Researchers know that people reported worse mental health, and in some cases more alcohol use, during the COVID-19 pandemic, but it’s not known how the pandemic affected people in recovery from alcohol problems, especially how they coped with new stressors.

A team of investigators led by Paul Gilbert, associate professor of community and behavioral health in the University of Iowa College of Public Health, conducted a study to better understand alcohol problems and recovery during the pandemic. The study was published online on April 17, 2023, in the journal PLOS One.

The researchers used two different methods to collect information about people’s coping experiences and recovery strategies during the pandemic, and they paid special attention to differences between women and men. In fall 2020, 1,492 U.S. adults who were in recovery or said they had resolved a past alcohol problem answered an online survey. First, participants were asked about coping strategies during the pandemic and could choose all that applied from a list of 19 possible activities. Second, 1,008 participants answered an open-ended question by describing their strategies to maintain recovery during the pandemic.

Most of the people who answered the survey met criteria for severe lifetime alcohol use disorder (73%), reported being in recovery more than five years (76%), and had never gotten treatment or attended mutual-help groups, like Alcoholics Anonymous (60%).

Based on the coping checklist, the order of strategies was quite similar for women and men; however, the top strategy (talking with family and friends by phone, text, or video) was endorsed by more women than men.

Among themes in the open-ended answers, “staying connected” was the most common, with most participants mentioning family members, and women mentioning children more often than men. Among other themes, “cognitive strategies” (such as staying positive and recalling past drinking consequences) mirrored established types of psychotherapy, and “active pursuits” (keeping oneself occupied in various ways) aligned with many recent recommendations for service providers working with substance-using populations during the pandemic.

A surprising finding was that some people reported that pandemic restrictions, like bar closures or quarantines, helped them by reducing exposure to relapse risks, like places or people associated with past drinking.

“These results give us a better understanding of the things that people did to ensure their recovery during a stressful time with greater social isolation,” says Gilbert. “Based on what we learned, we will be better prepared to support recovery in the future, especially during periods when treatment and recovery support are less available, and during natural disasters or other catastrophic events.”

The research team included Loulwa Soweid, Paul J. Holdefer, and Sarah Kersten from the University of Iowa Department of Community and Behavioral Health, and Nina Mulia from the Alcohol Research Group, Public Health Institute, in Emeryville, California.