COVID-19 Stress (Traumatic Symptoms, Compulsive Checking, Xenophobia, and Danger & Contamination) and Alcohol Use Uniquely Explain State Alcohol Cravings

Stressful events may lead to the consumption of alcohol as a self-medicating and coping strategy. The self-medication hypothesis and addiction loop model served as the theoretical frameworks to understand how various COVID-19 pandemic stressors serve as risks for alcohol usage and state alcohol cravings. The study hypothesized that higher COVID-19 stressors (past month) would predict higher alcohol use (past month), and both were hypothesized to uniquely explain stronger alcohol cravings (state). Adult alcohol users (N = 366) participated in this cross-sectional study. Respondents completed measures of the COVID Stress Scales (socioeconomic, xenophobia, traumatic symptoms, compulsive checking, and danger & contamination), drink frequency and drink quantity, and state alcohol cravings (Alcohol Urge Questionnaire and Desires for Alcohol Questionnaire). Results from a structural equation model involving latent factors determined that higher pandemic stress explained greater alcohol use, and both factors uniquely contributed to stronger state alcohol cravings. A structural equation model premised on specific measures revealed that higher xenophobia stress, higher traumatic symptoms stress, higher compulsive checking stress, and lower danger & contamination stress uniquely predicted drink quantity, but not drink frequency. Furthermore, greater drink quantity and drink frequency independently predicted stronger state alcohol cravings. The findings recognize that pandemic stressors operate as cue-induced triggers for alcohol use and cravings. The COVID-19 stressors identified in this study could be targeted in interventions based on the addiction loop model designed to mitigate the effects of stress cues on alcohol use and present cravings for alcohol.