newly initiated substance use. | Not reported | Not reported | Poor |
| Neill et al. (2020) | Social distancing related to COVID-19 pandemic | Self-reported changes to past week amount of alcohol use | 30.8% reported drinking a lot more than normal. | None | 69.2% reported no change or reducing their alcohol use. | Fair |
| Newby et al. (2020) | Border closures, lockdowns, social distancing and isolation related to COVID-19 | AUDIT-C | 52.7% met criteria for hazardous drinking; higher than the 42% found in previous primary care samples in Australia. | Not reported | Not reported | Fair |
| Niedzwiedz et al. (2021) | Physical distancing related COVID-19 | AUDIT-C | Binge drinking increased from 10.8% in 2017–2019 to 16.2% during lockdown, and dinking four or more times per week increased from 13.7% to 22%. | 5.6% consumed 5 or more drinks on a typical occasion during lockdown, compared with 13.6% 2017–2019. | Not reported | Good |
| Oksanen et al. (2021) | Social distancing related to COVID-19 pandemic | AUDIT-C | 25.4% increased their alcohol use; 53.4% of those who increased their alcohol use during COVID-19 had hazardous (5 or more) AUDIT scores. | 26.62% decreased their alcohol use. | 48.02% did not change their alcohol use behavior. | Good |
| Pollard et al. (2020) | Social distancing related to COVID-19 pandemic | Self-reported number of drinking days, heavy alcohol use and average number of drinks in past 30 days: 15- Item Short Inventory of Problems | Frequency of alcohol use increased by 0.74 days; a 14% increase over the baseline of 5.48 days in 2019. | Not reported | Not reported | Fair |
| Rodriguez et al. (2020) | Stay-at-home orders, social distancing, quarantine, and school closures related to COVID-19 pandemic. | Quantity/Frequency/Peak alcohol use index, in past month | Psychological distress was associated with a 7% increase in the maximum number of drinks consumed, 8% increase in the drinks consumed on a typical occasion and 8% increase in the number of past months drinking days. | Not reported | Not reported | Good |
| Rodriguez et al. (2020) | Home confinement related to COVID-19 pandemic | PREDIMED MedDiet (Mediterranean Diet) Adherence Screener which assesses weekly intake of seven or more glasses of wine | 10.4% increased alcohol use. | 57.3% decreased alcohol use. | 32.3% did not change alcohol use. | Poor |
| Rolland et al. (2020) | Lockdown and only continuing essential services such as medical visits and food supply related to COVID-19 pandemic | Self-reported increase or decrease of alphol and cannabis | 15.5% increased alcohol use. Among drinkers 24.8% increased their alcohol use, and among those who used cannabis 31.2% increased their use. | 10.9% decreased alcohol use. Among those that drank before the lockdown, 17.4% reduced or stopped. Among those who used cannabis before the lockdown, 29.3 reduced or stopped. | 57.8% did not change their alcohol use (36.1% stayed the same, and 37.6% already did not use), and 39.5% did not change their cannabis use. | Fair |
| Rossinot et al. (2020) | Travel bans and restricted trips outside of homes related to COVID-19 pandemic | Self-reported changes in alcohol use | 22.7% increased alcohol use. | 12.2% of decrease in their alcohol use. | 39.1% did not change their alcohol use. | Fair |
| Sallie et al. (2020) | Self-isolation related to COVID-19 pandemic | Self-reported units amount, frequency of alcohol use and AUDIT-C | 36% increased weekly alcohol use. | Units consumed during quarantine decreased, except in the UK; 45% decreased weekly alcohol use. | 19% did not change weekly alcohol use. | Good |
| Scarmozzino and Visioli (2020) | Home confinement related to COVID-19 pandemic | Self-reported change in alcohol use | 10.1% increased alcohol use. | 36.8% decreased alcohol use. | Not reported | Poor |
| Sidor and Rzymski (2020) | Social distancing measures related to COVID-19 | Self-reported frequency of alcohol use | 14.6% increased alcohol use. | Not reported | 77% reported no change in alcohol use. | Fair |
