ArticlePDF AvailableLiterature Review

Beyond Confinement: A Systematic Review on Factors Influencing Binge Drinking Among Adolescents and Young Adults During the Pandemic

Journal of Clinical Medicine (JCM)

February 2025
14(5):1546

DOI:10.3390/jcm14051546

License
CC BY 4.0

Authors:

Javier Fagundo Rivera

University of Seville

Pablo Fernández-León

University of Seville

Objectives: This study aimed to enhance the understanding of factors influencing changes in binge drinking (BD) behavior during the COVID-19 pandemic, with a particular focus on its impact on the health of individuals aged 12 to 25 years. Methods: A systematic review was conducted, encompassing studies published between January 2020 and September 2024. Articles were retrieved from PubMed, Web of Science, and Scopus, following PRISMA guidelines and the Joanna Briggs Institute (JBI) review protocols. Inclusion criteria targeted studies focusing on BD during the COVID-19 pandemic in adolescents or school-aged individuals without specific medical conditions. Exclusions included studies limited to a single gender, ethnicity, or profession, as well as doctoral theses and editorials. JBI tools were used to assess the quality of the selected studies. Results: From 33 studies (19 cross-sectional and 14 longitudinal), trends in BD during the pandemic varied: 2 studies reported an increase, while 21 indicated a decrease. Key factors linked to increased BD included pandemic stressors (e.g., isolation, social disconnection and non-compliance with restrictions), psychosocial issues (e.g., depression, anxiety, boredom, and low resilience), prior substance use, and sociodemographic variables (e.g., low education, economic extremes, living arrangements, and limited family support). Female gender and academic disengagement were also risk factors. Conversely, factors like stay-at-home orders, fear of contagion, family support, studying health sciences, and resilient coping strategies contributed to reduced BD. Other variables, such as pandemic stress and self-efficacy, had inconsistent effects. Conclusions: Factors contributing to increased BD included pandemic-related stress, mental health conditions, and unhealthy habits, while protective factors included stay-at-home orders, social support, and resilient coping. The study highlights the need for effective prevention and intervention strategies, emphasizing a holistic approach in healthcare, early detection, and tailored interventions, particularly for vulnerable groups such as adolescents.

Figures - available via license: Creative Commons Attribution 4.0 International

Content may be subject to copyright.

Access to this full-text is provided by MDPI.

Content available from Journal of Clinical Medicine (JCM)

This content is subject to copyright.

Academic Editor: Icro Maremmani

Received: 6 January 2025

Revised: 21 February 2025

Accepted: 22 February 2025

Published: 25 February 2025

Citation: Merino-Casquero, A.;

Andrade-Gómez, E.; Fagundo-Rivera,

J.; Fernández-León, P. Beyond

Conﬁnement: A Systematic Review on

Factors Inﬂuencing Binge Drinking

Among Adolescents and Young

Adults During the Pandemic. J. Clin.

Med. 2025,14, 1546. https://doi.org/

10.3390/jcm14051546

Licensee MDPI, Basel, Switzerland.

This article is an open access article

distributed under the terms and

conditions of the Creative Commons

Attribution (CC BY) license

(https://creativecommons.org/

licenses/by/4.0/).

Review

Beyond Conﬁnement: A Systematic Review on Factors

Inﬂuencing Binge Drinking Among Adolescents and Young

Adults During the Pandemic

Andrea Merino-Casquero

, Elena Andrade-Gómez

* , Javier Fagundo-Rivera

* and Pablo Fernández-León

3,4

1Cruces University Hospital, Osakidetza-Basque Health Service, 48903 Bizkaia, Spain

2Department of Nursing, Faculty of Health Sciences, University of La Rioja, 26004 Logroño, Spain

3Red Cross University Nursing Centre, University of Seville, 41009 Seville, Spain

4School of Doctorate, University of Seville, 41009 Seville, Spain

*Correspondence: elena.andrade@unirioja.es (E.A.-G.); javier.fagundo@cruzroja.es (J.F.-R.);

Tel.: +34-941299065 (E.A.-G.); +34-954350997 (J.F.-R.)

Abstract: Objectives: This study aimed to enhance the understanding of factors inﬂu-

encing changes in binge drinking (BD) behavior during the COVID-19 pandemic, with a

particular focus on its impact on the health of individuals aged 12 to 25 years. Methods:

A systematic review was conducted, encompassing studies published between January

2020 and September 2024. Articles were retrieved from PubMed, Web of Science, and

Scopus, following PRISMA guidelines and the Joanna Briggs Institute (JBI) review proto-

cols. Inclusion criteria targeted studies focusing on BD during the COVID-19 pandemic

in adolescents or school-aged individuals without speciﬁc medical conditions. Exclusions

included studies limited to a single gender, ethnicity, or profession, as well as doctoral

theses and editorials. JBI tools were used to assess the quality of the selected studies.

Results: From 33 studies (19 cross-sectional and 14 longitudinal), trends in BD during the

pandemic varied: 2 studies reported an increase, while 21 indicated a decrease. Key factors

linked to increased BD included pandemic stressors (e.g., isolation, social disconnection

and non-compliance with restrictions), psychosocial issues (e.g., depression, anxiety, bore-

dom, and low resilience), prior substance use, and sociodemographic variables (e.g., low

education, economic extremes, living arrangements, and limited family support). Female

gender and academic disengagement were also risk factors. Conversely, factors like stay-

at-home orders, fear of contagion, family support, studying health sciences, and resilient

coping strategies contributed to reduced BD. Other variables, such as pandemic stress and

self-efﬁcacy, had inconsistent effects. Conclusions: Factors contributing to increased BD

included pandemic-related stress, mental health conditions, and unhealthy habits, while

protective factors included stay-at-home orders, social support, and resilient coping. The

study highlights the need for effective prevention and intervention strategies, emphasizing

a holistic approach in healthcare, early detection, and tailored interventions, particularly

for vulnerable groups such as adolescents.

Keywords: binge drinking; alcohol abuse; alcohol consumption; the COVID-19 pandemic;

adolescents; young adults; risk factors; prevention; wellbeing; public health

1. Introduction

Alcohol consumption is a considerable public health concern that plays an important

role in our society and culture. Based on the latest Global Status Report on Alcohol and

J. Clin. Med. 2025,14, 1546 https://doi.org/10.3390/jcm14051546

J. Clin. Med. 2025,14, 1546 2 of 25

Health and Treatment of Substance Use Disorders [

], 2.6 million deaths were attributable

to alcohol consumption in 2019, representing 4.7% of all deaths in that year. The WHO

European Region continues to have the highest level of per capita alcohol consumption

in the world [

], despite a decrease from 12 L in 2000 to 9.5 L in 2019, which corresponds

to a decrease of 10% in 2010 and 21% in 2019. It should also be noted that Europe is the

WHO region with the highest percentage of deaths attributable to alcohol consumption

(10.1%) [

]. In Spain, an estimated 13,887 deaths were attributable to alcohol consumption

in 2021 [

]. Moreover, over 90% of the population aged 15 to 64 report having consumed

alcohol at some point in their lives [

]. These ﬁgures highlight alcohol consumption as a

signiﬁcant public health concern, particularly considering that they account only for the

direct effects on consumers and do not include harm to third parties [6].

Adolescents and young adults are a particularly vulnerable population about devel-

oping harmful patterns of alcohol consumption, such as binge drinking (BD), which may

emerge during this developmental stage and become established. Binge drinking is deﬁned

as the consumption of a large quantity of alcohol within a single occasion—typically ﬁve

or more alcoholic drinks for men and four or more for women—resulting in a state of

intoxication, which is subsequently followed by periods of abstinence [

]. This drinking

pattern has severe long-term consequences, including trafﬁc accidents, violence, homicide,

suicide, early and high-risk sexual behavior, academic and occupational failure, mental

disorders, and delinquency. Additionally, it leads to short-term effects such as alcohol

poisoning, loss of consciousness, and memory blackouts [

]. Globally, the prevalence of BD

was 18.2% in 2018, which amounts to one billion people worldwide [

]. Furthermore, it

shows high picks of frequency and more percentages of episodes in adolescents and young

adults [9–12].

Since December 2019, the emergence of the severe acute respiratory syndrome coro-

navirus 2 (SARS-CoV-2), the primary causative agent of the coronavirus disease 2019

(COVID-19) pandemic, has led to the declaration of a public health emergency of inter-

national concern. This pandemic has resulted in more than 776 million conﬁrmed cases

and over 7 million deaths [

]. The global nature of this pandemic has profound economic,

social, and public health implications [

]. In this context, health behaviors play a crucial

role in sustaining health and preventing both infectious and non-infectious diseases. Al-

though individuals should have pursued multiple protective behaviors and avoid risky

behaviors, adherence to behavioral recommendations during COVID-19 was variable [

Speciﬁcally, alcohol consumption and BD behavior during the COVID-19 pandemic had a

signiﬁcant inﬂuence with different and even opposite results between diverse countries

and population groups [

]. Several studies conducted during the pandemic have reported

divergent ﬁndings, indicating that BD patterns among adolescents and young adults were

inﬂuenced by lockdown measures in two distinct ways. While some individuals exhibited

an increase in these behaviors [16,17], others reported a decline [18,19].

Although the existing evidence suggests various factors that may contribute to the

increase or decrease of BD among teenagers and early adulthood population during the

COVID-19 pandemic, there appears to be a lack of systematic reviews that compile and stan-

dardize this information. Consequently, this study aims to bridge this gap by summarizing

and updating which factors modulate the increase or reduction of the alcohol BD pattern

during the COVID-19 pandemic. It provides a comprehensive overview of the relevant

literature and examines its implications for the health of adolescents and early adults.

J. Clin. Med. 2025,14, 1546 3 of 25

2. Materials and Methods

2.1. Protocol and Registration

The review process was based on the Joanna Briggs Institute (JBI) guidelines for sys-

tematic reviews [

] and followed the PRISMA statement [

] (Table S1. PRISMA checklist).

Furthermore, this systematic review was registered in PROSPERO (code: CRD42024552338).

2.2. Design

For this systematic review, the PICO approach was adopted to structure the review

questions and deﬁne eligibility criteria:

P (population): adolescents and young adults;

I (intervention): binge drinking during the COVID-19 pandemic;

C (comparison): binge drinking before the COVID-19 pandemic;

O (outcome): modulating factors of the increase/reduction of the BD.

In adolescents and young adults (P), what were the modulating factors of the in-

crease/decrease in BD (O) before (C) and during the COVID-19 pandemic (I)?

2.3. Information Sources and Search Strategy

The searches were carried out in September 2024 in the Pubmed, Web of Science, and

Scopus (Science Direct) databases by two reviewers. A third reviewer acted in case of discrep-

ancies. Articles conducted on humans and published between January 2020 and September

2024 were selected. The search strategy included MeSH terms: (adolescent* OR youth*

OR teen* OR student*) AND (“binge drinking” OR “binge alcohol consumption”) AND

(COVID-19 OR SARS-CoV-2 OR “COVID-19 pandemic” OR “Coronavirus Disease 2019”).

The search strategy in each database is presented in Table 1.

Table 1. Search strategies in databases.

Database Search Strategy Search Date Outcomes

PubMed

(adolescent* OR youth* OR teen* OR student*) AND

(“binge drinking” OR “binge alcohol consumption”)

AND (COVID-19 OR SARS-CoV-2 OR “COVID-19

pandemic” OR “Coronavirus Disease 2019”).

2020–2024 75

WOS

(adolescent* OR youth* OR teen* OR student*) AND

(“binge drinking” OR “binge alcohol consumption”)

AND (COVID-19 OR SARS-CoV-2 OR “COVID-19

pandemic” OR “Coronavirus Disease 2019”).

2020–2024 152

Scopus

(adolescent OR youth OR teen OR student) AND

(“binge drinking” OR “binge alcohol consumption”)

AND (COVID-19 OR “COVID-19 pandemic”).

2020–2024 517

Total 744

2.4. Eligibility Criteria

The research inclusion criteria were as follows: (1) original studies (quantitative or

qualitative design) that addressed binge drinking during the COVID-19 pandemic; and (2)

studies carried out in adolescents and scholar-aged individuals, without speciﬁc patholo-

gies or medical conditions. The exclusion criteria for the research were as follows: (1)

documents focused on populations exclusively of one gender, profession, or ethnicity; (2)

systematic reviews, meta-analyses, doctoral dissertations, brief reports, conference proceed-

ings, commentaries, and editorial articles; and (3) studies with low quality in methodologi-

cal assessment according to the Joanna Briggs Institute (JBI) critical appraisal tools.

J. Clin. Med. 2025,14, 1546 4 of 25

2.5. Selection and Data Collection Process

A total of 744 publications were identiﬁed through database searches. From this

initial pool, 141 duplicate entries were removed. Following a review of titles and abstracts,

465 articles were eliminated for failing to align with the speciﬁed objectives and research

questions. Subsequently, 138 reports were evaluated for eligibility, resulting in the exclusion

of 105 reports for various reasons (not related to the main objective (n= 44); design,

methodology, or article type (n= 25); not the population of interest (n= 34); low quality in

the methodological assessment (n= 2). Finally, 33 studies were included in the review. The

selection process and the rationale for exclusions are illustrated in the PRISMA ﬂowchart

presented in Figure 1.

J. Clin. Med. 2025,14, x FOR PEER REVIEW 4 of 28

2.5. Selection and Data Collection Process

A total of 744 publications were identied through database searches. From this ini-

tial pool, 141 duplicate entries were removed. Following a review of titles and abstracts,

465 articles were eliminated for failing to align with the specied objectives and research

questions. Subsequently, 138 reports were evaluated for eligibility, resulting in the exclu-

sion of 105 reports for various reasons (not related to the main objective (n = 44); design,

methodology, or article type (n = 25); not the population of interest (n = 34); low quality in

the methodological assessment (n = 2). Finally, 33 studies were included in the review.

The selection process and the rationale for exclusions are illustrated in the PRISMA

owchart presented in Figure 1.

Figure 1. PRISMA owchart.

2.6. Study Risk of Bias Assessment

The Joanna Briggs Institute (JBI) critical appraisal tools have been designed for its use

in systematic reviews, enabling the assessment of the reliability, relevance, and outcomes

of published works. These critical appraisal tools were developed by the JBI and its col-

laborators and approved by the JBI Scientic Commiee following extensive peer review.

The quality of all selected articles was examined using dierent checklists, depending on

the type of study. In this regard, the tool for analytical cross-sectional studies and the tool

for cohort studies were used [22]. Studies scoring below half of the maximum possible

value (i.e., 4/8 or lower for analytical cross-sectional studies and 5/11 or lower for cohort

studies) were categorized as low quality and were thus removed from the nal selection

(Tables S2 and S3).

Figure 1. PRISMA ﬂowchart.

2.6. Study Risk of Bias Assessment

The Joanna Briggs Institute (JBI) critical appraisal tools have been designed for its use

in systematic reviews, enabling the assessment of the reliability, relevance, and outcomes

of published works. These critical appraisal tools were developed by the JBI and its

collaborators and approved by the JBI Scientiﬁc Committee following extensive peer review.

