Alcohol Sales and Adverse Events during the Covid-19 Pandemic

Background
Alcohol sales increased at the onset of the coronavirus disease 2019 (Covid-19) pandemic, while alcohol-related emergency department (ED) visits decreased. It is unknown whether these patterns of alcohol use persisted or led to delayed effects on health.

Objective
This study analyzed six years of alcohol sales data in Ontario, Canada, to compare pre-pandemic and pandemic trends in sales, as well as alcohol-related ED visits, hospital admissions, and toxicity deaths.


Methods
We conducted a cross-sectional time series analysis of alcohol sales and alcohol-related adverse events in Ontario, Canada. We analyzed six years of alcohol sales data and monthly counts of alcohol-related ED visits, hospitalizations, and deaths. Using linear mixed models and Poisson regression, we compared alcohol sales and adverse events before and during the COVID-19 pandemic (March 1, 2020–February 26, 2022).


Results
Alcohol sales increased, on average, by CA$43.5 million per month during the pandemic years compared with the pre-pandemic period. We observed a 7% increase in the proportion of alcohol-related ED visits during the pandemic years, due to a modest decrease in alcohol-related ED visits and a larger decrease in all-cause ED visits. Overall, an average increase of 191 alcohol-related admissions occurred per month and there was an average increase of 8 toxicity deaths per month.

Conclusion
Alcohol sales and alcohol-related adverse events increased during the Covid-19 pandemic.

Citation
Yaseen W, Kiss A, Chau J, Huang Q, Wang S, Iacono A, Yang J, Malikov K, Hillmer MP, Gomes T, Redelmeier DA, Zipursky JS. (2025). Alcohol sales and adverse events during the Covid-19 pandemic. NEJM Evidence.

Access the full article and additional resources: