Betty Ford Foundation Breaks 73-Year Admission Record Because of Pandemic Alcoholism Surge

As many Americans shift their focus to a new, post-pandemic life, rehabilitation centers across the country say they are still dealing with the consequences of a surge in alcohol use that began during the pandemic.

The Hazelden Betty Ford Foundation, which runs 16 treatment centers nationwide, had close to 700 admissions across all of its sites in the month of March —  the highest number of monthly admissions it has recorded since it was founded 73 years ago, the foundation’s chief medical officer, Dr. Alta DeRoo, told National Review in a recent interview.

Though some of the patients are receiving treatment for use of methamphetamines, benzodiazepines, or opioids, DeRoo said alcohol-use disorder is the primary disease the foundation is treating.

“We’re hearing all of this in the media, about how people are suffering the consequences of a pandemic, but we’re actually seeing it here,” she said. “We’re at 100 percent [capacity] at all of our facilities. We’ve had more admissions than we’ve ever had in our entire existence. No longer do I have to look at the media and believe it because I can see the numbers here in our facility.”

During the pandemic, many Americans let their health needs slide, including treatment for substance-use disorders, DeRoo said, noting that many patients struggling with alcohol-use disorder had difficulty accessing doctor’s appointments, meetings, and other preventative health care.

“So when we’re seeing patients now that come in with alcohol-use disorder, or any substance-use disorder, we’re seeing that they’re sicker, that the acuity is higher with all of our patients,” she said, adding that Hazelden has seen more liver disease, more mental health issues, and more significant effects on the brain from long-term alcohol use and substance use.

Meanwhile, alcohol-related deaths, including from liver disease and accidents, increased to 99,017 in 2020, up from 78,927 the year prior, according to a study published last month by researchers with the National Institute on Alcohol Abuse and Alcoholism, a division of the National Institutes of Health.

The study, which was published in the Journal of the American Medical Association, found that alcohol-related deaths among adults younger than 65 outnumbered deaths from Covid-19 in the same age group in 2020.

While 74,408 Americans ages 16 to 64 died of alcohol-related causes, 74,075 individuals under 65 died of Covid-19, the study found. The rate of increase for alcohol-related deaths in 2020 (25 percent) was greater than the rate of increase of deaths from all causes (16.6 percent).

The report’s lead author, Aaron White, who is a senior scientific adviser at the alcohol-abuse institute, told the New York Times that researchers believe there were “lots of people who were in recovery and had reduced access to support that spring and relapsed.”

Dr. Deni Carise, co-founder and chief science officer at Recovery Centers of America, said the centers have also seen a surge in alcohol-use disorder.

RCA, which collects data on the average number of days people used alcohol, found that the number of days people used alcohol in 2020 increased by 28 percent over the year before. The average number of days fell slightly in 2021, by 8 percent, before rising 7 percent in 2022.

Heavy usage, or the consumption of five or more drinks in one sitting, increased as well; the number of days people reported using alcohol heavily increased 20 percent in 2020 compared to 2019.

RCA has also seen a steady rise in patients seeking treatment for alcohol as their primary drug, a trend that began before the pandemic. Among thousands of patients at RCA’s centers in 2017–18, the percentage of people who said alcohol was their main problem went up 59 percent in 2018, 110 percent in 2019, 39 percent in 2020, and 42 percent in 2021.

Meanwhile, the number of patients who cited alcohol as their drug of choice soared between 2016 and 2022: in 2016, 37 percent of patients said alcohol was their drug of choice, while 57 percent listed opioids, RCA data show. By 2022, 66 percent list alcohol as their drug of choice and only 25 percent said the same about opioids. Every other drug, including cannabis, cocaine, hallucinogens, and stimulants stayed basically the same.

As for the rise in alcohol use after the pandemic began in March 2020, several experts told National Review that addiction thrives when people are isolated — as they were, particularly in the early days of the pandemic.

DeRoo said that many people managed their stress and uncertainty brought on by the pandemic with drugs and alcohol.

“There was alcohol delivered directly to the house. Some of the liquor stores were permitted to stay open and so people could drink around the clock,” she said. “Before, people would have these protective measures of going in to work, people seeing that somebody may be under the influence, family visiting.”

“But if you’re in your home, isolating and distancing from the rest of the public and you’re getting alcohol delivered to your home, then there’s nothing governing your alcohol use,” she added.

RCA found mental-health disorders also surged during the pandemic, with the number of days that patients reported experiencing depression jumping 31 percent when the pandemic hit. The number of days people had trouble sleeping because of anxiety increased 29 percent, RCA found. Both impacts have held steady in the time since.

Hazelden saw an increase in mental-health needs among its youth population particularly. DeRoo said the mental-health needs have been higher at their Plymouth, Minn., site, where they serve young adults, than at some of the foundation’s other sites.