The quality of all selected articles was examined using different checklists, depending on

the type of study. In this regard, the tool for analytical cross-sectional studies and the tool

for cohort studies were used [

]. Studies scoring below half of the maximum possible

value (i.e., 4/8 or lower for analytical cross-sectional studies and 5/11 or lower for cohort

studies) were categorized as low quality and were thus removed from the ﬁnal selection

(Tables S2 and S3).

J. Clin. Med. 2025,14, 1546 5 of 25

2.7. Synthesis Methods

In this systematic review, a narrative synthesis approach was employed to qualitatively

integrate and interpret the ﬁndings from the selected studies. This method facilitated a com-

prehensive and coherent analysis by identifying key themes, patterns, and inconsistencies

within the literature. By synthesizing diverse sources without the application of statistical

meta-analysis, this approach enabled the contextualization of evidence, the identiﬁcation

of knowledge gaps, and the provision of meaningful insights into the research topic.

3. Results

3.1. Study Selection and Characteristics

A total of 33 studies were chosen for the systematic review after screening based on

the inclusion and exclusion criteria, title, abstract, and full text.

Table 2presents speciﬁc information about the 33 included studies [16–19,23–51].

The selected research studies were conducted across various countries, including

the United States [

], Italy [

], Germany [

], Australia [

Canada [

–

], France [

], Guatemala [

], United Kingdom [

], Spain [

Netherlands [

], Turkey [

], Israel [

], Belgium [

], Denmark [

], Portugal [

], and

Switzerland [51], and included one nationwide study [24].

The studies focused on specific periods of the pandemic. For instance, some studies examined

a single month, such as April 2020 [

] and May 2020 [

]. Other investigations covered a range

of months within 2020, including March to May [

], April to May [

], April to June [

February to March and July to August [

], April to July [

], May to June [

], May to July

2020 [

], April to September [

], April to November [

], August to November [

], and

October to December [

]. Additionally, some studies spanned broader timeframes, such as 2009

to 2021 [

], 2015 to 2020 [

], 2017 to 2020 (including May–June 2020) [

], 2017 to 2021 [

], 2018

to 2021 [28,30], 2019 to 2020 [18,35,39], and 2020 to 2021 [16,23,36,38,44,45,51].

The studies indicated that the estimated mean age was 21 years, with an age range

varied from 12 to 25 years. Furthermore, the average proportion of female participants

across all studies was found to be 65%.

The studies indicate a varied prevalence of BD, with some reporting an increase in

trends [16,17], while others have noted a decline [18,19,24,25,27,28,31,32,35–39,41–43,46–50].

The research includes 19 cross-sectional studies [

–

] and 14

longitudinal studies [16–18,27–30,37–39,44,45,50,51].

J. Clin. Med. 2025,14, 1546 6 of 25

Table 2. Study selection.

Reference and

Context Data Collection Objective of the Study Type of Study Participants Methods Main Findings Quality of

Studies

Ahuja et al.,

2024.

USA.

[23]

2020–2021

To examine the relationship

between loneliness and

varying levels of alcohol

consumption among

college students in a rural

region of the United States

during the COVID-19

pandemic.

Cross-sectional

study

Sample of (n= 310) people

of a same region;

age range: 18–25 (mean =

21.3; SD = 1.9 years); 69.7%

women; 30.3% men.

UCLA-3 loneliness scale;

binge drinking: “During the last 12

months, how often did you have 5

or more (for males) or 4 or more

(for females) drinks containing any

kind of alcohol in within a

two-hour period?”

logistic regression analysis to

assess the association between

loneliness binge drinking, heavy

alcohol use, and weekly alcohol

use.

The prevalence of binge drinking was found to be 11.0% (n

= 34) of the sample. The COVID-19 pandemic has resulted

in increased feelings of isolation and disconnection among

many students, rendering them more vulnerable to

experiencing loneliness. Severe loneliness was signiﬁcantly

associated with a higher likelihood of binge drinking

(AOR = 2.96; 95% CI: [1.16, 7.51]). Furthermore, lifetime

regular smoking was also correlated with binge drinking

(AOR = 4.68; 95% CI: [1.85, 11.81]).

6/8

Ammar et al.,

2020.

International

[24]

April 2020

To elucidate the behavioral

and lifestyle consequences

(on physical activity and

nutrition behaviours) of

COVID-19 restrictions.

Cross-sectional

study

Sample of (n= 1047) people

from Asia, Africa, Europe,

America and others;

age range: 18 to +55 (55.1%

from 18 to 35 years; 35.1%

from 36 to 55 years);

54% women and 46% men.

International online survey on

mental health and

multi-dimensional lifestyle

behaviors before and during home

conﬁnement;

SDBQ-L (Question 4. Alcohol

Binge Drinking);

t-tests and effect size (Cohen’s d)

were used.

Prevalence of binge drinking included 12.31% (n= 129) of

the sample before COVID-19 and 6.79% (n= 71) during

conﬁnement. The COVID-19 home conﬁnement had a

positive healthy effect on alcohol binge drinking, whose

prevalence decreased signiﬁcantly (t = −12.16, p< 0.001;

effect size: d = 0.58). The responses that indicated alcohol

binge drinking were lower during home conﬁnement (5.4%

for sometimes, 1.2% for most of the time, and 0.2% for

always).

Alternatively, COVID-19 home conﬁnement had a negative

effect on all levels of physical activity, increased

sedentarism and revealed unhealthy patterns of food

consumption.

6/8

Bianchi et al.,

2021

Italy

[25]

March–May 2020

To investigate binge

drinking and binge eating

behaviors among emerging

adults in Italy during the

COVID-19 lockdown, while

examining potential

changes in these behaviors

in comparison to the

pre-pandemic period.

Cross-sectional

study

Sample of n= 1925

emerging adults;

mean age: 24.18 (SD = 2.75

years); age range: 18–29

years;

71.9% women and 28.1%

men.

BD: “During the last 30 days before

the introduction of national

lockdown, how many times have

you drunk 5 or more alcoholic

drinks—4 if you are female—on

one single occasion?”; and during

the current quarantine (i.e.,

“During the current period of

lockdown, how many times have

you drunk 5 or more alcoholic

drinks—4 if you are female—on

one single occasion?”).

Three MANOVA analyses were

conducted.

During the quarantine period, the incidence of binge

drinking (BD) episodes demonstrated a signiﬁcant decline.

Nonetheless, 320 participants (16.6%) reported

experiencing BD, while 84 participants (4.4%) indicated an

increase in the frequency of BD during the lockdown.

Participants with primary or middle school education, as

opposed to those with higher educational attainment, along

with individuals from lower economic backgrounds, were

more likely to belong to the BD increase group. Conversely,

participants residing with their families exhibited a

reduced likelihood of reporting BD; those living alone, with

partners, or with other individuals during the lockdown

were more frequently categorized in the BD increase group.

No statistically signiﬁcant differences were observed

concerning pandemic-related stress or social support

among the BD increase groups.

7/8

J. Clin. Med. 2025,14, 1546 7 of 25

Table 2. Cont.

Reference and

Context Data Collection Objective of the Study Type of Study Participants Methods Main Findings Quality of

Studies

Bonar et al.,

2021

USA

[19]

April–May 2020

To examine ﬁrst-year

college students’ binge

drinking habits after their

university’s

pandemic-related

suspension of in-person

operations and investigate

differences in demographic,

psychosocial and

COVID-19-related variables

among students.

Cross-sectional

study

Students from a single

university campus (n= 741);

mean age = 18.05 (SD = 0.22

years);

472 women (63.6%) and

269 men (36.3%).

COVID-19-related variables;

sex-speciﬁc binge drinking

frequency pre- and post-campus

closure;

20-item Drinking Motives

Questionnaire.

Non-parametric paired t-test, and

variable contrast using chi-square

and F-tests were used.

The study examined binge drinking prevalence before and

after the COVID-19 campus closure. Results showed a

decrease in binge drinking frequency, with M pre = 1.54

(SD = 1.38) and M post = 0.72 (SD = 1.10). While 49.66% of

students did not binge drink at either time, 6.75%

maintained consistent binge drinking behavior. Notably,

39.41% reported reduced binge drinking post-closure,

while 4.18% increased their binge drinking. Additionally,

19.35% shifted from abstaining from alcohol to binge

drinking after the closure, and 33.22% who previously

binge drank stopped entirely. Lower post-closure binge

drinking was linked to coping motives and feelings of

isolation, while higher levels were associated with Greek

life involvement. Non-binge drinkers experienced

signiﬁcantly less isolation and loneliness due to COVID-19.

6/8

Busse et al.,

2021

Germany

[26]

May 2020

To investigate the impact of

the COVID-19 pandemic,

with particular emphasis on

the lockdown period, on the

engagement in

health-related behaviors

(HRBs) among university

students in Germany

Cross-sectional

study

Sample consisted on

(n= 5021) students of four

German universities;

age range: 17 to 25; mean

age = 24.4 (SD = 5.1 years);

69% women and 29% men.

A web-based survey using the HRB

scale (with pre-during pandemic

questions): (item 3) binge drinking,

consisting on the question “How

often do you have six or more

drinks on a single occasion?”;

8-item Center for Epidemiologic

Studies—Depression Scale.

Descriptive analysis and

multinomial logistic regression

analyses were used.

A latent transition analysis among

substance use behavior (smoking,

binge drinking, and cannabis use)

was conducted.

A total of 45.8% of students (n= 4965) reported engaging in

binge drinking both before and during the COVID-19

pandemic. Prior to the pandemic, 2% of students indicated

binge drinking more than once per week, which increased

to 4% during the pandemic. Nearly half of the participants

acknowledged binge drinking before the pandemic, while

24.4% reported a decrease in such behavior during this

period, and 5.4% noted an increase; however, 70.2%

experienced no changes in their binge drinking patterns.

Factors contributing to increased binge drinking included

depressive symptoms, boredom, and complex

relationships. Interestingly, women and younger

individuals were more likely to reduce their binge drinking

during the pandemic. Additionally, a signiﬁcant

co-occurrence of smoking, binge drinking, and cannabis

use was observed among the student population.

7/8

Clare et al., 2021

Australia

[27]

Four phases:

1. September 2017–July

2018;

2. September 2018–May

2019;

3. August 2019–January

2020;

4. May–June 2020.

To estimate the changes in

alcohol consumption

among young people

during the COVID-19

restrictions and to analyze

whether these changes

varied by gender and

pre-pandemic consumption

levels

Prospective

longitudinal cohort

study

Subsample of a cohort

(n= 443) of secondary

school students;

mean age: 19.7 (SD = 0.5

years);

60.8% women and 39.2%

men;

data from the Australian

Parental Supply of Alcohol

Longitudinal Study.

Sociodemographic: time, gender,

and level of consumption prior to

the pandemic. In addition,

frequency and typical quantity of

alcohol consumption, binge

drinking, peak consumption,

alcohol-related harm and drinking

contexts.

Frequency of binge drinking:

participants who reported any

alcohol consumption were asked

how often they consumed ≥5

standard drinks.

During the COVID-19 restrictions, young Australians

experienced a signiﬁcant reduction in overall alcohol

consumption, binge drinking, and alcohol-related harms.

Binge drinking rates were stable prior to the pandemic but

declined by 28% from February to May–June 2020. During

this period, the proportion of participants abstaining from

binge drinking increased from 35.3% to 50.0%, while those

reporting sporadic binge drinking decreased from 50.6% to

40.8%. Additionally, the prevalence of weekly binge

drinking fell from 14.1% to 9.2%. These changes in drinking

patterns were observed across genders, though the decline

in overall consumption was notably signiﬁcant among

women. The main motivations for binge drinking included

feelings of boredom and limited engagement in activities.

8/11

J. Clin. Med. 2025,14, 1546 8 of 25

Table 2. Cont.

Reference and

Context Data Collection Objective of the Study Type of Study Participants Methods Main Findings Quality of

Studies

Dumas et al.,

2022

Canada

[16]

Four phases:

T1: April 2020;

T2: August to September

2020;

T3: January to February

2021;

T4: June 2021.

To investigate adolescent

substance use patterns

throughout the pandemic,

emphasizing the impact of

stay-at-home orders and

re-opening phases

Longitudinal cohort

study

Sample of n= 1068

adolescent students; age

range: 14–18 years; mean

age = 16.95 (SD = 0.84 years);

76.7% women and 23.3%

men.

The study included demographic

questions and inquiries related to

substance use during the pandemic.

Binge drinking is operationally

deﬁned as the intake of four or

more standard drinks for females

and ﬁve or more for males in one

sitting, where a standard drink is

equivalent to 341 mL of beer,

142 mL of wine, 43 mL of liquor, or

341 mL of a premixed beverage.

Before the pandemic, the prevalence of binge drinking was

19.4%. The study identiﬁed variations in binge drinking

rates across different lockdown phases: a low of 9.4%

during the ﬁrst lockdown (T1), a peak of 20.8% after

restrictions were lifted (T2), a decrease to 17.8% during the

second lockdown (T3), and a stabilization at 18.6%

following the third lockdown (T4). Statistical analyses

revealed that participants exhibited a signiﬁcantly higher

likelihood of abstaining from binge drinking during T1

compared to later phases, with increased abstinence from

T2 to T4 (p< 0.001). Additionally, adolescents

demonstrated a decreased propensity for binge drinking

after the initial stay-at-home orders were lifted.

9/11

Fruehwirth

et al., 2021

USA

[18]

Wave I: October 2019 and

February 2020 (prior to

the pandemic).

Wave II: June/July 2020.

To study how COVID-19

stress-related factors and

changes in social

engagement during the

pandemic contributed to

changes in alcohol use

among ﬁrst-year college

students.

Longitudinal cohort

study

Sample of n= 439 ﬁrst-year,

university students;

age range: 18–20 years;

mean age = 18.9

(SD = 0.018);

72% women, 28% men.

Youth Risk Behavior Surveillance

System: analysis of prevalence and

days of binge drinking.

Associations between pre- and

intra-pandemic stressors and social

engagement were established. All

models were estimated as a

function of COVID-19

stressors/stress and social

engagement variables.

Over the past 30 days, the prevalence of binge drinking

(BD) among participants signiﬁcantly declined from 35.5%

to 24.6%, particularly during the initial wave of data

collection, with a corresponding decrease in binge drinking

days; however, the overall frequency of alcohol

consumption remained statistically unchanged. This

reduction in binge drinking prevalence is primarily

attributed to social distancing measures. Notably, none of

the stressors related to COVID-19 were found to correlate

with either the prevalence or the severity of binge drinking

episodes. In contrast, increased alcohol consumption was

associated with distance learning, pre-existing binge

drinking behaviors prior to the pandemic, and the use of

substances as coping mechanisms. Furthermore, binge

drinking was not associated with resilient coping strategies.

8/11

Gohari et al.,

2023

Canada

[28]

Three cohorts: T1

(2018/19), T2 (2019/20),

and T3 (2020/21).

