Interrupted Time Series Analysis of Alcohol Use Disorder Treatment Utilisation During the Coronavirus Pandemic in Hamburg, Germany.

introductionAlcohol use and treatment for alcohol use disorder (AUD) changed during the pandemic. Alcohol consumption increased among high-risk groups, while treatment utilisation declined, raising concerns about an expanding treatment gap. This study analyses inpatient and outpatient AUD treatment trends during the pandemic.

methodsWe analysed electronic health records from 5671 patients residing in Hamburg, Germany, who utilised at least one alcohol-related treatment between January 2016 and December 2021. Data from two statutory health insurance providers and two pension funds provided weekly numbers of patients receiving AUD treatment, including outpatient (psychiatric consultations, psychotherapy, pharmacotherapy), inpatient standard and intensive treatment, and outpatient and inpatient rehabilitation programs. Using a segmented regression approach, we examined changes over time for: (i) any treatment; (ii) outpatient treatment; and (iii) inpatient treatment across five periods of the pandemic: pre-pandemic, first lockdown, between lockdowns, second lockdown and post-second lockdown.

resultsDuring the first lockdown in spring 2020, AUD treatment utilisation declined by 27% before briefly returning to near pre-pandemic levels. A gradual decline was observed in later pandemic periods, even after containment measures were lifted. The decline was more pronounced in inpatient settings than in outpatient settings, at -45% and -15%, respectively, during the first lockdown. DISCUSSION AND

conclusionsThe utilisation of AUD treatment services dropped substantially during the pandemic, particularly in inpatient settings. This reduction may have contributed to the rise in alcohol-related deaths during this period. This study is the first to assess long-term inpatient and outpatient treatment trends across multiple pandemic phases.