eISSN: 2450-5722
ISSN: 2450-5927
Journal of Health Inequalities
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2/2024
vol. 10
 
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abstract:
Original paper

Polarization of alcohol consumption or coding changes as the cause of the increase in 100% alcohol-attributable deaths in Lithuania during the COVID-19 pandemic

Jürgen Rehm
1
,
Robertas Badaras
2
,
Ahmed S. Hassan
1
,
Shannon Lange
1
,
Alexander Tran
1
,
Mindaugas Stelemekas
3
,
Huan Jiang
1

  1. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
  2. Faculty of Medicine, Clinic of Anaesthesiology and Intensive Care, Vilnius University, Lithuania
  3. Health Research Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
J Health Inequal 2024; 10 (2): 162–165
DOI: https://doi.org/10.5114/jhi.2024.145604
Online publish date: 2024/12/28
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Introduction:
Fully (i.e., 100%) alcohol-attributable mortality rates increased markedly in Lithuania during the COVID-19 pandemic. Polarization of alcohol consumption (that is, the decrease in consumption among people who drink at light to moderate levels and the increase in consumption among people who drink at a heavy level) has been most often cited as the main reason, but alternatively, changes in coding guidelines from unspecified to alcohol-related liver cirrhosis have been listed as an alternative explanation.

Material and methods:
We used interrupted time series analysis to test this explanation.

Results:
We found no evidence that the changed coding guidelines had impacted the ratio between unspecified and alcohol-related liver cirrhosis. Thus, changes in coding guidelines cannot explain the observed increases in 100% alcohol-attributable mortality.

Conclusions:
Polarization of drinking remains the most likely cause, with decreases in medical services for treatment of alcohol use disorders and/or liver cirrhosis during the COVID-19 pandemic likely aggravating the situation.

keywords:

alcohol use, 100% alcohol-attributable deaths, COVID-19, Lithuania, coding change, stigma, polarization
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