In T2, data collection was

conducted pre-pandemic

(from September 2019 to

February 2020, T2a) and

post-pandemic (from

May to June 2020, T2b),

To investigate changes in

alcohol consumption

patterns among youth

subpopulations during the

pandemic. It focuses on

analyzing drinking

behavior proﬁles within

this demographic and

assessing the pandemic’s

impact by comparing

transitions between

different subgroups before

and after the pandemic.

Longitudinal cohort

study

Using data from an ongoing

prospective cohort study

(n= 5347) in Canadian

college students:

T2a (n= 3447; 57.3%

women; aged 12–18);

T2b (n= 1900; 65.2%

women; aged 12–18).

This study examines the

prevalence of binge drinking

through participants’ self-reported

instances of consuming ﬁve or

more alcoholic beverages in a

single occasion over the past year.

Participants were classiﬁed into

four categories: non-binge

drinkers, occasional binge drinkers,

monthly binge drinkers, and

weekly binge drinkers. To identify

distinct patterns of alcohol

consumption and analyze

temporal transitions between these

patterns, latent transition analysis

(LTA) was employed, utilizing both

overall drinking frequency and

binge drinking frequency as

primary variables.

Individuals were classiﬁed as occasional, monthly, or

weekly binge drinkers. Before the COVID-19 pandemic, the

probability of binge drinking among occasional drinkers

was 61%, which decreased to 43% during the early

pandemic period. A minor fraction of occasional binge

drinkers shifted to more frequent patterns (monthly or

weekly), with female occasional drinkers showing a higher

likelihood of this transition compared to males. Cohort T2b

reported slightly higher binge drinking levels than Cohort

T2a, with T2b’s occasional drinkers increasing from 7% to

10%, while in T2a, it rose from 8% to 16%. For Cohort T2a,

the probability of maintaining occasional binge drinking

was 37%, with transitions to monthly and weekly binge

drinking at 22% and 2%, respectively. Overall, the

pandemic’s impact on transitions between different alcohol

consumption patterns was not statistically signiﬁcant.

10/11

J. Clin. Med. 2025,14, 1546 9 of 25

Table 2. Cont.

Reference and

Context Data Collection Objective of the Study Type of Study Participants Methods Main Findings Quality of

Studies

Gohari et al.,

2022

Canada

[29]

Four cohorts: T1

(2017/18); T2 (2018/19);

T3 (2019/20); T4

(2020/21).

To analyze variations in

alcohol consumption across

two phases of the

pandemic.

Longitudinal cohort

study

Longitudinal data

(n= 14,089) students;

age range: 13–18 years;

52.9–63.1% women along

the study.

(COMPASS) study (2012–2027).

The frequency of binge drinking:

“In the last 12 months, how often

did you have 5 drinks of alcohol or

more in a two-hour period

(women).

Demographics and academic

characteristics, students’ health

habits, smoking, alcohol

consumption, exercise intensity

and duration, and COVID-related

questions.

Prevalence ratios were calculated.

The majority of individuals reported some binge drinking

behavior: 125 participants (18.4%) in the high frequency

category and 317 (46.7%) in the low frequency category.

SARS-CoV-2 infection was 2.8 times more likely among

those who reported a high frequency of BD.

5/8

Miech et al.,

2021

USA

[34]

February–March 2020

and July–August 2020

To assess if substantial

reduction in drug

availability will lead to

reductions in drug

prevalence.

Cross-sectional

study

Sample of n= 582 12th

grade college students;

age range: +18 years;

50% women; 50% men.

BD in the past two weeks: “Think

back over the LAST TWO WEEKS.

How many times have you had ﬁve

or more drinks in a row? (A “drink”

is a bottle of beer, a glass of wine, a

wine cooler, a shot glass of liquor, a

mixed drink, etc.)”.

Multivariable regressions were

performed.

Perceived availability of alcohol declined across the two

survey waves. Despite these declines, prevalence BD levels

did not signiﬁcantly change. Changes in binge drinking

prevalence across the two survey waves differed across the

social distancing groups.

5/8

Monzon et al.,

2024

Guatemala

[35]

May to September 2019

(Wave 1); June to

November 2020 (Wave 2).

To assess whether the

COVID-19 school

shutdown inﬂuenced

adolescent alcohol

(including binge drinking)

use.

Cross-sectional

study

Wave 1 (n= 20,969); Wave 2

(n= 1606). Sample of high

school students in

Guatemala City.

Age range: 13–>15;

51.8% women; 48.2% men.

BD: “Have you ever had about 4 or

more drinks on one occasion over

the prior 30 days?”.

Logistic Generalized Estimating

Equations to estimate the inﬂuence

of the COVID-19 lockdown on BD.

Prevalence declined for binge drinking (24% to 13%;

p< 0.001

). Friends’ and household members’ substance use

was signiﬁcantly associated with teenagers’ substance use,

and they all signiﬁcantly decreased in Wave 2.

5/8

Niedzwiedz

et al., 2020

United

Kingdom

[17]

Data from 2015 to 2019,

compared to data of the

COVID-19 pandemic

onset (April 2020)

To investigate the impact of

the UK’s COVID-19

lockdown on mental health

and health behaviours, as

well as whether any

observed impacts differed

by age, gender, ethnicity,

and education level.

Longitudinal study,

based on various

cross-sectional

analysis by waves.

Longitudinal analysis

composed by (n= 9748)

adults, of whom n= 655

were aged 18–24 years;

52.0% women; 48% men.

GHQ-12 and AUDIT-C. BD: 6+

drinks in a single sitting on a

weekly basis.

Prevalence estimates (with 95%

CIs) for each outcome were

calculated. Multi-level Poisson

regression was used.

Psychological distress increased into lockdown with the

prevalence rising from 19.4% to 30.6% in April 2020. BD

increased from 10.8% in 2017–2019 to 16.2% during the

lockdown. The proportion of people drinking four or more

times per week increased, as did binge drinking (RR = 1.5;

95% CI: 1.3 to 1.7). Relative risk for BD was signiﬁcant for

women aged 18–24 in comparison to pre-pandemic data.

9/11

Patin et al., 2022

France

[36]May 2020 and May 2021

To assess the progression of

healthy behaviors from the

pre-COVID-19 period to

May 2021.

Retrospective online

cross-sectional

study.

Sample of (n= 6991)

university students;

mean age: 20.8 (SD = 2.5);

73.4% of women; 26.6%

men.

BD in the past week was deﬁned as

the consumption of six or more

glasses of alcohol on a single

occasion. The frequency of BD was

classiﬁed into three categories:

never, occasional, and regular.

CES-D8, socio-demographic, and

COVID-19-related questions.

A multivariate logistic regression

model was used.

BD (both occasional and regular) declined in 2020 and 2021

compared to the pre-COVID-19 period. However, a notable

increase was observed in May 2021, approaching

pre-pandemic levels. This resurgence may be attributed to

the relaxation of restrictions, including curfews and partial

lockdowns, which allowed for small social gatherings.

6/8

J. Clin. Med. 2025,14, 1546 11 of 25

Table 2. Cont.

Reference and

Context Data Collection Objective of the Study Type of Study Participants Methods Main Findings Quality of

Studies

Patrick et al.,

2022

USA

[37]

April to November 2020

To examine drinking trends

(prevalence, frequency,

contexts, and reasons) prior

to and during the

COVID-19 pandemic in

2020 and whether they

differed by age and college

status.

Longitudinal cohort

study

Data from the MTF study

(

n= 29,940

) college students.

Aged: 18–30 years, with

57.0% from 18 to 24 years;

53.1% women; 46.9% men.

BD: “Think back over the last two

weeks. How many times have you

had ﬁve or more drinks in a row?”

Alcohol prevalence and frequency

data were obtained through MTF

survey.

Sensitivity analyses were

conducted and full multivariable

models including covariates were

run.

Prevalence of young adult BD was generally stable from

2015 to 2019 (29.5–31.1%), but 2020 was associated with

downward deviation (26.4%) in BD prevalence (young

adults). In addition, there was an upward non-signiﬁcant

deviation in BD among drinkers aged 19–30. Among the

factors, it was prevalent to drink alone and at

home/apartment/dorm, to relax/relieve tension and

because of boredom.

8/11

Pelham et al.,

2022

USA

[38]

June 2020, December

2020, and June 2021

To examine the impact of

the COVID-19 pandemic on

drinking and nicotine use

through June of 2021 in a

community-based sample

of young adults

Longitudinal cohort

study

Sample of n= 348

individuals;

age range: 18–22 years;

mean age: 20 years;

49% women; 51% men.

BD: the number of days in the past

30 days during which individuals

consumed

≥

5 alcoholic drinks (

≥

for females) on an occasion.

There were no statistically signiﬁcant differences between

the pre-pandemic and during-pandemic time points for BD.

However, a non-signiﬁcant reduction was observed in BD

in June and December 2020. The pandemic impact on

participants’ ﬁnancial economy did not moderate drinking

outcomes.

7/11

Rogés et al.,

2021

Spain

[39]

October 2019 to February

2020 and June to July

2020.

To identify the changes in

binge drinking, the

hazardous drinking, the

hazardous consumption of

cannabis, and the daily

smoking of tobacco, in a

cohort of 14- to 18-year-old

adolescents, due to the

COVID-19 pandemic

conﬁnement.

Longitudinal cohort

study

DESK-COVID-Cohort

Wave 2 (n= 303);

age range: 14–18;

29.7% men and 70.3%

women.

BD: “How often do you have ≥6

alcoholic drinks on a single

occasion?”. AUDIT-Ctest. CAST.

DESK-COVID-Cohort survey.

Cumulative Incidence of Change

(IC) and the relative risks (RR) were

obtained.

There were 36.3% of participants who consumed alcohol in

a binge drinking pattern. Older adolescents attending

advanced vocational courses had a signiﬁcantly (p< 0.05)

higher risk of binge drinking (RR = 3.21; 95% CI: 1.00–10.34).

The overall prevalence of BD decreased from the

pre-COVID period (36.3%) to after conﬁnement (5.9%)

(p< 0.05).

The likelihood of BD (RR = 1.46; 95% CI:0.49–4.33) was

higher among students with medium and high economic

incomes.

9/11

Romano et al.,

2022

Canada

[40]

May–July 2020

To examine how substance

use is associated with

perceptions of and

adherence to early

COVID-19-related public

health measures.

Cross-sectional

study

Data of a sample (n= 7876)

in a prospective cohort of

Canadian adolescents;

age range: 12–19 years;

mean age: 15

(SD = 1.6 years);

60% women; 36% men.

COMPASS Student Questionnaire.

Participation in BD in the past 12

months; current BD was deﬁned as

5 or more drinks on one occasion at

least once per month.

Two models were used to estimate

how substance use was associated

with perceptions and adherence to

early COVID-19 restrictions.

There were 11.4% (n= 895) of students who reported

current binge drinking. Binge drinking was associated with

perceptions that restrictions were too strict and with

nonadherence, reporting that they did not take COVID-19

restrictions seriously compared to those who did not drink.

7/8

Rubio et al.,

2023

Netherlands

[41]

April–July 2020

To examine the impact of

the initial lockdown on

alcohol consumption

among university students

who engaged in regular

binge drinking prior to its

implementation.

Cross-sectional

study

Sample of (n= 7355)

university students;

mean age: 21.4

(SD = 2.3 years);

60.8% women, 39.2% men.

Participants were categorized as

either frequent binge drinkers or

regular drinkers according to the

response to the speciﬁed question:

“How often did you drink 6

servings or more on a single

occasion before the COVID-19

outbreak?”

CES-D8, BRS.

Out of 2065 surveyed students, 35.7% were identiﬁed as

binge drinkers. During the lockdown period, a majority of

regular binge drinkers (70.1%) demonstrated a notable

decrease in BD frequency, with a reduction from 12.8% to

7.6%. Factors contributing to increased or sustained alcohol

consumption among binge drinkers included older age, a

lower baseline alcohol intake prior to the COVID-19

pandemic, greater social interactions, and living

independently rather than with parents. Additionally,

among regular binge drinkers, males exhibited a

signiﬁcantly greater increase in alcohol consumption

compared to females. Furthermore, individuals with

pronounced depressive symptoms and lower resilience

levels were more likely to increase their alcohol use.

8/8

J. Clin. Med. 2025,14, 1546 12 of 25

Table 2. Cont.

Reference and

Context Data Collection Objective of the Study Type of Study Participants Methods Main Findings Quality of

Studies

Serkut Bulut

et al., 2021

Turkey

[42]

May–June 2020

To explore the relationship

between students’ social

support systems,

health-risk behaviors, and

mental/academic

well-being of

higher-education students

in ˙

Istanbul during the

COVID-19 pandemic.

Cross-sectional

study

Sample of (n= 2583)

higher-education students;

mean age = 22.84

(SD = 4.79 years);

65.5% women; 34.5% men.

COVID-19 International Student

Well-Being Study.

CES-D-8, UCLA-3 Loneliness Scale,

Academic Stress Scale, and

Academic Satisfaction Scale.

Bivariate associations and a binary

logistic regression test were

conducted.

BD frequency signiﬁcantly decreased during COVID-19.

The frequency of BD was associated with depressive

symptoms, loneliness, increased levels of academic stress,

and lower academic satisfaction. An accessible and

supportive social network was found to be a protective

factor against depression. Women and men were almost

never binge drinkers before or during COVID-19. During

the pandemic, BD was signiﬁcantly higher among male

students compared to females.

6/8

Shapiro et al.,

2022

Israel

[43]

April–September 2020

To examine the prevalence

of risky behaviors among

adolescents in Israel during

the COVID-19 pandemic

and assess the potential

impact of the pandemic on

the occurrence of these

behaviors.

Cross-sectional

study

Sample of (n= 1020)

adolescents;

age range: 15–18 years;

mean age = 16.73

(SD = 0.99 years);

57.3% women; 42.7% men.

BD: “In the past 30 days, how many

times have you drank ﬁve drinks of

alcohol or more within a period of a

few hours?”.

HBSC survey, FAS, and MSPSS.

Binary logistic regression models

were used.

In the studied population, BD emerged as the most

common risky behavior, reported by 33.8% of participants.

A signiﬁcant correlation was observed between BD and

broader patterns of risky behavior, including tobacco use

and cannabis consumption. During the pandemic, the

majority of respondents (55.2%) exhibited no change in the

frequency of their drinking behavior. Conversely, 14.4%

reported initiating or increasing their BD frequency, while

15.9% noted a decrease in alcohol consumption. Factors,

such as low family support, high socioeconomic status,

advanced age, male gender, and elevated emotional

distress, were identiﬁed as predictors of BD. Notably,

support from friends, levels of physical activity, and

COVID-19-related restrictions did not signiﬁcantly

inﬂuence binge drinking behavior.

7/8

Sharma et al.,

2022

USA

[44]

April 2020–March 2021

To study the associations

between demographic

factors, psychological

distress, and changes in

alcohol use before and after

the onset of COVID-19 in

adolescents and young

adults.

Longitudinal cohort

study

Sample of (n= 2216)

individuals;

age range: 16–20 years, with

40.7% from 16 to 18 years;

81% women and 19% men.

Risk of increased alcohol

consumption: binge drinking

(never, less than monthly, monthly,

weekly, or daily), number of drinks,

and drinking regularity.