DeRoo said that while the media has reported some of the consequences of young people being forced to attend remote schooling, the foundation is “actually seeing proof of this” at the Plymouth site, where there are now more patients, and more patients with a higher acuity of mental-health needs.

Teachers and school administrators have historically been able to identify students with alcohol-use disorder or substance-use disorder and help get those students into treatment. However, Dr. Joseph Garbely, Caron Treatment Centers’ chief medical officer and executive vice president of medical research and education, told National Review that remote learning took away that point of referral for students, potentially allowing their addiction to proceed unchecked.

Now, he has seen that the teens seeking treatment at the centers have begun using alcohol and other substances earlier than before.

“When you talk about teens, you’re talking about brains that are not fully mature, so when you start adding substances into that mix with a brain that is not fully mature, then you have the epigenetics that may very well lead to an alcohol-use disorder and opioid-use disorder independent really of genetics,” he explained.

“The pandemic was a source of trauma,” Garbely added. “If you look at the [Adverse Childhood Experiences] study, you know that if there are childhood experiences that are adverse, that epigenetically they increase the risk of going on to have a fully codified substance-use disorder.”

The increased prevalence of alcohol-use disorder is just one more way children and adolescents have been negatively impacted by the pandemic — whether it be among youth themselves or family members. Before the pandemic, roughly 10.5 percent of U.S. children ages 17 and younger — 7.5 million — lived with a parent with alcohol-use disorder, according to a 2017 report. The number is now believed to be higher due to a rise in alcohol consumption during the pandemic.

Growing up in a household with someone who suffers from alcohol-use disorder is considered an adverse childhood experience (ACE). ACEs “can increase the risks of injury, sexually transmitted infections, maternal and child health problems (including teen pregnancy, pregnancy complications, and fetal death), involvement in sex trafficking, and a wide range of chronic diseases and leading causes of death such as cancer, diabetes, heart disease, and suicide,” according to the CDC.

Garbely noted that there has also been an increase in abuse during the pandemic with everyone at home, especially among families where a family member has a substance-use disorder.

“I think that’s something that without question has gotten worse. It’s something we see, when patients come in, that that’s something that they’ve been experiencing, unfortunately, because everyone is packed into one home trying to all access the Internet, and do school, do work, do whatever they need to do, but from their home, and they can’t — they really didn’t have anywhere else to go.”

Susan Guthrie has been a family law and mediation attorney for 32 years and says it feels that in almost any case where she offers consulting for couples going through divorce, the use of alcohol is brought up in some way as an issue.

Relationships with alcohol abuse are at least 20 percent more likely to end in divorce, according to statistics from before a pandemic-led rise in divorces.

She noted that she has seen an increase in conflict in general, as parents argue over newfound dilemmas including whether to mask children and whether to spend time with family members outside the home.

At-home schooling was also a source of stress for many parents as well, Garbely said.

“The lifestyle change, which was isolation, social distancing, having to become a teacher as well as a parent, working remotely, trying to figure that all out, those factors serve to cause a lot of trauma and stress,” he said. “And what happened is the folks were starting to reach for alcohol and other substances for relief.”

And it’s not only the alcohol use itself that inflicts harm on children, but the conflict that is oftentimes caused by the disorder, Guthrie said.

“There’s not just the problems that arise out of seeing a parent under the influence of alcohol, and perhaps anything that might happen while they’re in that state, but then the ongoing conflict between their parents over the issue, which tends to escalate, because it is a problem that . . . is difficult to get under control for many people.”

While the addiction treatment specialists National Review spoke to detailed having hit full capacity or at least having recorded a surge in admittance, Guthrie detailed the other side of the rising demand for treatment, where she has seen families struggle to help loved ones get the care they need for addiction.

Finding treatment for alcohol- or other substance-use disorders as well as other mental-health assistance for clients these days is “one of the biggest problems,” she said.

“Trying to find placement in a rehab facility is almost impossible right now, even when you are able to pay,” Guthrie said. “But if you are in a situation where you need an insurance-based facility, that can be months, if not longer, unfortunately.”

“I’ve absolutely seen that it’s the same with trying to get somebody into even an intensive outpatient program, or even with a therapist who specializes in alcohol-use disorder or substance-use issues,” she added. “They’re all just slammed, they don’t have room, they aren’t taking more clients.”

However, Caron’s Dr. Garbely insists there is hope for those struggling with addiction.

“I’m going to make the bold statement that substance-use disorder is preventable and treatable,” he said. “It’s a chronic disease, but it’s also preventable and treatable.”

There are more than 20 million people in America currently living in recovery, and 75 percent of people achieve long-term recovery, he noted.

“There’s a lot of hope in our field, that if things are done right and the patients get the right quality care and all the different co-occurring issues are addressed simultaneously, not in series, but in parallel,” that patients can live in recovery.