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的作用还没有得到很好的理解， 在COVID-19大流行的背景下，这是公共卫生的首要任务。早期报告显示，COVID-19 这一流行病严重影响了酒精的使用。然而，为了有效地了解暴露于 这种流行病以及影响个人饮酒具体方面需要数据 灾前收集的真实的时间（而不是依赖于回顾性报告）。其中包括：过去 酒精使用和相关的风险因素，不同年龄的先前灾害暴露，不同程度的暴露 严重程度相同的大规模灾难，先前的心理健康和背景因素。这项研究还要求 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，利用COVD-19作为一种天然药物， 一项旨在探索大规模灾难暴露对酒精使用的影响的实验。纽约市（NYC） 是2020年3月COVID-19大流行的美国震中。纽约市第一例确诊病例是 2020年3月1日确诊，2020年3月14日确诊首例COVID-19死亡。3月20日，一个避难所 命令是强制执行的。与此同时，酒类商店和送货上门被认为是"必不可少的 服务"，沿着着杂货店和医院。这项拟议的研究将借鉴我们的压力和 COVID研究（N = 866），居住在纽约大都会地区，并已进行了六次评估 自2007年以来（3人在COVID前和3人在COVID期间），他们暴露于大规模灾难（9/11和COVID-19），饮酒， 心理健康和家庭/背景因素。在获得这六波数据之后，这项研究将增加 在该队列的一个子集中进行三次新的前瞻性数据收集（2022 - 2027年），并将调查 COVID-19酒精使用行为的详细信息。这项研究的首要目标是调查酒精的使用 受到COVID-19大流行的长期影响，采取了大流行前酒精使用，精神 健康和先前创伤暴露。利用每一个先验知识的丰富信息 结合对酒精使用、心理健康和 其他物质的使用，以及他们的流行病经验的独特特征，我们将确定具体的 大规模灾难对酒精使用的影响。我们的研究结果将对临床公共卫生产生重大影响， 减轻当前大流行病的长期危害，同时加深我们对大规模灾难如何 影响酒精使用行为。这项研究的结果是迫切需要提供证据，是否 饮酒和饮酒问题的人口水平的增加是暂时的增加，还是 COVID-19和认为酒精是必不可少的组合的非预期长期剩余结果 在庇护所的地方秩序。我们的估计将为政策制定者提供信息，并为以下方面的影响提供新的见解： 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.