PHQ-9 and GAD-7.

Logistic regression models were

used.

No changes in BD were reported by 74.6% of the sample,

and 17.0% reported an increase in BD. Older age, college

students, increased anxiety, and smoking status showed

signiﬁcant associations during the pandemic.

8/11

Sylvestre et al.,

2022

Canada

[45]

December 2020–June

2021

To assess changes in

substance use among young

adults before and during

the COVID-19 pandemic,

with a focus on identifying

factors that contribute to the

initiation or increase of

substance use during this

time.

Longitudinal cohort

study

Longitudinal investigation

of (n= 1294) youth from

1999 to 2021; a sample of

(n= 704) was obtained

during the pandemic.

Mean age: 33.6

(SD = 0.6 years);

58.2% women; 41.8% men.

BD: consuming ≥5 alcoholic

beverages on one occasion.

Data on the utilization of cannabis,

alcohol, combustible cigarettes,

e-cigarettes, and binge drinking

prior to the pandemic were

gathered.

Modiﬁed Poisson regression was

used.

Amid the pandemic, 7.9% of respondents reported weekly

occurrences of binge drinking, and 12% reported daily

occurrences. The rate of individuals who either

discontinued or diminished their binge drinking behavior

was signiﬁcantly higher during this period, at 53.5%,

particularly among those aged between 24.0 and 30.6 years.

Additionally, low socioeconomic status, mental health

conditions, and solitary living arrangements were

associated with an elevated likelihood of engaging in

weekly or daily binge drinking.

7/11

J. Clin. Med. 2025,14, 1546 13 of 25

Table 2. Cont.

Reference and

Context Data Collection Objective of the Study Type of Study Participants Methods Main Findings Quality of

Studies

Tavolacci et al.,

2021

France

[46]

March–May 2020

To assess the modiﬁcations

in health-related behaviors

among students enrolled at

a university in France

throughout the COVID-19

lockdown

Cross-sectional

study

Sample of (n= 3671)

university students;

mean age: 20.9

(SD = 2.47 years);

72.9% women; 27.1% men.

BD is operationally deﬁned as the

consumption of six or more

alcoholic beverages in one sitting,

with frequency classiﬁed into four

categories: never, occasional,

weekly, and daily.

CESD-8, academic, and

COVID-related data. A

multivariable logistic regression

model was used.

The data revealed a signiﬁcant decrease in binge drinking

prevalence from 35.9% before the COVID-19 pandemic to

9.3% during the pandemic. Only 3.1% of participants

reported an increase, predominantly among male students

who had never lived with their parents and had higher

CESD-8 scores. Factors linked to the reduction in binge

drinking included enrolment in healthcare programs, being

in the second year or beyond of their studies, returning to

live with parents, living alone during the pandemic,

awareness of local COVID-19 cases, and concerns about

severe health risks from the virus.

7/8

Tholen et al.,

2022

Belgium

[47]

April–May 2020

To examine associations

between pandemic-related

stressors, psychosocial

distress, and self-reported

alcohol, tobacco, and

cannabis use before and

during the ﬁrst wave of the

pandemic.

Cross-sectional

study

Sample of (n= 18,346)

higher education students;

age range: 17 to 24;

75% women and 25% men.

BD is deﬁned as the consumption

of six or more alcoholic beverages

during a single event.

To analyze the data, multinomial

logistic regression techniques were

employed.

A total of 2289 (12.5%) students declared the use of BD

during

COVID-19. A total of N = 7335 students declared

themselves as no binge drinkers. BD decreased during the

pandemic (87.4%) due to limited social gatherings and low

economic status. Returning to the parental home is linked

to reduced BD, whereas depressive symptoms and

psychosocial distress are associated with increased BD.

Perceived threat and academic stress were also associated

with increased BD.

7/8

Vallentin-

Holbech et al.,

2023

Denmark

[48]

August 2020 and

November 2020

To investigate the changes

in hazardous alcohol

consumption, social

interactions, and overall

well-being among ﬁrst-year

Danish students during the

second wave of the

COVID-19 pandemic.

Cross-sectional

study

Sample of (n= 352) Danish

students in secondary

school;

age range: 15–20 years;

mean age: 16.8

(SD = 0.74 years);

66.8% women and 33.2%

men.

BD: the number of days.

Alcohol use was measured using

the Timeline Follow-back;

alcohol-related negative

consequences were assessed using

the RAPI23.

COVID-19 variables were

measured using the PHQ-4.

Multilevel regression models were

used.

During COVID-19-pandemic, students decreased the

frequency and quantity of binge drinking reduced from a

mean of 2.35 ±2.35 days a month to 1.46 ±2.59 days.

Decrease in BD was associated with attending fewer parties.

Variations in mental health and experiences of loneliness

did not correlate with a reduction in hazardous alcohol use.

6/8

van Hooijdonk

et al., 2022

Netherland

[49]

April–June 2020

To examine the inﬂuence of

COVID-19 on trends in

weekly smoking, binge

drinking, and cannabis use

among Dutch university

students, as well as

associated characteristics

related to the pandemic.

Cross-sectional

study

Sample of (n= 9967)

university students;

mean age: 22.0

(SD = 2.6 years);

70.3% women and 29.7%

men.

BD before and during COVID-19:

drinking ≥6 glasses on a single

occasion.

Multivariate logistic regression

analyses were used.

The prevalence of weekly binge drinking was higher

among males than females both before and during the

initial COVID-19 lockdown. A study of 6884 students

indicated a signiﬁcant decline in weekly binge drinking

from 27.8% to 13.9% during the pandemic. Among those

who did not binge drink prior to COVID-19, 6.2% reported

an increase in such behavior. Key factors associated with

increased risk included being male, not living with parents,

being an undergraduate student, having limited ﬁnancial

resources, and lower adherence to COVID-19 safety

measures. Older age was linked to a reduced likelihood of

binge drinking before the pandemic but a higher likelihood

during it. Complicated relationship status also raised the

probability of binge drinking during COVID-19, whereas

strict adherence to safety measures correlated with lower

binge drinking rates.

6/8

J. Clin. Med. 2025,14, 1546 14 of 25

Table 2. Cont.

Reference and

Context Data Collection Objective of the Study Type of Study Participants Methods Main Findings Quality of

Studies

Vasconcelos

et al., 2021

Portugal

[50]

April–May 2020;

October–November 2020.

To examine the impact of

the COVID-19 pandemic on

college students’ alcohol

consumption habits by

evaluating how personal

characteristics, emotional

states, lifestyle choices, and

social context inﬂuenced

their alcohol use and binge

drinking behaviors.

Longitudinal cohort

study

Sample of 146 college

students; mean age: 19.5

(SD = 1.5 years); age range:

17–26 years;

81% women and 19% men.

Regular binge drinkers, deﬁned as

individuals who consume ﬁve or

more alcoholic beverages on a

single occasion at least once a

month, as well as infrequent binge

drinkers and non-binge drinkers.

AUDIT, PACS, and DASS-21.

Linear regressions were

implemented. Linear mixed-effects

models were estimated.

The alcohol consumption of regular binge drinkers (BDs)

signiﬁcantly decreased from the pre-lockdown period

(M = 10.9) to the lockdown period (M = 4.8; p< 0.001) and

further declined post-lockdown (M = 2.2; p< 0.001).

Regular BDs maintained lower alcohol intake than usual

even after the cessation of isolation restrictions. During the

lockdown, signiﬁcant differences in weekly binge drinking

were observed only between the non-binge drinkers and

regular binge drinkers. No signiﬁcant interactions were

found between stress, anxiety, depression, and drinking

group that could explain variations in alcohol consumption.

Factors positively correlated with increased alcohol intake

during the lockdown included a history of drunkenness,

heightened cravings, and cohabiting with friends. The

COVID-19 mitigation measures and social distancing likely

disrupted the typical social contexts that facilitate binge

drinking.

10/11

Zysset et al.,

2022

Switzerland

[51]

April 2020–June 2021

To examine increase in

alcohol consumption, single

and multiple binge

drinking, and associated

factors in students during

the lockdown and

post-lockdown periods.

Longitudinal cohort

study

Sample of n= 947 university

students;

mean age: 27.0

(SD = 6.5 years);

75.8% women and 24.2%

men.

BD: any binge drinking in the past

30 days (≥5 drinks on one or more

occasion); “Think back again over

the last 30 days. How many times

(if any) have you had ﬁve or more

drinks on one occasion?”.

GAD-7, ASKU, BRCS, and Oslo-3

Social Support Scale.

Generalized Estimating Equations

models were used.

There were 26% of the students who engaged in BD during

the pandemic. Higher anxiety scores were associated to

binge drinking. Additional factors associated with BD were

male gender, younger age, higher perceived social support,

and not living with parents. University students who

consumed more alcoholic drinks at baseline were more

likely to report at least one binge drinking event in the past

30 days. BD was not associated with lower resilience or

self-efﬁcacy.

9/11

Table legend: ASKU: General Self-Efﬁcacy Expectations Short Scale; AUDIT: Alcohol Use Disorder Identiﬁcation Test; BD: binge drinking; BRCS: Brief Resilient Coping Scale; BRS: Brief

Resilience Scale; CAST: Cannabis Abuse Screening Test; CES-D8: Centre for Epidemiologic Studies Depression Scale; CESD-R-10: 10-item Center for Epidemiologic Studies Depression

Scale Revised Scale; DASS-21: Depression Anxiety Stress Scale-21; D-I-D: difference-in-difference; FAS: Family Afﬂuence Scale; GAD-7: Generalized Anxiety Disorder 7-item Scale;

HBSC: Health Behavior in School-Aged Children; HRB: Health Risk Behaviors; IC: Cumulative Incidence of Change; MSPSS: Multidimensional Scale of Perceived Social Support; MTF:

Monitoring the Future; PACS: Penn Alcohol Craving Scale; PHQ-4: Patient Health Questionnaire for Depression and Anxiety 4 items; PHQ-9: Patient Health Questionnaire 9 items;

RAPI23: Rutgers Alcohol Problem Index 23 items; RR: relative risk; SDBQ-L: Short Diet Behavior Questionnaire for Lockdowns; UCLA-3: University of California, Los Angeles-3 item

Loneliness Scale.

J. Clin. Med. 2025,14, 1546 15 of 25

3.2. Risk of Bias in Studies

The included studies met the minimum threshold according to the JBI critical appraisal

tools, achieving a rating of moderate to high quality. For cross-sectional studies, the obtained

scores were 5/8 [

–

], 6/8 [

], 7/8 [

], and 8/8 [

]. For

cohort or longitudinal studies, the scores were 7/11 [

], 8/11 [

], 9/11 [

and 10/11 [28–30,50].

3.3. Results of Individual Studies

Longitudinal research provided more signiﬁcant insights into the evolution of BD

over time and the causal relationships between various factors and behaviors. These

studies revealed ﬂuctuations in BD patterns throughout different phases of the pandemic,

highlighting consistent trends and identifying protective or risk factors. Notable ﬁndings

included an initial decrease in BD, primarily associated with reduced social opportunities

due to lockdowns and restrictions, followed by a resurgence in the second year of the

pandemic, particularly among men [

] and older adolescents, linked to feelings of bore-

dom [

], loneliness, and depression [

]. The longitudinal studies identiﬁed several

consistent predictors of BD, including psychosocial factors such as depression [28,30] and

anxiety [

]; a lack of coping strategies and low academic engagement [

];

prior excessive alcohol consumption as a signiﬁcant risk factor [

]; and insufﬁcient so-

cial and familial support [

], which contributed to the increase in BD. These

ﬁndings emphasize the intricate interplay between social conditions [44,50].

Considering both longitudinal and cross-sectional studies, several factors associated with

the COVID-19 pandemic have been identified as contributing to an increase in BD. These include

the direct effects of COVID-19 infection [

], experiences of isolation [

], disconnection from

social environments [

], loneliness [

], stress related to COVID-19 [

], social

restrictions resulting from the pandemic [

], and non-compliance with these restrictions

[40,49]

Several factors contributing to the increase in BD associated with psychosocial health include:

lack of coping strategies [

], depressive symptoms [

], anxiety symp-

toms [

], boredom [

], risk of suicide [

], low resilience [

], and having a

previous mental health diagnosis [45].

Various factors can be identiﬁed that connect BD to other health-related behaviors.

These include a lifetime of regular smoking [

], binge drinking prior to the

pandemic [

], lack of physical activity [

], using substances (i.e., cannabis) [

and other risk behaviors [43].

The sociodemographic variables contributing to various outcomes include educational

attainment such as primary or middle school education [

], vocational training [

], and

bachelor studies [

]. Additionally, economic status plays a significant role, encompassing both

low [

] and high economic status [

]. Social living arrangements, whether living alone,

with a partner, or with friends, are also relevant factors [

–

]. Furthermore,

involvement in Greek life and the presence of friends or social groups [

], and being

in a complicated relationship [

] are determinants. Other notable influences include low

family support [

], limited recreational activities [

], and the impact of distance learning and

academic disengagement [18,42,47].

Numerous studies have indicated a correlation between female gender and an in-

creased risk of BD during the COVID-19 pandemic [

]. Conversely, other research

has identiﬁed male gender as a contributing factor to the risk [

]. Addition-

ally, both younger [

] and older adolescents [

] have been associated with

heightened levels of BD. Furthermore, the second year of the pandemic was related to an

increase in BD compared to the year 2020 [29].

J. Clin. Med. 2025,14, 1546 16 of 25

Several factors associated with COVID-19 have been linked to a reduction in BD.

These include conﬁnement measures and the implementation of initial stay-at-home

orders [

–

]. Additionally, social distancing practices played a role in this de-

crease [

]. The presence of supportive relationships during this period [

]

also contributed positively. Furthermore, the anxiety surrounding potential infection and

the risk of transmitting the virus to others was a signiﬁcant factor [

]. Resilient coping

strategies were found to correlate with a decline in BD [

]. Moreover, individuals who

did not have a history of alcohol consumption were also observed to have a lower risk of

experiencing BD [28].

A reduction in BD has been associated with several sociodemographic factors, includ-

ing residing with family members [

] and being enrolled as a student [

], with a

particular emphasis on those studying health sciences [

]. Additionally, individuals from

lower economic backgrounds have also been linked to a decrease in BD [47].

Conversely, the factors of being female [

] and younger [

–

] appeared

to mitigate the incidence of BD, whereas [

] reported a decreased risk of BD among

older individuals.

Additionally, various studies have identiﬁed certain variables that did not correlate

with ﬂuctuations in BD, including pandemic-related stress and social support [

smoking and cannabis use [

], pandemic-related stressors [

], low economy [

physical activity [

], support from friends [

], as well as low resilience and low self-

efﬁcacy [51].

4. Discussion

This systematic review highlights a range of risk factors that contribute to the preva-

lence of the BD behavior. Evidence suggests that BD may be linked to various underlying

causes, including the impact of COVID-19 restrictions, mental and behavioral health disor-

ders, familial difﬁculties, and socioeconomic challenges.

