1. Introduction

The COVID-19 pandemic has posed a continuous and significant threat to individual health and safety worldwide. In response, many countries implemented preventive measures such as social distancing and lockdowns from the early stages of the pandemic to reduce physical contact. Even in the post-COVID era, where vaccines have become widespread and various medical and social treatment strategies have been established, social distancing remains an important strategy. The infectious disease crisis brought on by the COVID-19 pandemic has fundamentally increased both individual and collective stress levels. In particular, social distancing inevitably leads to physical and psychological isolation, which has been reported to induce depression and psychological distress [1, 2]. This effect has been especially pronounced among adolescents, with a significant rise in the number of students experiencing anxiety, loneliness, and depression following the outbreak of COVID-19 [3]. Ultimately, the heightened levels of anxiety and fear caused by the pandemic, along with the inability to engage in previously enjoyed social activities for infection prevention, have resulted in extreme stress. Research suggests that such chronic stress increases the risk of substance abuse, particularly alcohol addiction [4, 5]. This is because individuals experiencing psychological distress in response to adverse environmental conditions tend to seek out addictive or potentially addictive behaviors as a coping mechanism [6]. In fact, during the “stay-at-home” campaign in the United States, household alcohol consumption reportedly increased by 54%. Additionally, the World Health Organization officially expressed concern over the potential rise in alcohol consumption during the COVID-19 pandemic [7]. Similarly, in South Korea, a national mental health survey found that between March and May 2020, the frequency of alcohol consumption increased from 8.3 times per month to 11.6 times per month. Furthermore, the overall drinking rate rose to 64.9%, surpassing the 60.9% recorded in 2018 [8].

Prior research on the impact of COVID-19 on alcohol addiction has primarily focused on four key areas: the polarization of alcohol consumption, the demographic characteristics of increased alcohol use, its effects on alcohol addiction, and the implications for alcohol addiction treatment and services. Regarding the polarization of alcohol consumption, studies have reported that in the UK, social distancing and lockdown measures reduced opportunities for social drinking, leading to decreased alcohol consumption in some groups, while others experienced an increase, resulting in a polarization effect [9]. A similar trend has been observed in South Korea. According to a study conducted by the Korea Health Promotion Institute, 63.1% of individuals who drank once a week reported a decrease in alcohol consumption after the pandemic. In contrast, 26.3% of those who drank more than once a week reported an increase. Regarding the demographic characteristics of increased alcohol consumption, prior research suggests that the rise in alcohol use during COVID-19 was particularly pronounced among women. A study conducted in the United States found that excessive drinking and alcohol-related problems among women increased by up to 39%. Similarly, in the UK, the increase in alcohol consumption was more significant among women than men. In South Korea, the frequency of drinking among women also increased more than that of men immediately after the onset of the pandemic [10]. This trend has been interpreted in prior studies as a result of social distancing and lockdowns acting as greater stressors for women. The COVID-19 crisis disproportionately affected women, as they experienced higher job losses and an increased burden of domestic and caregiving responsibilities. These factors negatively impacted their mental health, ultimately leading to higher alcohol consumption [11]. From a depression standpoint, data from the Korean Welfare Panel Survey indicated that female workers exhibited higher depression levels after COVID-19 compared to their male counterparts [12]. In terms of alcohol addiction, research has shown that the number of individuals suffering from alcohol dependency increased after the onset of COVID-19. A U.S. study that tracked alcohol-related problems on a monthly basis for six months after the pandemic began reported a general rise in alcohol addiction. The prevalence of suspected alcohol use disorder continued to increase throughout the six-month period, with self-isolation being identified as a significant risk factor for alcohol use disorder [13].

Research on alcohol addiction treatment and service accessibility during the COVID-19 pandemic indicates that while alcohol consumption patterns changed, access to addiction treatment and related services significantly declined, further exacerbating alcohol addiction. This decline was primarily due to healthcare resources being heavily concentrated on COVID-19 response efforts, leading to a reduction in non-emergency medical services, including addiction treatment programs. In the early stages of the pandemic, in-person support groups, such as self-help meetings, were largely canceled, making it difficult for individuals in recovery to maintain sobriety. Prior studies suggest that the combination of weakened social support networks and pandemic-related stress created a dual burden, increasing the risk of relapse [12]. In fact, the relapse rate among individuals registered at integrated addiction management centers in the first half of the pandemic rose from 21.9% in the first half of 2019 to 32.8%. However, due to social distancing policies, addiction treatment services were reduced, leading to decreased accessibility to necessary care [14].

Although various national-level studies have been conducted on the impact of COVID-19 on alcohol consumption, research focusing on specific local communities remains insufficient. Alcohol-related issues fundamentally pose a social problem that affects local communities. Therefore, it is essential to examine how COVID-19 has specifically influenced alcohol-related problems at the community level.

Based on the key theories presented in prior research, this study aims to examine how the crisis of COVID-19 has affected alcohol-related harm in local communities.

This study contributes to the literature in several ways. It provides empirical evidence on the link between COVID-19 and alcohol-related health outcomes, expanding prior work that largely addressed general mental health. It further identifies gender-specific differences, showing that women were more affected, which highlights the need for tailored interventions. By analyzing regional hospital data, the study underscores the vulnerability of local healthcare systems during crises and the value of community-based evidence. The findings on reduced access to medical services emphasize the importance of strengthening tele-mental health support and essential in-person care. Finally, the study suggests directions for future research, including nationwide analyses and an exploration of why hospital visits declined.

