Abstract
Polarization of alcohol consumption or coding changes as the cause of the increase in 100% alcohol-attributable deaths in Lithuania during the COVID-19 pandemic
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Faculty of Medicine, Clinic of Anaesthesiology and Intensive Care, Vilnius University, Lithuania
- Health Research Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
Introduction:
Fully (i.e., 100%) alcohol-attributable mortality rates increased markedly in Lithuania during the COVID-19 pandemic. Polarization of alcohol consumption (that is, the decrease in consumption among people who drink at light to moderate levels and the increase in consumption among people who drink at a heavy level) has been most often cited as the main reason, but alternatively, changes in coding guidelines from unspecified to alcohol-related liver cirrhosis have been listed as an alternative explanation.
Material and methods:
We used interrupted time series analysis to test this explanation.
Results:
We found no evidence that the changed coding guidelines had impacted the ratio between unspecified and alcohol-related liver cirrhosis. Thus, changes in coding guidelines cannot explain the observed increases in 100% alcohol-attributable mortality.
Conclusions:
Polarization of drinking remains the most likely cause, with decreases in medical services for treatment of alcohol use disorders and/or liver cirrhosis during the COVID-19 pandemic likely aggravating the situation.
Keywords
alcohol use, 100% alcohol-attributable deaths, COVID-19, Lithuania, coding change, stigma, polarization
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