Numerous factors linked to the pandemic have emerged as signiﬁcant inﬂuences,

including COVID-19 infection [

], experiences of isolation [

], social disconnec-

tion [

], feelings loneliness [

], stress stemming from the health crisis, social

restrictions [

], and instances of non-compliance with pandemic restrictions [

Furthermore, the second year of the pandemic saw a rise in BD compared to 2020 [29].

Several factors contribute to a low psychosocial health, including insufﬁcient coping

mechanisms [

], depressive symptoms [

], anxiety [

feelings of boredom [

], suicide risk [

], low resilience [

], and pre-existing mental

health conditions [

]. Research suggests that neuroticism, boredom proneness, and type

D personality—characterized by a heightened sensitivity to negative emotions and a

tendency to suppress emotional expression in social contexts—may serve as inefﬁcient

strategies for dealing with emotional problems [

]. Additionally, another study identiﬁes

BD as a potential strategy to mitigate depressive or anxious moods which can create a

bidirectional cycle where excessive alcohol consumption and emotional distress reinforce

each other [

]. In relation to mental health, social behavior disorders or ADHD issues

may also correlate with BD [

]. Sensation-seeking behavior, along with low self-control

and impulsivity—traits more commonly observed in adolescents and males—can lead to

difﬁculties in resisting urges, such as the consumption of alcohol [

]. Moreover, BD is

signiﬁcantly associated with an increased risk of suicide and suicide attempts [

] and has

been connected to the onset of anxiety and depression [55].

Various additional habits, including habitual smoking [

], high levels of

alcohol intake before the onset of the pandemic [

], lack of physical activity [

substance use (such as cannabis), and other risky behaviors [

], were also identiﬁed as

J. Clin. Med. 2025,14, 1546 17 of 25

contributing factors for BD. Research has indicated a correlation between self-identifying

as a social smoker and instances of BD [

]. Similarly, cannabis consumption appears

to exacerbate this association, particularly among college students and undergraduates.

Furthermore, binge drinkers who also use cannabis exhibit diminished neuropsychological

performance, notably characterized by deﬁcits in episodic memory [57–59].

Sociodemographic factors contributing to the phenomenon include educational attain-

ment (such as middle school, bachelor’s degrees, and vocational training) [

], low

socioeconomic status [

], and, conversely, high socioeconomic status [

]. Addi-

tional factors encompass living alone [

–

], limited familial support [

a lack of engaging activities [27], the prevalence of distance learning, and academic disen-

gagement [

]. The correlation with extraversion, potentially linked to peer inﬂuence,

underscores the considerable impact of the social context on BD [

]. Consequently, it is

signiﬁcant to note how both feelings of loneliness and social isolation have variably affected

BD during the pandemic. Speciﬁcally, these factors have led to an increased prevalence

of BD among individuals exhibiting depressive or anxious tendencies, as well as those

experiencing heightened loneliness. Conversely, a general trend observed across studies

indicates a substantial reduction in BD, attributed to diminished social interactions and

fewer opportunities for alcohol consumption. Other relevant variables include family

dysfunction [

], parental drinking behaviors [

], and living independently from one’s

family [

], all of which were associated with BD prior to the onset of the COVID-19

pandemic. Furthermore, relatively high income [

] or the availability of disposable

income, which facilitates access to alcohol, particularly among university students during

weekends, has also been linked to BD [60].

Our research outlines various factors associated with a decrease of BD in the con-

text of COVID-19. Pandemic-related factors include conﬁnement and stay-at-home or-

ders [

–

], social distancing [

], fear of contagion [

], and resilient coping

strategies [

]. Feeling supported by loved ones [

] and not having been a prior alcohol

consumer [28] are also linked to lower levels of BD.

In terms of sociodemographic factors, living with family [

], being a student

(particularly in health sciences) [

], or having a low economic status are associated

with reduced BD levels [

]. Furthermore, it has been observed that the risk of BD tends to

decline among older adolescents [

]. Factors such as religiosity [

], social support from

family and friends [

], and parental control [

] have been identiﬁed as protective

factors for BD before the pandemic, and thus, these factors remained active from 2020

onwards.

Numerous studies have examined the inﬂuence of sociodemographic factors, par-

ticularly sex, on the prevalence of BD during the COVID-19 pandemic. Some research

indicates that being female is associated with a heightened risk of BD during this pe-

riod [

]. Conversely, other studies suggest that being male may correlate with an

increased risk [

]. This ﬁnding aligns with earlier research that identiﬁed a

higher prevalence of BD among males compared to females [64].

The variable of age similarly demonstrates a correlation with BD, as both younger [

]

and older adolescents [

] have been associated with this behavior. Individuals

within the 18–29 age range exhibited a higher likelihood of reporting fluctuations in BD—both

increases and decreases—during the COVID-19 pandemic, suggesting that distinct mechanisms

may underlie these divergent trends. Research indicates that the psychological ramifications

of the pandemic may have disproportionately affected young and middle-aged adults in

comparison to older individuals [

–

]. Furthermore, studies reveal that adolescents who

initiate regular alcohol consumption priorto the age of 15 are up to four times more susceptible

to developing alcohol dependence than those who start drinking at a later age [

]. This finding

J. Clin. Med. 2025,14, 1546 18 of 25

supports the notion that alcohol consumption tends to increase in both frequency and quantity

as individuals age [69,70].

Longitudinal studies conducted during the COVID-19 pandemic have provided valu-

able insights into the evolving patterns of BD. A comprehensive analysis indicates that,

while there was a notable decline in BD prevalence during the initial lockdowns, particu-

larly in the ﬁrst year, a resurgence was observed in the second year of the pandemic [

The initial reduction in BD was primarily linked to diminished social opportunities [

which were a consequence of restrictions such as lockdowns and stay-at-home orders [

Factors including cohabitation with family and a decrease in social interactions were identi-

ﬁed as protective elements [

]. However, as restrictions began to relax in the later stages of

the pandemic, an increase in BD patterns was particularly evident among males and older

adolescents [

]. Research has indicated that feelings of boredom [

], loneliness [

and depression [

] played signiﬁcant roles in inﬂuencing BD behaviors, with some studies

noting that women experienced higher rates of BD initiation and escalation compared to

men during the pandemic [

]. Furthermore, younger individuals and students who had

pre-existing BD habits were more inclined to resume or amplify their BD as restrictions were

lifted [

]. Conversely, when examining the interplay of sex and age, being female [

]

appeared to mitigate the risk of BD, although [

] noted a reduced risk of BD among older

adolescents during the second year of the pandemic compared to 2020. The variability

observed across different demographic groups and time periods highlights the intricate

relationship between pandemic-related stressors, mental health, and alcohol consumption

behaviors. These ﬁndings underscore the necessity for targeted interventions that can

effectively address the ﬂuctuating nature of BD during extended crises.

4.1. Future Approach and Implications

Considering the results, particularly those from longitudinal studies, future measures

aimed at curbing excessive alcohol consumption should take several key factors into

account, especially in the context of the COVID-19 pandemic and its aftermath.

First, psychosocial support is essential [

]. Providing mental health support, es-

pecially during periods of isolation or social restrictions, could mitigate the increase in

alcohol consumption associated with depression, anxiety, and boredom. The prolonged

uncertainty and emotional distress caused by the pandemic have intensiﬁed these psy-

chological challenges, making it even more crucial to ensure accessible mental health

resources [

]. Additionally, promoting resilient coping strategies may help individuals

manage pandemic-related stress without resorting to BD, particularly as people continue

to adapt to post-pandemic societal changes [18,28].

Social support, including peer support, has proven to be an effective resource for

improving mental health during the pandemic. Family support also plays a crucial role,

as living with family has been identiﬁed as a protective factor against BD [

]. During

lockdowns, the home environment became a central inﬂuence on behavior, either reinforc-

ing protective factors or, in some cases, exacerbating stressors. Encouraging participation

in recreational activities could further reduce BD associated with boredom, which was a

major contributor to increased alcohol use during periods of strict conﬁnement and limited

social interaction [73].

Moreover, sex- and age-speciﬁc interventions should be developed, given that these

demographic factors inﬂuence BD patterns. The pandemic highlighted distinct vulnerabili-

ties among different groups, with studies showing that men and older adolescents were

particularly prone to increased alcohol use during lockdowns [

]. Tailoring interventions

to address these speciﬁc needs is essential. Additionally, the social environment must be

considered, as peer inﬂuence is a signiﬁcant factor [

]. The shift from in-person

J. Clin. Med. 2025,14, 1546 19 of 25

to virtual socialization during the pandemic altered drinking behaviors, and interventions

should address both online and ofﬂine peer pressures [74].

Another critical aspect is distance education, as challenges related to remote learning

and academic disengagement have been linked to an increase in BD [

]. The transi-

tion to online education during the pandemic disrupted students’ routines, reduced their

access to structured environments and contributed to feelings of disconnection, all of which

may have powered unhealthy coping mechanisms such as excessive alcohol consumption.

Addressing these educational challenges and fostering engagement in academic activities

can serve as a protective factor [75].

Additionally, early intervention is necessary to prevent alcohol consumption at a

young age, as early alcohol use has been associated with a higher risk of developing

addiction-related problems. The pandemic underscored the importance of early preventive

measures, given that many adolescents experienced increased exposure to alcohol due to

changes in parental supervision and home dynamics during lockdowns. Initiating alcohol

consumption at an early age has been found to be associated with an increased risk of

developing addiction problems. This highlights the importance of directing intervention

and approach efforts towards adolescents; these measures would be implemented in both

primary care and pediatric services, as well as educational institutions [

–

] and those

professionals specialized in the prevention of addictive behaviors [80].

A notable association has been identiﬁed between BD and attitudes associated with

drunkorexia, as well as the use of cocaine and novel psychoactive substances [

–

Research indicates that fasting BD and intoxication serve as predictors of drunkorexic be-

haviors [

]. Furthermore, the reduction in physical activity during the pandemic may have

exacerbated these behaviors in two signiﬁcant ways. Individuals might have attempted

to offset the perceived decrease in caloric expenditure by resorting to disordered eating

practices, such as fasting or omitting meals prior to alcohol consumption, which are charac-

teristic of drunkorexia [

]. Additionally, BD, which is closely associated with drunkorexia,

may have intensiﬁed due to increased emotional stress and boredom experienced in times

of social distancing, as documented in various studies examining alcohol consumption

during the pandemic [26,27,37,43,47,83,85].

Furthermore, the pandemic not only inﬂuenced drinking behaviors in the short term

but may also have long-term effects on alcohol consumption patterns. Thus, it is crucial

to recognize that prevention and intervention strategies should adopt a holistic approach,

considering the physical, mental, and social consequences of BD, including the increased

likelihood of alcohol dependence. Despite often being misconceived as a lifestyle choice

tied to university culture, various studies have explored the interplay between food, alcohol,

and physical activity, particularly in young adults [

–

]. Nonetheless, results are not

conclusive, and it is necessary to continue with further research to understand whether

binge behaviors (eating or drinking) interaction [

]. This way, future research should

invest in time and resources for health promotion from an early age to mitigate the pattern

of BD consumption among young people [

]. It has been identiﬁed the need to expand

the preventive approaches beyond the individual, leading to healthier habits and a better

quality of life in the short and long term. Implementing environmental measures in places

frequented by young people, such as bars, pubs, and mass events, as well as interventions in

the family, educational, and media environments [

], are effective strategies to guarantee

the success of these approaches. Addressing these risks requires a comprehensive approach

that integrates public health policies, mental health initiatives, and community-based

support systems to mitigate the lasting impact of the pandemic on alcohol use behaviors.

J. Clin. Med. 2025,14, 1546 20 of 25

4.2. Limitations

This study acknowledges variability in the deﬁnition of BD across included studies.

This inconsistency may hinder the comparability and synthesis of results, although the

operational deﬁnitions of BD were explored in all the included studies to assure the

consistency of the results. In addition, data collection bias is addressed in this study, as

self-reported data from included studies may underestimate actual alcohol consumption

due to social desirability bias or memory inaccuracies. Sampling bias is also acknowledged

as some included studies suffered from small sample sizes, reducing statistical power and

generalizability. Finally, factors such as pandemic-related stress, social support, and self-

efﬁcacy were reported inconsistently across studies, complicating a cohesive understanding

of their role in BD. The cross-sectional design of most studies may have contributed to this

limitation. Not all results obtained in the study hold the same level of signiﬁcance, and more

relevant conclusions can be drawn from certain factors, depending on the methodology

employed. While cross-sectional studies have provided valuable insights, their ability

to establish causal relationships is limited. For instance, although some cross-sectional

studies reported a higher risk of BD among females during the pandemic, others suggested

the opposite. These discrepancies may arise from variations in study populations or the

inherent limitations of cross-sectional studies in capturing shifting behavioral patterns

during the pandemic.

5. Conclusions

This systematic review included 33 studies, with 19 cross-sectional and 14 longitudi-

nal studies. Findings on BD during the COVID-19 pandemic are clearly unbalanced, as

two studies reported an increase in BD prevalence, while 21 reported a decrease. Factors

contributing to increased BD included pandemic-related stressors like COVID-19 infection,

isolation, loneliness, and non-compliance with social restrictions. Psychosocial factors such

as depression, anxiety, lack of coping strategies, and pre-existing mental health conditions

were signiﬁcant, as were habits like prior excessive alcohol use, smoking, cannabis con-

sumption, and physical inactivity. Sociodemographic factors like low education, varying

economic status, and limited family support were also linked to BD.

Conversely, some pandemic-related factors were also associated with reduced BD,

including stay-at-home orders, fear of contagion, resilient coping, and feeling supported

by loved ones. Protective factors included living with family, studying health sciences,

and having a low economic status. Variables like pandemic-related stress and self-efﬁcacy

showed inconsistent relationships with BD. These ﬁndings underscore the importance of

understanding the ineffective coping strategies that inﬂuence BD behaviors during crises

such as the pandemic.

The study concludes that effective prevention and intervention strategies are essential,

focusing on the physical, mental, and social consequences of BD, including the increased

likelihood of alcohol dependence. A holistic approach to BD in healthcare settings is needed,

integrating early detection, risk factor evaluation, and tailored interventions, particularly

for vulnerable groups like adolescents. Training healthcare professionals is crucial for

effectively addressing BD behaviors and implementing preventive measures.

Supplementary Materials: The following supporting information can be downloaded at:

https://www.mdpi.com/article/10.3390/jcm14051546/s1, Table S1. PRISMA checklist; Table S2. JBI

score for cross-sectional studies; Table S3. JBI score for cohort studies.

Author Contributions: All authors have made substantial intellectual contributions to this work and

meet the criteria for authorship. This manuscript is original, has not been previously published and is

not currently under review by any other journal. Furthermore, it adheres to the ICMJE guidelines for

J. Clin. Med. 2025,14, 1546 21 of 25

the conduct, reporting, editing, and publication of scholarly articles in medical journals. All authors

have read and agreed to the published version of the manuscript.

Funding: This research received no external funding.

Institutional Review Board Statement: Not applicable.

Informed Consent Statement: Not applicable.

Data Availability Statement: The original contributions presented in this study are included in the

article/Supplementary Materials. Further inquiries can be directed to the corresponding authors.

