Abstract Background The Coronavirus Disease 2019 (COVID-19) pandemic and associated public health measures had an impact on alcohol use. Based on the literature of past crises (health, economic, etc.), it was hypothesized that the COVID-19 pandemic led to a polarization of drinking. That is, heavy drinkers increased their drinking, while light to moderate drinkers decreased their drinking and/or temporarily abstained. The aim of the current study was to test the respective hypothesis. Methods Data from the Reducing Alcohol Related Harm Standard European Alcohol Survey for Lithuania were obtained for 2015 and 2020. Average daily consumption (in grams per day) was decomposed into deciles for each year, and compared pre-COVID to onset-of-COVID pandemic across the highest, second highest, and lowest deciles. A comparison of population-levels of mental health was conducted between pre-COVID and the onset-of-COVID. Results The findings indicated that overall, there was higher consumption in 2015, M2015 = 11.49 (SD = 8.23) vs. M2020 = 10.71 (SD = 12.12), p < .00001. However the opposite was found in the highest decile M2015 = 29.26 (SD = 5.44) vs. M2020 = 39.23 (SD = 20.58), p = .0003. This reversal pattern was not observed in the second highest nor the lowest decile. There was a lower proportion of respondents indicating bad mental health pre- vs.post-COVID (3.4% vs. 6.5%). Conclusion Although COVID was associated with nationwide declines in alcohol consumption, this was not the case for all segments of the population. In Lithuania, it appears that there was an increase in consumption among the heaviest drinkers, supporting the polarization hypothesis.

The authors have declared no competing interest.

The authors would like to acknowledge the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (Award Number 1R01AA028224) of the National Institutes of Health for funding this research.

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Ethics Statement All analyses received Centre for Addiction and Mental Health (CAMH) Research Ethics Board (REB) approval as per protocol: #050/2020.

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