From 9/11 Through COVID-19: Mass Disaster and Alcohol

大规模灾难作为酒精使用增加的风险因素所起的作用还没有得到很好的理解，并出现了如下情况 在新冠肺炎大流行的背景下，这是公共卫生的首要任务。早期的报道表明，新冠肺炎 大流行极大地影响了酒精的使用。然而，要有效地了解暴露在何种程度上 影响个人饮酒的大流行以及这种经历的具体层面需要数据 在灾前实时收集(而不是依赖回溯性报告)。这包括：他们的过去 酒精使用及相关风险因素、不同年龄、不同暴露程度的既往灾害暴露 同样的大规模灾难的严重性、既往的心理健康和背景因素。这样的研究还需要 在COVD-19期间和之后，对他们的酒精使用和相关风险因素进行前瞻性、重复的评估。 通过满足这些标准，目前的研究提供了一个独特的机会来利用COVD-19作为一种天然的 探索暴露在大规模灾难中对酒精使用的影响的实验。纽约市(NYC) 2020年3月是美国新冠肺炎大流行的震中。纽约市第一例确诊病例是 2020年3月1日确认，第一例新冠肺炎死亡病例于2020年3月14日死亡。3月20日，一个避难所就位 命令是强制执行的。与此同时，酒类商店和送货上门的酒类被认为是一种“必需品” 服务“，以及杂货店和医院。这项拟议的研究将在我们的压力和 COVID研究(N=866)，居住在纽约市大都市区，已经进行了六次评估 自2007年(3人感染新城疫前和3人感染期间)以来，他们因接触到大规模灾难(9/11和新冠肺炎)，酗酒， 心理健康和家庭/背景因素。有了这六波之前的数据，这项研究将补充 在该队列的子集中进行三次新的预期数据收集浪潮(2022-2027)，并将调查POST 新冠肺炎饮酒行为详解。这项研究的首要目标是调查酒精的使用情况 长期受到新冠肺炎大流行的影响，获取了大流行前酒精使用、精神疾病的大量数据 考虑到健康和先前的创伤暴露。使用关于每个人之前的丰富信息 新冠肺炎，结合这项前瞻性检查(2022-2027年)， 其他物质的使用，以及他们大流行经历的独特特征，我们将确定具体的 大规模灾难对饮酒的影响。我们的发现将对以下方面产生重大的临床公共卫生影响 减轻当前大流行造成的长期危害，同时加深我们对大规模灾难如何 影响饮酒行为。这项研究的结果迫切需要提供证据来证明 人群水平的酒精使用增加和酒精使用问题是暂时的增加还是 新冠肺炎和认为酒精是必需的联合治疗的意外长期残余结果 在原地避难所秩序期间。我们的估计将为政策制定者提供信息，并为以下影响提供新的见解 随着时间的推移，酒精使用方面的大规模灾难，这将是制定健全的公共卫生政策的关键。

The role of mass disaster as a risk factor for increased alcohol use is not well understood and has emerged as a top public health priority in the context of the COVID-19 pandemic. Early reports suggest that the COVID-19 pandemic has substantially affected alcohol use. Yet, to effectively understand the degree to which exposure to the pandemic, and specific dimensions of that experience, affect an individual’s alcohol use requires data collected pre-disaster, in real time (as opposed to relying on retrospective reporting). This includes: their past alcohol use and related risk factors, prior disaster exposure at varying ages, differing degrees of exposure severity to the same mass disaster, prior mental health and contextual factors. Such a study also requires prospective, repeated assessments, during and following COVD-19, of their alcohol use and related risk factors. By meeting these criteria, the current study offers a unique opportunity to utilize COVD-19 as a natural experiment to explore the impact of exposure to mass disaster on alcohol use over time. New York City (NYC) was the U.S. epicenter of the COVID-19 Pandemic in March, 2020. The first confirmed case in NYC was identified on March 1, 2020, and the first COVID-19 death on March 14, 2020. On March 20th, a shelter in place order was mandated. Simultaneously, liquor stores and home delivery of alcohol were deemed an “essential service", along with grocery stores and hospitals. The proposed study will draw on participants in our Stress & COVID Study (N=866), who reside in the NYC Metropolitan Area, and have already been assessed six times since 2007 (3 pre-COVID and 3 during) for their exposure to mass disaster (9/11 and COVID-19), alcohol use, mental health and family/contextual factors. Having access to those six prior waves of data, this study will add three new prospective waves of data collection (2022-2027) in a subset of that cohort and will investigate post COVID-19 alcohol use behaviors in detail. The overarching goal of this study is to investigate how alcohol use is impacted long-term by the COVID-19 pandemic, taking extensive data on pre-pandemic alcohol use, mental health and prior trauma exposure into account. Using the wealth of information available on each individual prior to COVID-19, in combination with this prospective examination (2022-2027) of alcohol use, mental health and other substance use, as well as unique features of their pandemic experience, we will determine the specific impact of mass disaster on alcohol use. Our findings will have substantial clinical public health implications for mitigating long-term harm from the current pandemic, while deepening our understanding of how mass disaster affects alcohol use behaviors. This study’s results are urgently needed to provide evidence on whether a population-level increase in alcohol use and alcohol use problems was a temporary increase or whether it is an unintended long-term residual outcome of the combination of COVID-19 and deeming alcohol to be essential during shelter-in-place order. Our estimates will inform policymakers and provide new insight into the impact of mass disasters on alcohol use over time, which will be critical in developing sound public health policy.