Conﬂicts of Interest: The authors declare no conﬂicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:

BD binge drinking

COVID-19 Coronavirus Disease 2019

JBI Joanna Briggs Institute

PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses

WHO World Health Organization

SARS-CoV-2 Severe Acute Respiratory Syndrome Coronavirus 2

References

World Health Organization. Global Status Report on Alcohol and Health and Treatment of Substance Use Disorders; World Health

Organization: Geneva, Switzerland, 2024.

World Health Organization Regional Ofﬁce for Europe. Making the WHO European Region Safer: Developments in Alcohol Control

Policies, 2010–2019; WHO Regional Ofﬁce for Europe: Copenhagen, Denmark, 2021.

3. World Health Organization. Global Status Report on Alcohol and Health 2018; World Health Organization: Geneva, Switzerland, 2018.

Observatorio Español de las Drogas y las Adicciones. Monografía Alcohol 2024. Consumo y Consecuencias; Ministerio de Sanidad,

Delegación del Gobierno para el Plan Nacional sobre Drogas: Madrid, Spain, 2024.

Observatorio Español de las Drogas y las Adicciones. Informe 2023. Alcohol, Tabaco y Drogas Ilegales en España; Ministerio de

Sanidad, Delegación del Gobierno para el Plan Nacional sobre Drogas: Madrid, Spain, 2023.

Babor, T.F.; Casswell, S.; Graham, K.; Huckle, T.; Livingston, M.; Österberg, E.; Rehm, J.; Room, R.; Rossow, I.; Sornpaisarn, B.

Alcohol: No Ordinary Commodity. Research and Public Policy, 3rd ed.; Oxford University Press: Oxford, UK, 2022.

National Institute of Alcohol Abuse and Alcoholism (NIAAA). Drinking Levels Deﬁned; National Institute of Alcohol Abuse and

Alcoholism: Bethesda, MD, USA, 2015.

8. White, A.M.; Tapert, S.; Shukla, S.D. Binge Drinking. Alcohol Res. 2018,39, 1–3. [PubMed]

Patrick, M.E.; Schulenberg, J.E. Prevalence and predictors of adolescent alcohol use and binge drinking in the United States.

Alcohol Res. 2013,35, 193–200. [PubMed]

10.

Patrick, M.E.; Terry-McElrath, Y.M.; Lanza, S.T.; Jager, J.; Schulenberg, J.E.; O’Malley, P.M. Shifting Age of Peak Binge Drinking

Prevalence: Historical Changes in Normative Trajectories Among Young Adults Aged 18 to 30. Alcohol. Clin. Exp. Res. 2019,43,

287–298. [CrossRef]

11.

Villalbí, J.R.; Serral, G.; Espelt, A.; Puigcorbé, S.; Bartroli, M.; Sureda, X.; Teixidó-Compañó, E.; Bosque-Prous, M. Prevalence of

binge drinking among high school students and urban contextual factors. Rev. Esp. Salud Publica 2020,94, e202011150.

12. National Drug Plan. ESTUDES 2023: Survey on Drug Use Among Secondary School Students; Ministry of Health: Madrid, Spain, 2023.

13.

World Health Organization. WHO Coronavirus (COVID-19) Dashboard—WHO Data. 2024. Available online: https://covid19.

who.int (accessed on 4 December 2024).

14.

Nicola, M.; Alsaﬁ, Z.; Sohrabi, C.; Kerwan, A.; Al-Jabir, A.; Iosiﬁdis, C.; Agha, M.; Agha, R. The socio-economic implications of

the coronavirus pandemic (COVID-19): A review. Int. J. Surg. 2020,78, 185–193. [CrossRef]

15.

Hutchins, H.J.; Wolff, B.; Leeb, R.; Ko, J.Y.; Odom, E.; Willey, J.; Friedman, A.; Bitsko, R.H. COVID-19 Mitigation Behaviors by Age

Group—United States, April-June 2020. MMWR Morb. Mortal. Wkly. Rep. 2020,69, 1584–1590. [CrossRef] [PubMed]

16.

Dumas, T.M.; Ellis, W.E.; Van Hedger, S.; Litt, D.M.; MacDonald, M. Lockdown, bottoms up? Changes in adolescent substance

use across the COVID-19 pandemic. Addict. Behav. 2022,131, 107326. [CrossRef] [PubMed]

J. Clin. Med. 2025,14, 1546 22 of 25

17.

Niedzwiedz, C.L.; Green, M.J.; Benzeval, M.; Campbell, D.; Craig, P.; Demou, E.; Leyland, A.; Pearce, A.; Thomson, R.; Whitley, E.;

et al. Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: Longitudinal analyses

of the UK Household Longitudinal Study. J. Epidemiol. Community Health 2021,75, 224–231. [CrossRef]

18.

Fruehwirth, J.C.; Gorman, B.L.; Perreira, K.M. The Effect of Social and Stress-Related Factors on Alcohol Use Among College

Students During the COVID-19 Pandemic. J. Adolesc. Health 2021,69, 557–565. [CrossRef]

19.

Bonar, E.E.; Parks, M.J.; Gunlicks-Stoessel, M.; Lyden, G.R.; Mehus, C.J.; Morrell, N.; Patrick, M.E. Binge drinking before and after

a COVID-19 campus closure among ﬁrst-year college students. Addict. Behav. 2021,118, 106879. [CrossRef]

20.

Stephenson, M.; Riitano, D.; Wilson, S.; Leonardi-Bee, J.; Mabire, C.; Cooper, K.; Monteiro da Cruz, D.; Moreno-Casbas, M.;

Lapkin, S. Chapter 12: Systematic reviews of measurement properties. In JBI Manual for Evidence Synthesis; Aromataris, E., Munn,

Z., Eds.; JBI: Adelaide, Australia, 2020. [CrossRef]

21.

Page, M.; McKenzie, J.; Bossuyt, P.; Boutron, I.; Hoffmann, T.; Mulrow, C. The PRISMA 2020 statement: An updated guideline for

reporting systematic reviews. BMJ 2021,372, 71.

22.

Moola, S.; Munn, Z.; Tufanaru, C.; Aromataris, E.; Sears, K.; Sfetcu, R.; Currie, M.; Qureshi, R.; Mattis, P.; Lisy, K.; et al. Chapter

7: Systematic reviews of etiology and risk. In JBI Manual for Evidence Synthesis; Aromataris, E., Munn, Z., Eds.; JBI: Adelaide,

Australia, 2020.

23.

Ahuja, M.; Miller-Slough, R.; Adebayo-Abikoye, E.; Williams, C.; Haubner, A.; Dooley, M.G.; Bansal, M.; Sathiyaseelan, T.;

Pons, A.; Karki, A.; et al. Loneliness and Alcohol use among College Students During the COVID-19 Pandemic in Rural

Appalachia. Chronic Stress 2024,8, 24705470241264909. [CrossRef]

24.

Ammar, A.; Brach, M.; Trabelsi, K.; Chtourou, H.; Boukhris, O.; Masmoudi, L.; Bouaziz, B.; Bentlage, E.; How, D.; Ahmed, M.; et al.

Effects of COVID-19 Home Conﬁnement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International

Online Survey. Nutrients 2020,12, 1583. [CrossRef]

25.

Bianchi, D.; Baiocco, R.; Pompili, S.; Lonigro, A.; Di Norcia, A.; Cannoni, E.; Longobardi, E.; Zammuto, M.; Di Tata, D.; Laghi, F.

Binge Eating and Binge Drinking in Emerging Adults During COVID-19 Lockdown in Italy: An Examination of Protective and

Risk Factors. Emerg. Adulthood 2022,10, 291–303. [CrossRef]

26.

Busse, H.; Buck, C.; Stock, C.; Zeeb, H.; Pischke, C.R.; Fialho, P.M.M.; Wendt, C.; Helmer, S.M. Engagement in Health Risk

Behaviours before and during the COVID-19 Pandemic in German University Students: Results of a Cross-Sectional Study. Int. J.

Environ. Res. Public Health 2021,18, 1410. [CrossRef]

27.

Clare, P.J.; Aiken, A.; Yuen, W.S.; Upton, E.; Kypri, K.; Degenhardt, L.; Bruno, R.; McCambridge, J.; McBride, N.; Hutchinson, D.;

et al. Alcohol use among young Australian adults in May-June 2020 during the COVID-19 pandemic: A prospective cohort study.

Addiction 2021,116, 3398–3407. [CrossRef]

28.

Gohari, M.R.; Varatharajan, T.; MacKillop, J.; Leatherdale, S.T. Dynamic Changes in Drinking Behaviour among Subpopulations

of Youth during the COVID-19 Pandemic: A Prospective Cohort Study. Healthcare 2023,11, 1945. [CrossRef]

29.

Gohari, M.R.; Varatharajan, T.; MacKillop, J.; Leatherdale, S.T. Examining the Impact of the COVID-19 Pandemic on youth Alcohol

Consumption: Longitudinal Changes From Pre-to Intra-pandemic Drinking in the COMPASS Study. J. Adolesc. Health 2022,71,

665–672. [CrossRef]

30.

Gohari, M.R.; Varatharajan, T.; Patte, K.A.; MacKillop, J.; Leatherdale, S.T. The intersection of internalizing symptoms and alcohol

use during the COVID-19 pandemic: A prospective cohort study. Prev. Med. 2023,166, 107381. [CrossRef]

31.

Hoots, B.E.; Li, J.; Hertz, M.F.; Esser, M.B.; Rico, A.; Zavala, E.Y.; Jones, C.M. Alcohol and Other Substance Use Before and During

the COVID-19 Pandemic Among High School Students—Youth Risk Behavior Survey, United States, 2021. MMWR Suppl. 2023,

72, 84–92. [CrossRef]

32.

Kinouani, S.; Macalli, M.; Arsandaux, J.; Montagni, I.; Texier, N.; Schück, S.; Tzourio, C. Factors related to increased alcohol

misuse by students compared to non-students during the ﬁrst COVID-19 lockdown in France: The Conﬁns study. BMC Public

Health 2024,24, 646, Correction in BMC Public Health 2024,24, 772. https://doi.org/10.1186/s12889-024-18275-6. [CrossRef]

33.

Mallis, N.; Dailey, C.; Drewry, S.; Howard, N.; Cordero, J.F.; Welton, M. SARS-CoV-2 infection and e-cigarette use, binge drinking,

and other associated risk factors in a college population. J. Am. Coll. Health 2022,72, 366–370. [CrossRef] [PubMed]

34.

Miech, R.; Patrick, M.E.; Keyes, K.; O’Malley, P.M.; Johnston, L. Adolescent drug use before and during U.S. national COVID-19

social distancing policies. Drug Alcohol Depend. 2021,226, 108822. [CrossRef]

35.

Monzon, J.; Barnoya, J.; Mus, S.; Davila, G.; Vidaña-Pérez, D.; Thrasher, J.F. Changes in substance use among adolescents before

and during the COVID-19 pandemic in Guatemala. Front. Psychiatry 2024,15, 1331962. [CrossRef]

36.

Patin, A.; Ladner, J.; Tavolacci, M.P. Change in University Student Health Behaviours after the Onset of the COVID-19 Pandemic.

Int. J. Environ. Res. Public Health 2022,20, 539. [CrossRef]

37.

Patrick, M.E.; Terry-McElrath, Y.M.; Miech, R.A.; Keyes, K.M.; Jager, J.; Schulenberg, J.E. Alcohol use and the COVID-19 pandemic:

Historical trends in drinking, contexts, and reasons for use among U.S. adults. Soc. Sci. Med. 2022,301, 114887. [CrossRef]

J. Clin. Med. 2025,14, 1546 23 of 25

38.

Pelham, W.E., 3rd; Yuksel, D.; Tapert, S.F.; Baker, F.C.; Pohl, K.M.; Thompson, W.K.; Podhajsky, S.; Reuter, C.; Zhao, Q.; Eberson-

Shumate, S.C.; et al. Did the acute impact of the COVID-19 pandemic on drinking or nicotine use persist? Evidence from a cohort

of emerging adults followed for up to nine years. Addict. Behav. 2022,131, 107313. [CrossRef]

39.

Rogés, J.; Bosque-Prous, M.; Colom, J.; Folch, C.; Barón-Garcia, T.; González-Casals, H.; Fernández, E.; Espelt, A. Consumption of

Alcohol, Cannabis, and Tobacco in a Cohort of Adolescents before and during COVID-19 Conﬁnement. Int. J. Environ. Res. Public

Health 2021,18, 7849. [CrossRef]

40.

Romano, I.; Patte, K.A.; de Groh, M.; Jiang, Y.; Leatherdale, S.T. Perceptions of and adherence to early COVID-19-related

restrictions and associations with substance use among youth in Canada. Perceptions et respect des premières restrictions liées à

la COVID-19 et associations avec la consommation de substances chez les jeunes au Canada. Health Promot. Chronic Dis. Prev.

Can. 2022,42, 479–489. [CrossRef]

41.

Rubio, M.; van Hooijdonk, K.; Luijten, M.; Kappe, R.; Cillessen, A.H.; Verhagen, M.; Vink, J.M. University students’ (binge)

drinking during COVID-19 lockdowns: An investigation of depression, social context, resilience, and changes in alcohol use.

Soc. Sci. Med. 2023,326, 115925. [CrossRef]

42.

Serkut Bulut, N.; Yorguner, N.; Akvardar, Y. Impact of COVID-19 on the Life of Higher-Education Students in ˙

Istanbul:

Relationship Between Social Support, Health-Risk Behaviors, and Mental/Academic Well-Being. Alpha Psychiatry 2021,22,

291–300. [CrossRef] [PubMed]

43.

Shapiro, O.; Gannot, R.N.; Green, G.; Zigdon, A.; Zwilling, M.; Giladi, A.; Ben-Meir, L.; Adilson, M.; Barak, S.; Harel-Fisch, Y.;

et al. Risk Behaviors, Family Support, and Emotional Health among Adolescents during the COVID-19 Pandemic in Israel. Int. J.

Environ. Res. Public Health 2022,19, 3850. [CrossRef] [PubMed]

44.

Sharma, P.; Kamath, C.; Kurani, S.; Pazdernik, V.; Kremers, H.M.; Sauver, J.S.; Croarkin, P.; Geske, J.; Prasad, K.; Patten, C.;

et al. Longitudinal Correlates of Increased Alcohol Use Among Adolescents and Young Adults During the COVID-19 Pandemic.

Alcohol Alcohol. 2022,57, 648–655. [CrossRef]

45.

Sylvestre, M.P.; Dinkou, G.D.T.; Naja, M.; Riglea, T.; Pelekanakis, A.; Bélanger, M.; Maximova, K.; Mowat, D.; Paradis, G.;

O’Loughlin, J. A longitudinal study of change in substance use from before to during the COVID-19 pandemic in young adults.

Lancet Reg. Health Am. 2022,8, 100168. [CrossRef] [PubMed]

46.

Tavolacci, M.P.; Wouters, E.; Van de Velde, S.; Buffel, V.; Déchelotte, P.; Van Hal, G.; Ladner, J. The Impact of COVID-19 Lockdown

on Health Behaviors among Students of a French University. Int. J. Environ. Res. Public Health 2021,18, 4346. [CrossRef]

47.

