Functional relations between alcohol use and mental/physical health in the wake of the COVID-19 pandemic

Project Summary Beyond the impact of infection itself, the COVID-19 pandemic has resulted in far-reaching effects onbehavioral, social, psychiatric, and substance use outcomes. Early data has documented increases in alcoholuse in the wake of the pandemic, consistent with prior evidence of increased alcohol consumption during timesof stress and following traumatic events. Immediate and downstream implications of increased alcohol use, anddevelopment of alcohol use disorder (AUD), on public health include the interplay between alcohol use andpsychiatric distress (i.e., posttraumatic stress disorder; PTSD), potential for problematic alcohol use to increasebehavioral risk for infection/transmission of COVID-19, and the possibility that weakened immune systems andhealth conditions associated with AUD may impact disease severity in those who develop COVID-19. Theoverarching goals of this K01 Supplement are twofold. First, this supplement aims to extend the PI's training toincorporate health impacts of AUD and how it relates to COVID-19 risk and severity, along with analytic trainingin longitudinal modeling and methodological training in an intensive time-series data collection method to try anddevelop a mechanistic understanding of the functional relations between alcohol use, PTSD, risky behaviors,and health outcomes. Second, two new research aims associated with these training aims were added whichseek to address gaps in the current stress and alcohol use literature by leveraging an existing, longitudinaldataset, with prospective (i.e., pre-pandemic) data. The two new research aims are to 1) assess the immediate,and trajectory of, COVID-19 impacts on alcohol phenotypes (e.g., consumption, binge drinking, problems) incomparison to pre-pandemic data and 2) in the context of COVID-19 as an ongoing stressor, collect repeated,time-series data to examine the temporal relations between alcohol phenotypes, PTSD, and COVID-specificrisky behaviors (e.g., lack of social distancing). To achieve these training and research aims, an additional mentorwith expertise in both the health impact of AUD and COVID-19 treatment trials has been added to themultidisciplinary mentorship team. Further, the PI's primary K01 mentor has specific expertise in theimplementation of COVID-19 surveys on substance and mental health outcomes and experience with time-seriesdata collection in traumatic stress populations. The proposed research represents an important contributiontowards advancing our understanding of the complicated interrelationship between AUD, PTSD, and riskybehaviors in the context of the COVID-19 pandemic to determine not only who is at risk, but when risk behaviorsoccur. This information will be important for attempts to plan for a public health response during and after thepandemic. Under the umbrella of a career development award, this pilot data will inform future large-scale studiesand R-level grants aimed at identification and prevention of COVID-19-related impact, further positioning the PIto continue this line of work by adapting ongoing training to be responsive to medical pandemics and decreasethe burden of alcohol-related problems, consistent with NIAAA research priority.