2. Materials and Methods

Based on prior research, this study analyzes the established research topics by examining how COVID-19 has increased stress levels among community members, leading to higher alcohol consumption. This, in turn, contributes to various alcohol-related diseases, including alcohol addiction, ultimately impacting the local healthcare infrastructure.

For Research Topic 1, this study extracted regional stress index and alcohol consumption rate data from the 2020 National Statistical Portal operated by Statistics Korea and conducted a correlation analysis.

For Research Topics 2 and 3, this study analyzed changes in alcohol-related patients after COVID-19 by extracting and examining data from 662 patients diagnosed with alcohol-related diseases at a general hospital. The criteria for selecting patients diagnosed with alcohol-related diseases were based on alcohol-related disease codes, as shown in Table 2.

This study was approved by the Institutional Review Board (IRB) of the hospital responsible for protecting the rights, safety, and welfare of the research participants.

To analyze the research topics established in this study, correlation analysis, descriptive statistical analysis, cross-tabulation analysis, multivariable logistic regression analysis and firth correction were conducted using IBM SPSS software. To examine the factors influencing alcohol-related outcomes during the COVID-19 pandemic, we employed a multivariate logistic regression model. Logistic regression is appropriate in this context because the dependent variable was binary, defined as the occurrence of alcohol-related diseases and hospital visits due to alcohol addiction after the onset of COVID-19. Independent variables included the number of psychiatric consultations, emergency room visits, and hospitalizations, while sex and age were incorporated as covariates to adjust for potential confounding effects.

The correlation analysis was performed on the stress index and alcohol consumption rate data extracted from regional data provided by Statistics Korea. For descriptive statistical analysis, cross-tabulation analysis, and logistic regression analysis, data from a general hospital, including emergency room visits, psychiatric care usage, and hospitalization records, were utilized.

3. Results

4. Discussion

The key findings from this study on the impact of COVID-19 on community alcohol-related issues are as follows. First, the stress index of community members was found to be a contributing factor to increased alcohol consumption in the region. Second, COVID-19 has restricted access to hospital infrastructure for alcohol-related patients. Analyzing the hospital utilization rate of alcohol-related patients at a general hospital revealed that nearly 50% of patients during the study period had not visited the hospital after the onset of COVID-19. This limitation in accessing hospital services after COVID-19 appears to have worsened the condition of alcohol-related patients in the community. The analysis showed that patients who accessed the hospital infrastructure for the first time after COVID-19 had an emergency room visit rate approximately 14 times higher than those who did not, along with significantly higher rates of psychiatric visits and hospitalizations. Furthermore, for alcohol addiction, the most severe alcohol-related disorder, the hospitalization rate of those who visited the hospital for the first time after COVID-19 was more than 47 times higher than that of those who had not. Lastly, regarding gender distribution, the findings indicate that COVID-19 has had a greater impact on alcohol-related issues among women.

These findings empirically support previous studies on the impact of COVID-19 on alcohol consumption. Specifically, first, the results align with prior research suggesting that social isolation due to infectious disease crises like COVID-19 induces both individual and collective stress in a region, leading to increased alcohol consumption. Second, the study confirms previous research indicating that crises such as COVID-19 reduce non-emergency hospital services, subsequently decreasing access to addiction-related services. Furthermore, the findings show that while the proportion of patients with preexisting alcohol-related disorders who did not seek hospital care increased due to the reduction in non-emergency services after COVID-19, those who did use hospital infrastructure had significantly higher utilization rates of emergency services, psychiatric consultations, and hospitalizations. This suggests that patients are only seeking medical care after their conditions have severely worsened. Notably, patients with alcohol use disorder who visited the hospital for the first time after COVID-19 had particularly high hospitalization rates, a non-emergency service, indicating that this trend is even more pronounced. Ultimately, these findings support prior research emphasizing the need to strengthen effective guidelines and planning for remote mental health services and essential in-person care for addiction treatment during infectious disease outbreaks. It also underscores the necessity of developing non-contact service methods to minimize physical contact. Lastly, the results align with previous studies indicating that the impact of COVID-19 on alcohol-related issues has been more significant for women than for men.

This study provides empirical analysis of the impact of the COVID-19 crisis on alcohol-related disorders in the community, demonstrating that increased stress among community members due to COVID-19 has led to higher alcohol consumption and restricted access to infrastructure, resulting in greater harm. This contribution underscores the value of the research. In terms of originality, this study makes several notable contributions. Unlike most prior research that has relied on national-level data, our analysis is based on a community hospital dataset, thereby providing concrete evidence of how local healthcare systems were affected during the COVID-19 crisis. The study also identifies a clear gender-specific difference, with women being more adversely affected, highlighting the need for gender-sensitive interventions. Furthermore, by quantifying the risk of emergency visits and hospitalizations, this research provides a more precise understanding of the severity of pandemic-related alcohol problems. Finally, the study advances the discussion beyond descriptive findings by suggesting practical policy implications, including the expansion of tele-mental health services and the preservation of essential in-person treatments.

However, the study is limited by its focus on a specific general hospital in a particular region, which restricts the generalizability of the findings. Additionally, there may be other reasons for patients not visiting the hospital after COVID-19 beyond limited access to hospital infrastructure. Therefore, future research should include nationwide verification and further analysis of the reasons why alcohol-related patients did not seek hospital care after COVID-19.

5. Conclusions

The pandemic crisis of COVID-19 has a serious impact on community alcohol issues. Specifically, the increase in community stress leads to higher alcohol consumption; however, access to alcohol-related hospital infrastructure services has decreased, resulting in the worsening of various alcohol-related diseases among community residents.