Tholen, R.; Ponnet, K.; Van Hal, G.; De Bruyn, S.; Buffel, V.; Van de Velde, S.; Bracke, P.; Wouters, E. Substance Use among Belgian

Higher Education Students before and during the First Wave of the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2022,

19, 4348. [CrossRef]

48.

Vallentin-Holbech, L.; Ewing, S.W.F.; Thomsen, K.R. Hazardous alcohol use among Danish adolescents during the second wave

of COVID-19: Link between alcohol use and social life. Nord. Alkohol. Nark. 2023,40, 127–145. [CrossRef]

49.

van Hooijdonk, K.J.M.; Rubio, M.; Simons, S.S.H.; van Noorden, T.H.J.; Luijten, M.; Geurts, S.A.E.; Vink, J.M. Student-, Study- and

COVID-19-Related Predictors of Students’ Smoking, Binge Drinking and Cannabis Use before and during the Initial COVID-19

Lockdown in The Netherlands. Int. J. Environ. Res. Public Health 2022,19, 812. [CrossRef]

50.

Vasconcelos, M.; Crego, A.; Rodrigues, R.; Almeida-Antunes, N.; López-Caneda, E. Effects of the COVID-19 Mitigation Measures

on Alcohol Consumption and Binge Drinking in College Students: A Longitudinal Survey. Int. J. Environ. Res. Public Health 2021,

18, 9822. [CrossRef]

51. Zysset, A.; Volken, T.; Amendola, S.; von Wyl, A.; Dratva, J. Change in Alcohol Consumption and Binge Drinking in University

Students During the Early COVID-19 Pandemic. Front. Public Health 2022,10, 854350. [CrossRef]

52.

Adan, A.; Forero, D.A.; Navarro, J.F. Personality Traits Related to Binge Drinking: A Systematic Review. Front. Psychiatry 2017,8,

134. [CrossRef] [PubMed]

53.

Martínez-Hernáez, A.; Marí-Klose, M.; Julià, A.; Escapa, S.; Marí-Klose, P. Consumo episódico excesivo de alcohol en adolescentes:

Su asociación con los estados de ánimo negativos y los factores familiares. Rev. Española de Salud Pública 2012,86, 101–114.

[CrossRef] [PubMed]

54.

Stolle, M.; Sack, P.M.; Thomasius, R. Binge drinking in childhood and adolescence: Epidemiology, consequences, and interventions.

Dtsch. Arztebl. Int. 2009,106, 323–328. [CrossRef]

55.

Valencia Martín, J.L.; Galán, I.; Segura García, L.; Camarelles Guillem, F.; Suárez Cardona, M.; Brime Beteta, B. Episodios de

consumo intensivo de alcohol “Binge drinking”: Retos en su deﬁnición e impacto en salud [Binge drinking: The challenges of

deﬁnition and its impact on health]. Rev. Esp. Salud Publica 2020,94, e202011170.

56.

Gubner, N.R.; Delucchi, K.L.; Ramo, D.E. Associations between binge drinking frequency and tobacco use among young adults.

Addict. Behav. 2016,60, 191–196. [CrossRef]

57.

Keith, D.R.; Hart, C.L.; McNeil, M.P.; Silver, R.; Goodwin, R.D. Frequent marijuana use, binge drinking and mental health

problems among undergraduates. Am. J. Addict. 2015,24, 499–506. [CrossRef]

J. Clin. Med. 2025,14, 1546 24 of 25

58.

Deniel, S.; Mauduy, M.; Cheam-Bernière, C.; Mauny, N.; Montcharmont, C.; Cabé, N.; Bazire, A.; Mange, J.; Le Berre, A.P.; Jacquet,

D.; et al. Why should we ask binge drinkers if they smoke cannabis? Additive effect of alcohol and cannabis use on college

students’ neuropsychological performance. Addict. Behav. Rep. 2021,14, 100362. [CrossRef]

59.

Tetteh-Quarshie, S.; Risher, M.L. Adolescent brain maturation and the neuropathological effects of binge drinking: A critical

review. Front. Neurosci. 2023,16, 1040049. [CrossRef]

60.

Mejía Martínez, A.; Guzmán Facundo, F.R.; Rodríguez Aguilar, L.; Cristina Pillon, S.; Candia Arrendondo, J.S. Modelo de sistemas

del consumo excesivo de alcohol en estudiantes universitarios. Index. de Enfermería 2021,30, 323–327.

61.

García-Carretero, M.A.; Moreno-Hierro, L.; Robles Martínez, M.; Jordán-Quintero, M.A.; Morales-García, N.; O’Ferrall-González,

C. Patrones de consumo de alcohol en estudiantes universitarios de Ciencias de la Salud. Enfermería Clínica 2019,29, 291–296.

[CrossRef]

62.

Sellés, P.M.; Tomás, M.T.C.; Costa, J.A.G. Diagnostic Utility of New Short Versions of AUDIT to Detect Binge Drinking in

Undergraduate Students. Clínica y Salud 2021,32, 49–54. [CrossRef]

63.

Cheng, T.C.; Lo, C.C. A Causal Analysis of Young Adults’ Binge Drinking Reduction and Cessation. Eur. J. Investig. Health Psychol.

Educ. 2023,13, 870–882. [CrossRef]

64.

Tavolacci, M.P.; Boerg, E.; Richard, L.; Meyrignac, G.; Dechelotte, P.; Ladner, J. Prevalence of binge drinking and associated

behaviours among 3286 college students in France. BMC Public Health 2016,16, 178. [CrossRef]

65. Farhoudian, A.; Radfar, S.R.; Mohaddes Ardabili, H.; Rafei, P.; Ebrahimi, M.; Khojasteh Zonoozi, A.; De Jong, C.A.J.; Vahidi, M.;

Yunesian, M.; Kouimtsidis, C.; et al. A Global Survey on Changes in the Supply, Price, and Use of Illicit Drugs and Alcohol, and

Related Complications During the 2020 COVID-19 Pandemic. Front Psychiatry 2021,12, 646206. [CrossRef]

66.

Ueda, M.; Stickley, A.; Sueki, H.; Matsubayashi, T. Mental health status of the general population in Japan during the COVID-19

pandemic. Psychiatry Clin. Neurosci. 2020,74, 505–506. [CrossRef]

67.

Yamamoto, T.; Uchiumi, C.; Suzuki, N.; Yoshimoto, J.; Murillo-Rodriguez, E. The Psychological Impact of ‘Mild Lockdown’ in

Japan during the COVID-19 Pandemic: A Nationwide Survey under a Declared State of Emergency. Int. J. Environ. Res. Public

Health 2020,17, 9382. [CrossRef]

68.

Stickley, A.; Shirama, A.; Inagawa, T.; Sumiyoshi, T. Binge drinking in Japan during the COVID-19 pandemic: Prevalence,

correlates and association with preventive behaviors. Drug Alcohol Depend. 2022,234, 109415. [CrossRef]

69. Busto Miramontes, A.; Moure-Rodríguez, L.; Mallah, N.; Díaz-Geada, A.; Corral, M.; Cadaveira, F.; Caamaño-Isorna, F. Alcohol

Consumption among Freshman College Students in Spain: Individual and Pooled Analyses of Three Cross-Sectional Surveys

(2005, 2012 and 2016). Int. J. Environ. Res. Public Health 2021,18, 2548. [CrossRef]

70.

Tran, A.; Jiang, H.; Lange, S.; Livingston, M.; Manthey, J.; Neufeld, M.; Room, R.; Štelem

ekas, M.; Telksnys, T.; Petkeviˇcien

e, J.;

et al. The Impact of Increasing the Minimum Legal Drinking Age from 18 to 20 Years in Lithuania on All-Cause Mortality in

Young Adults-An Interrupted Time-Series Analysis. Alcohol Alcohol. 2022,57, 513–519. [CrossRef]

71.

Amezcua, M.; García Pedregal, E.; Jordana, J.; Llisterri, J.L.; Rodríguez Sampedro, A.; Villarino Marín, A. La educación ante el

consumo de riesgo de bebidas alcohóli-cas: Propuesta de actuación multidisciplinar desde el profesional de la salud [Educa-tion

facing risk consumption of alcoholic beverages—A proposal for interdisciplinary action from the health care professional].

Nutr. Hosp. 2020,34, 609–615. [CrossRef]

72.

Domínguez-Salas, S.; Gómez-Salgado, J.; Andrés-Villas, M.; Díaz-Milanés, D.; Romero-Martín, M.; Ruiz-Frutos, C. Psycho-

Emotional Approach to the Psychological Distress Related to the COVID-19 Pandemic in Spain: A Cross-Sectional Observational

Study. Healthcare 2020,8, 190. [CrossRef] [PubMed]

73. Abdeahad, N.; Mock, S. The role of past campus recreational sports participation in predicting students’ stress and competence

during the COVID-19 pandemic. J. Leis. Res. 2023,54, 269–285. [CrossRef]

74.

Hultgren, B.A.; Smith-LeCavalier, K.N.; Canning, J.R.; Jaffe, A.E.; Kim, I.S.; Cegielski, V.I.; Garcia, T.A.; Larimer, M.E. College

students’ virtual and in-person drinking contexts during the COVID-19 pandemic. Alcohol. Clin. Exp. Res. 2022,46, 2089–2102.

[CrossRef]

75.

Benner, A.D.; Harrington, M.K.; Kealy, C.; Nwafor, C.E. The COVID-19 pandemic and adolescents’ and young adults’ experiences

at school: A systematic narrative review. J. Res. Adolesc. 2025,35, e12935. [CrossRef]

76.

Jander, A.; Crutzen, R.; Mercken, L.; Candel, M.; de Vries, H. Effects of a Web-Based Computer-Tailored Game to Reduce Binge

Drinking Among Dutch Adolescents: A Cluster Randomized Controlled Trial. J. Med. Internet Res. 2016,18, e29. [CrossRef]

77.

Lima-Serrano, M.; Fernández-León, P.; Mercken, L.; Martínez-Montilla, J.M.; de Vries, H. An Animation- Versus Text-Based

Computer-Tailored Game Intervention to Prevent Alcohol Consumption and Binge Drinking in Adolescents: Study Protocol.

Int. J. Environ. Res. Public Health 2021,18, 9978. [CrossRef]

78.

Martinez-Montilla, J.M.; Mercken, L.; de Vries, H.; Candel, M.; Lima-Rodríguez, J.S.; Lima-Serrano, M. A Web-Based, Computer-

Tailored Intervention to Reduce Alcohol Consumption and Binge Drinking Among Spanish Adolescents: Cluster Randomized

Controlled Trial. J. Med. Internet Res. 2020,22, e15438. [CrossRef]

J. Clin. Med. 2025,14, 1546 25 of 25

79.

Vargas-Martínez, A.M.; Lima-Serrano, M.; Trapero-Bertran, M. Cost-effectiveness and cost-utility analyses of a web-based

computer-tailored intervention for prevention of binge drinking among Spanish adolescents. Alcohol. Clin. Exp. Res. 2023,47,

319–335. [CrossRef]

80.

Botella López, M.; Giménez Costa, J.A.; Cortés Tomás, M.T. AUDIT, AUDIT-C y AR2I para evaluar el binge drinking en

universitarios españoles. Health Addict./Salud Y Drog. 2020,20, 147–157. [CrossRef]

81.

Lupi, M.; Martinotti, G.; Di Giannantonio, M. Drunkorexia: An emerging trend in young adults. Eat. Weight Disord. EWD 2017,

22, 619–622. [CrossRef]

82.

Vogt, K.S.; Harper, M.; Grifﬁn, B.L. “

. . .

because I’m so drunk at the time, the last thing I’m going to think about is calories”:

Strengthening the argument for Drunkorexia as a food and alcohol disturbance, evidence from a qualitative study. Br. J. Health

Psychol. 2022,27, 1188–1208. [CrossRef] [PubMed]

83.

Pérez-Ortiz, N.; Andrade-Gómez, E.; Fagundo-Rivera, J.; Fernández-León, P. Comprehensive Management of Drunkorexia: A

Scoping Review of Inﬂuencing Factors and Opportunities for Intervention. Nutrients 2024,16, 3894. [CrossRef] [PubMed]

84.

Pompili, S.; Laghi, F. Drunkorexia among adolescents: The role of motivations and emotion regulation. Eat. Behav. 2018,29, 1–7.

[CrossRef] [PubMed]

85.

Kilian, C.; O’Donnell, A.; Potapova, N.; López-Pelayo, H.; Schulte, B.; Miquel, L.; Castillo, B.P.; Schmidt, C.S.; Gual, A.; Rehm, J.;

et al. Changes in alcohol use during the COVID-19 pandemic in Europe: A meta-analysis of observational studies. Drug Alcohol

Rev. 2022,41, 918–931. [CrossRef]

86.

Scott, S.; Muir, C.; Stead, M.; Fitzgerald, N.; Kaner, E.; Bradley, J.; Wrieden, W.; Power, C.; Adamson, A. Exploring the links

between unhealthy eating behaviour and heavy alcohol use in the social, emotional and cultural lives of young adults (aged

18–25): A qualitative research study. Appetite 2020,144, 104449. [CrossRef]

87.

Dinger, M.K.; Brittain, D.R.; O’Mara, H.M.; Peterson, B.M.; Hall, K.C.; Hadley, M.K.; Sharp, T.A. The relationship between

physical activity and binge drinking among college students: A qualitative investigation. Am. J. Health Educ. 2018,49, 33–39.

[CrossRef]

88.

Sampedro-Piquero, P.; Zancada-Menéndez, C.; Bernabéu-Brotons, E.; Moreno-Fernández, R.D. The Relationship between Binge

Drinking and Binge Eating in Adolescence and Youth: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health

2022,20, 232. [CrossRef]

89.

Pérez de Guzmán Pérez, M. Consumo intensivo de alcohol en adolescentes y riesgos en su desarrollo. Revisión Bibliográﬁca

Nuberos Cientíﬁca 2019,3, 22–29. Available online: https://ciberindex.com/c/nc/2822nc (accessed on 21 February 2025).

Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual

author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to

people or property resulting from any ideas, methods, instructions or products referred to in the content.

Available via license: CC BY 4.0

Content may be subject to copyright.

ResearchGate has not been able to resolve any citations for this publication.

