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Few multi-wave longitudinal studies have examined changes in drinking across extended periods of the coronavirus 2019 (COVID-19) pandemic. Using multiple indicators over three years, the current study examined: a) overall drinking changes; b) sex, income, age, and pre-COVID drinking level as moderators of changes; and c) the clinical significance of the observed changes. Using a longitudinal observational cohort design with nonclinical adults from the general community (N = 1395), assessments were collected over nine waves, two pre-COVID (April 2019 and October 2019) and seven intra-COVID (April 2020-April 2022). Drinking was measured as percent drinking days, percent heavy drinking days, and the Alcohol Use Disorders Identification Test (AUDIT) score. Clinically significant changes were defined based on the World Health Organization risk levels. All indicators exhibited significant changes from pre-pandemic to intra-pandemic periods, with drinking changes comprising early pandemic increases followed by subsequent decreases and AUDIT scores consistently declining. Pre-pandemic drinking level substantially moderated all changes. Heavier drinkers exhibited larger decreases compared to other drinking groups. In terms of clinically important changes, ∼10% of pre-pandemic abstinent or low-risk drinkers transitioned to medium- or high-risk status during the pandemic. In contrast, 37.1% of medium-risk drinkers and 44.6% of high-risk drinkers exhibited clinically significant decreases during the intra-pandemic period. Collectively, these findings highlight the multifarious impacts of the pandemic on drinking over time, comprising both increases and decreases in drinking behaviour., Competing Interests: Declaration of competing interest No authors declare any competing interests associated with this study. JM is a principal and senior scientist in BEAM Diagnostics, Inc., and a consultant to ClairvoyantRx, Inc. but no associated products or services were used in this study., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: The COVID-19 pandemic has been associated with major psychosocial disruptions and there is particular concern for individuals with substance use disorders. Objectives: This study characterized the psychosocial and experiential impacts of the pandemic on individuals seeking alcohol use disorder (AUD) recovery, including pandemic impacts on self-reported drinking, heavy drinking, tobacco, cannabis, and stimulant use. Methods: Participants were 125 AUD+ individuals (% males: 57.60; M age  = 49.11, SD = 12.13) reporting on substance use from January 1 st -24 th March, 2020 (pre-pandemic) and since the stay-at-home orders commenced, 24 th March-June 28 th 2020 (intra-pandemic). Within-subjects changes were examined and a latent profile analysis was performed to identify subgroups differentially impacted by the pandemic. Results: Large proportions reported psychosocial impacts of COVID-19, but drinking and other substance use did not reveal significant changes. Latent profile analyses revealed two subgroups: Profile 1 (n = 41/125), "Moderately Impacted") and Profile 2 (n = 84/125), "Severely Impacted"). Compared to the pre-pandemic period, the group that was moderately impacted by the pandemic exhibited significantly fewer heavy drinking days ( p  = .02) during the intra-pandemic period, but no other substance use changes. The group showing severe pandemic impacts did not exhibit changes in alcohol or other drug use but evidenced more severe anxiety and depression ( ps  < .001). Conclusions: We found heterogeneous subtypes of pandemic-related impacts in AUD recovery patients. There is need to provide psychosocial support to this particular population and further monitoring substance use and mental health.

Background: COVID-19 is a global pandemic and vaccination efforts may be impeded by vaccine hesitancy. The present study examined willingness to receive a COVID-19 vaccine, the associated reasons for willingness/unwillingness, and vaccine safety perceptions in a cross-sectional assessment of community adults in Ontario. Methods: One thousand three hundred sixty seven individuals (60.6% female, mean age = 37.5%) participated in this study between January 15, 2021 and February 15, 2021. Perceptions of vaccine safety and reasons for willingness/unwillingness to receive the COVID-19 vaccine were investigated using an online assessment. Perceptions were investigated in general and by age, sex and education using analysis of variance. Results: Overall, 82.8% of the sample reported they were willing to receive a COVID-19 vaccine and 17.2% reported they were unwilling. The three most common reasons for unwillingness were long-term side effects (65.5%), immediate side effects (60.5%), and lack of trust in the vaccine (55.2%). Vaccine willingness significantly differed by sex and education level, with female participants and those with less than a bachelor's degree being more likely to report unwillingness. Perception of COVID-19 vaccine safety was significantly lower (-10.3%) than vaccines in general and differed by age, sex and education, with females, older adults, and individuals with less than a bachelor's degree reporting lower perceived COVID-19 vaccine safety. Conclusion: In this sample of community adults, the COVID-19 vaccine hesitancy rate was less than one in five individuals, but with higher rates in population subgroups. Targeting public health messaging to females and individuals with less than bachelor's degree, and addressing concerns about long-term and immediate side effects may increase vaccine uptake., Competing Interests: JM is a principal and senior scientist in BEAM Diagnostics, Inc. and a consultant to Clairvoyant Therapeutics, Inc., but no related products or services were used in this research. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Syan, Gohari, Levitt, Belisario, Gillard, DeJesus and MacKillop.)