| Stanton et al. (2020) | Social distancing, travel bans and mass gathering cancellations related to COVID-19 pandemic | Self-reported frequency of alcohol use and change since pre-pandemic | 26.6% made "negative changes" (Drink much more, or a little more than usual). | 18.1% made "positive changes" (drank less or much less than usual, or have ceased drinking all together). | 55.3% reported no change in alcohol use. | Fair |
| Szajnoga et al. (2020) | School closures, travel bans, and social distancing related to COVID-19 pandemic | Self-reported frequency of alcohol use before and during home confinement | 17.9% used alcohol more often. | 39.3% used alcohol less often. | 42.8% reported the same amount of alcohol use. | Fair |
| Taylor et al. (2021) | Social distancing and stay-at-home orders related to COVID-19 pandemic | AUDIT and a COVID-19-related alcohol, the drug scales adapted from the AUDIT and self-reported yes/no increase in use | 23% of those who drank prior to the pandemic increased use; 31% reported of those who used drugs increased use; 23% increase in alcohol abuse and 16% increase in drug abuse. | Not reported | Not reported | Fair |
| Tran et al. (2020) | Social distancing related to COVID-19 pandemic | Self-reported changes in alcohol use | About one in five adults reported that they had been drinking more alcohol than usual since the COVID-19 pandemic began (20.9% weighted prevalence). | 10.5% reported less alcohol use. | 43.9% reported about the same alcohol use. | Fair |
| Vanderbruggen et al. (2020) | Lockdown and social distancing related to COVID-19 pandemic | Self-reported average number of standard drinks consumed in the prior week, number of joints consumed per day, and self-reported increase or decrease in use. | 5.8% of the population said they did not drink before but started during social distancing. 30.3% of the population said they drank more and 2.1% used more cannabis. There was a significant increase in the number of drinks per day from one (range 0–15) before to 1.4 during (Range 0–21). | 9.4% of the population quit drinking, 13.7% said used less alcohol and 1.1% used less cannabis. | Not reported | Good |
| Villanueva et al. (2021) | Confinement related to COVID-19 pandemic | AUDIT-C | Not reported | 15.1% reduction in people classified as risky alcohol consumers. | Not reported | Good |
| Wardell et al. (2020) | School closures, work closures, business closures, physical distancing, and stay-at-home recommendations related to COVID-19 pandemic | Quantity/ Frequency (QF) alcohol use index, in past month | Overall frequency of alcohol use was higher compared to 30 days prior to pandemic. | Overall amount per occasion was lower, which resulted in a stable QF score pre and during the pandemic. | Not reported | Good |
| Weerakoon et al. (2020) | Stay-at-home measures related to COVID-19 pandemic | Self-reported change in alcohol use and binge drinking during pandemic | 32.2% had more alcohol use. People who binge drank were more likely to increase alcohol use during the pandemic (60%) than non-binge drinkers (28%). | 10.2% had less alcohol use. | 34.9% had the same amount of alcohol use. | Good |
| Winkler et al. (2020) | Reduced hours for non-essential businesses and stay-at-home orders related to COVID-19 pandemic | Self-reported alcohol frequency and amount of alcohol use and binge drinking | There was a significant increase in number of drinks per drinking session and number of individuals who binge drank at least once per week. | Not reported | The prevalence of alcohol use disorder in 2020 was approximately the same as in 2017. | Fair |
| Zajacova et al. (2020) | Physical distancing and self-isolation related to COVID-19 pandemic | Self-reported alcohol use and cannabis use | 14% increased their alcohol use and 5.5% increased their cannabis use. | 9% decreased their alcohol use. | Not reported | Fair |
a
Assessed using the NIH quality assessment tools. Possible outcomes of these tools include Poor, Fair or Good, and the quality of evidence described relates to our research question (e.g., measures of change in substance use).