Comprehensive Management of Drunkorexia: A Scoping Review of Influencing Factors and Opportunities for Intervention

Article

Full-text available

Nov 2024

Background and objectives: Drunkorexia is a novel alcohol-related disorder prevalent among adolescents and young adults. Extensive research on the causes and their relationship is lacking. Identifying these aspects could improve early detection and management by healthcare professionals. The aim of this review was to identify the influencing factors of drunkorexia in adolescents and young adults, as well as the main opportunities for action by health professionals. Methods: A scoping review was conducted in June and July 2024 using three databases (Pubmed, Scopus, and Web of Science). A search and review protocol were established and registered in PROSPERO. The research questions were formulated in Patient, Concept, Context (PCC) formats for an adequate literature review. Original articles from January 2008 to July 2024 were included. Reviews, meta-analyses, and doctoral theses or academic texts were excluded. In the screening phase, a methodological assessment was conducted using the Joanna Briggs Institute’s (JBI) critical appraisal tools to support study eligibility. Depending on the study design, different checklists were used, and cross-sectional studies that received scores of 4/8 or higher, quasi-experimental designs that obtained 5/9 or higher, and qualitative research that obtained 5/10 or higher were accepted. Results: A total of 1502 studies were initially found. After applying the inclusion/exclusion criteria, 20 studies were selected. Complications of emotion regulation, both positive and negative metacognitive beliefs, inability to effectively manage stress and anxiety, symptoms of post-traumatic stress disorder, self-discipline and self-control, or differences in social expectations are predisposing factors for drunkorexia. The management of malnutrition and dehydration is an opportunity for clinical professionals to address this problem. In addition, mental health issues can provide another opportunity to manage heavy alcohol consumption. Conclusions: Drunkorexia must be recognized as a new disease to be addressed from a multidisciplinary perspective. In this way, increasing research on this trend would support prevention and intervention strategies. The use of digital platforms is essential for raising social awareness of this negative habit.

Loneliness and Alcohol use among College Students During the COVID-19 Pandemic in Rural Appalachia

Article

Full-text available

Aug 2024

Objective Binge drinking and heavy alcohol use are highly prevalent among college students. During the COVID-19 pandemic, due to lockdown restrictions and other challenges, many college students were burdened with loneliness, which can contribute to chronic stress, and substance use. The current study explores the association between loneliness and various levels of alcohol use among college students in the rural, underserved region of Central Appalachia, USA. Methods Data were collected from a regional sample (n = 320) of college age adults, age 18-25 in the Central Appalachian region. The UCLA-3 item Loneliness Scale (UCLA-3) was used in the study to evaluate loneliness. Logistic regression analysis was conducted to assess the association between levels of loneliness and three separate outcomes, including past year binge drinking, past year heavy alcohol use, and past year weekly alcohol use. Results Overall, 25.5% of the participants reported severe loneliness, 33.6% reported moderate, and 40.9% reported low levels of loneliness. Results of the adjusted models revealed that severe loneliness was associated with higher odds of heavy alcohol use (AOR = 1.89, 95% CI [1.02, 3.50]) and binge drinking (AOR = 2.96, 95% CI [1.16, 7.51]), and not associated with weekly alcohol use. Conclusion The study found that higher levels of loneliness were linked to both binged drinking and heavy alcohol use. Further efforts for counseling and treatment among college students who are burdened with severe loneliness should be considered. The chronic stress associated with severe loneliness needs to be further addressed, particularly among emerging adults.

Changes in substance use among adolescents before and during the COVID-19 pandemic in Guatemala

Article

Full-text available

Feb 2024

Objectives Due to the COVID-19 pandemic, on March 16th, schools had to be closed in Guatemala and went to online teaching. We sought to analyze the change in substance use among high school students in Guatemala associated with the lockdown. Methods Data from two surveys (2019, n=2096, and 2020, n=1606) of a student cohort in private high schools in Guatemala City was used. Logistic models for past 30-day cigarette, e-cigarette, marijuana, and alcohol (including binge drinking) were used, regressing these on survey wave, while adjusting for sex, scholastic performance, high school year of student, parental education, substance use, and household member tobacco use. Results Prevalence declined for smoking (10% to 3%, p<0.001), e-cigarette (31% to 14%, p<0.001), marijuana (4.3% to 1.9%, p<0.001), and alcohol use (47% to 38.5%, p<0.001), and binge drinking (24% to 13%, p<0.001). Adjusted models showed wave 2 associated with lower odds of using cigarettes (AOR=0.44, 95%CI=0.32-0.62), e-cigarettes (AOR=0.41, 95% CI=0.35-0.49, p<0.001), and binge drinking (AOR=0.73, 95%CI=0.59-0.89; p=0.002) Conclusion Among Guatemalan adolescents, COVID-19 restrictions were associated with a significant decrease in smoking, e-cigarette use, and binge drinking.

Article

Full-text available

Feb 2024
BMC PUBLIC HEALTH

Background The closure of bars and lockdowns related to the Covid-19 pandemic changed alcohol use levels in France during the spring of 2020. We wondered whether this sudden cessation of social interactions impacted students more than non-students and what factors specific to students would explain the increase in alcohol misuse. The aims of this study were to compare self-reported changes in alcohol misuse (alcohol intake and binge-drinking frequency) during the first Covid-19 lockdown from March 17 to May 10, 2020, between French students and non-students and describe factors associated with this alcohol misuse in each subgroup. Methods Data collected in the Confins study from April 8 to May 10, 2020, were used in cross-sectional analyses stratified by student status. Multiple logistic regression was performed to estimate the association between self-reported increase in alcohol intake or binge-drinking frequency (at least six drinks of alcohol on one occasion) and demographic, socioeconomic, and clinical factors, as well as conditions associated with the Covid-19 pandemic. The population-attributable fraction was then used to estimate the contribution of identified risk factors to increased alcohol misuse in students and non-students. Results Among both students and non-students, a self-reported decrease or no change in alcohol intake or binge-drinking was more common than an increase. However, the risk factors explaining an increase in alcohol intake differed among students (≥ 25 years old, not working or studying in the health field, and having suicidal ideation during the last 7 days) and non-students (having a medical diagnosis of mental disorders). The risk factors explaining an increase in binge-drinking frequency were similar in the two subgroups (being a tobacco smoker before lockdown and not practicing any physical activity during the last 7 days), except suicidal thoughts, which was a risk factor for alcohol misuse specific to students. Conclusions These results highlight the vulnerability of certain French students to alcohol misuse and the necessity of combining both mental health and substance use-related screening in the student population.

Dynamic Changes in Drinking Behaviour among Subpopulations of Youth during the COVID-19 Pandemic: A Prospective Cohort Study

Article

Full-text available

Jul 2023

Objective: Youth drinking is highly heterogenous, and subpopulations representing different alcohol use patterns may have responded differently to the COVID-19 pandemic. This study examined changing patterns of alcohol use in subpopulations of the youth population over the first two years of the pandemic. Method: We used linked survey data from 5367 Canadian secondary school students who participated in three consecutive waves of the COMPASS study between 2018/19 and 2020/21. Latent transition analysis (LTA) was used to identify patterns of alcohol use based on the frequency of drinking and frequency of binge drinking and to estimate the probability of transitioning between identified patterns. Results: LTA identified five patterns of alcohol use each representing a unique subpopulation: abstainer, occasional drinker-no binging, occasional binge drinker, monthly binge drinker, weekly binge drinker. Probability of being engaged in binge drinking for a subpopulation of occasional drinkers pre-pandemic was 61%, which reduced to 43% during the early-pandemic period. A lower proportion of occasional binge drinkers reported moving to monthly or weekly binge drinking. Female occasional drinkers were more likely to move to binge drinking patterns during the pandemic than males. Conclusions: Less frequent drinking and younger students were more likely to reduce their drinking and binge drinking than more established drinkers during the COVID-19 pandemic. Understanding of heterogenous patterns of alcohol drinking and different responses to public health crises may inform future preventive programs tailored to target subpopulations more effectively.

A Causal Analysis of Young Adults' Binge Drinking Reduction and Cessation

Article

Full-text available

May 2023

Background: This study, using the multiple disadvantage model (MDM), sought to identify factors (disadvantaging social disorganization, social structural, social integration, health/mental health, co-occurring substance use, and substance treatment access factors) in young adults' binge drinking reduction and cessation in the United States. Methods: We extracted data on 942 young adult binge drinkers (25-34 years, 47.8% female) from the National Longitudinal Study of Adolescent to Adult Health (Add Health), carrying out a temporal-ordered causal analysis, meaning the evaluation of select variables' impacts on an outcome at a subsequent time. Results: MDM found a relatively high reduction likelihood for non-Hispanic African Americans and respondents with relatively more education. MDM found a relatively low reduction likelihood accompanying an alcohol-related arrest, higher income, and greater number of close friends. Change to nondrinking was found more likely for non-Hispanic African Americans, other non-Hispanic participants having minority ethnicity, older respondents, those with more occupational skills, and healthier respondents. Such change became less likely with an alcohol-related arrest, higher income, relatively more education, greater number of close friends, close friends' disapproval of drinking, and co-occurring drug use. Conclusions: Interventions incorporating a motivational-interviewing style can effectively promote health awareness, assessment of co-occurring disorders, friendships with nondrinkers, and attainment of occupational skills.

Alcohol and Other Substance Use Before and During the COVID-19 Pandemic Among High School Students - Youth Risk Behavior Survey, United States, 2021

Article

Full-text available

Apr 2023

Adolescence is a critical phase of development and is frequently a period of initiating and engaging in risky behaviors, including alcohol and other substance use. The COVID-19 pandemic and associated stressors might have affected adolescent involvement in these behaviors. To examine substance use patterns and understand how substance use among high school students changed before and during the COVID-19 pandemic, CDC analyzed data from the nationally representative Youth Risk Behavior Survey. This report presents estimated prevalences among high school students of current (i.e., previous 30 days) alcohol use, marijuana use, binge drinking, and prescription opioid misuse and lifetime alcohol, marijuana, synthetic marijuana, inhalants, ecstasy, cocaine, methamphetamine, heroin, and injection drug use and prescription opioid misuse. Trends during 2009-2021 were assessed using logistic regression and joinpoint regression analyses. Changes in substance use from 2019 to 2021 were assessed using prevalence differences and prevalence ratios, stratified by demographic characteristics. Prevalence of substance use measures by sexual identity and current co-occurring substance use were estimated using 2021 data. Substance use prevalence declined during 2009-2021. From 2019 to 2021, the prevalence of current alcohol use, marijuana use, and binge drinking and lifetime use of alcohol, marijuana, and cocaine and prescription opioid misuse decreased; lifetime inhalant use increased. In 2021, substance use varied by sex, race and ethnicity, and sexual identity. Approximately one third of students (29%) reported current use of alcohol or marijuana or prescription opioid misuse; among those reporting current substance use, approximately 34% used two or more substances. Widespread implementation of tailored evidence-based policies, programs, and practices likely to reduce risk factors for adolescent substance use and promote protective factors might further decrease substance use among U.S. high school students and is urgently needed in the context of the changing marketplaces for alcohol beverage products and other drugs (e.g., release of high-alcohol beverage products and increased availability of counterfeit pills containing fentanyl).

Cost‐effectiveness and cost‐utility analyses of a web‐based computer‐tailored intervention for prevention of binge drinking among Spanish adolescents

Article

Full-text available

Feb 2023

Background Binge drinking (BD) among adolescents is a public health concern worldwide. This study assessed the cost‐effectiveness and cost‐utility of a web‐based computer‐tailored intervention to prevent BD in adolescence. Methods The sample was drawn from a study evaluating the Alerta Alcohol program. The population consisted of adolescents 15 to 19 years of age. Data were recorded at baseline (January to February 2016) and after 4 months (May to June 2017) and were used to estimate costs and health outcomes, as measured by the number of BD occasions and quality‐adjusted life years (QALYs). Incremental cost‐effectiveness and cost‐utility ratios were calculated from National Health Service (NHS) and societal perspectives and for a time horizon of 4 months. A multivariate deterministic sensitivity analysis of best/worst scenarios by subgroups was used to account for uncertainty. Results The cost of reducing BD occasions by one per month was €16.63 from the NHS perspective, which from the societal perspective resulted in savings of €7986.37. From the societal perspective, the intervention resulted in an incremental cost of €71.05 per QALY gained from the NHS perspective and this was dominant, resulting in savings of €34,126.64 per QALY gained in comparison with the control group. Subgroup analyses showed that the intervention was dominant for girls from both the perspectives and for individuals 17 years or older from the NHS perspective. Conclusions Computer‐tailored feedback is a cost‐effective way to reduce BD and increase QALYs among adolescents. However, long‐term follow‐up is needed to evaluate more fully changes in both BD and health‐related quality of life.

The COVID-19 pandemic and adolescents' and young adults' experiences at school: A systematic narrative review

Article

Mar 2024
J RES ADOLESCENCE

The COVID‐19 pandemic upended the lives of adolescents and young adults across the globe. In response to the pandemic onset, educational institutions were forced to pivot to online learning, a new teaching and learning format for most secondary and university students. This systematic narrative review summarizes findings from 168 publications spanning 56 countries on students' educational outcomes and school climate as well as the internal assets and contextual supports that promoted academic well‐being during the pandemic. Our findings suggest that young people commonly reported declines in their academic‐related outcomes and school‐based relationships due to the COVID‐19 pandemic. Internal assets (e.g., intrinsic motivation and self‐efficacy) and contextual supports (i.e., relationships with teachers, peers, and parents) promoted academic well‐being during the pandemic. Next steps for research on young people's academic well‐being during the pandemic are suggested.

University students’ (Binge) drinking during COVID-19 lockdowns: Changes in depression, social context, resilience, and alcohol use

Article

Apr 2023

Rationale: The first COVID-19 lockdown impacted the social life and behaviors of university students, such as alcohol use. While previous studies have reported changes in students' alcohol use during the lockdown, knowledge of risk groups like binge drinkers is limited. Objective: The purpose of this study is to investigate how the first lockdown impacted the alcohol use of university students who were regular binge drinkers before the lockdown. Methods: Cross-sectional data were used to explore self-reported changes in alcohol use and associated psychosocial effects in regular binge drinking versus regular drinking university students (N = 7355) during the first COVID-19 lockdown (Spring 2020) in the Netherlands. Results: University students generally drank less alcohol and reduced binge drinking behaviors during the lockdown. Being a binge drinker who increased/maintained alcohol use, or a regular drinker who increased, was associated with older age, fewer servings of alcohol per week before COVID-19, higher contact with friends, and not living with parents. Among regular binge drinkers, men increased their alcohol use during the lockdown significantly more than women. Among regular drinkers, those with high depressive symptoms and low resilience had increased alcohol use. Conclusions: These findings give insight into significant changes in drinking behaviors among university students during the first COVID-19 lockdown. More importantly, it underscores the need to reckon vulnerable students considering drinking type and associated psychosocial variables for increasing or maintaining higher alcohol use during societal stress periods. In the present study, an unexpected at-risk group emerged among regular drinkers who increased alcohol use during the lockdown in association with their mental state (i.e., depression and resilience). As the COVID-19 pandemic, and the possibility of similar scenarios in the future, is still present in the current student life, specific preventive strategies and interventions should be targeted accordingly.

Beyond Confinement: A Systematic Review on Factors Influencing Binge Drinking Among Adolescents and Young Adults During the Pandemic

Abstract and Figures

Recommended publications

Impact of the COVID-19 pandemic on alcohol consumption in young adults: A systematic review

Comprehensive Management of Drunkorexia: A Scoping Review of Influencing Factors and Opportunities f...

Change in University Student Health Behaviours after the Onset of the COVID-19 Pandemic

Dynamic Changes in Drinking Behaviour among Subpopulations of Youth during the COVID-19 Pandemic: A...