When Premier Doug Ford announced the closing of non-essential businesses in an effort to curb the spread of COVID-19, you may have been surprised that stores selling alcohol, like the LCBO, were left out of the cut.

According to Dr. Eileen De Villa, Toronto’s medical officer of health there’s a good reason for that. “With respect to the LCBO and its operations, there are many people in our community who have significant dependent issues with respect to alcohol,” she said at a press conference this week.

But with COVID-19 a priority in hospitals currently, the complicated decision to leave liquor stores open is one done in the hopes of reducing the influx of alcohol dependent patients being rushed to hospital

In Canada, about 3.2 per cent of the population has reported alcohol abuse or dependence, with over 15,000 deaths attributed to alcohol. Tim Stockwell, the Director of the Canadian Institute for Substance Use Research (CISUR) and a professor at the University of Victoria in British Columbia, says that while not everyone who suffers from alcohol use disorder will experience medical complications, those who do could face severe consequences.

“The thing about an alcohol use disorder is that it means different things for different people. It differs in severity,” he says, adding that for a small number of the population, it could mean such severe withdrawal that they get seizures. “It can be a medical emergency. We need to look out for people who find it very hard to control their alcohol use.”

Catherine Paradis, the leading expert on alcohol at the Canadian Centre on Substance Use and Addiction (CCSUA) in Ottawa, and a senior research and policy analyst, adds that the consequences of stopping the consumption of alcohol for some people could be ‘quite catastrophic,’ possibly leading to death.

“In normal times, we never advise folks with alcohol use disorder to stop drinking without seeking help from a health professional,” she says. “Well, now there’s very little access to medical care since everyone’s occupied with COVID-19.”

Research from the CCSUA shows that in 2017, the number of people hospitalized for alcohol use was comparable to those hospitalized for heart attacks. But with COVID-19 a priority in hospitals currently, the complicated decision to leave liquor stores open is one done in the hopes of reducing the influx of alcohol dependent patients being rushed to hospital.

“We shouldn’t exaggerate the risk of people stopping drinking,” says Stockwell. “This is a drug that is toxic, carcinogenic and this is a time we need to be safe, cautious and vigilant about what we’re doing to not pass on the virus. We all need to be really careful about limiting our alcohol use.”

But the risks around access to alcohol go beyond people struggling with alcohol use disorders.Paradis says that stockpiling and panic-buying alcohol can cause excessive drinking.

“For many people, having more alcohol than usual in their immediate surroundings increases their frequency of drinking and the quantity of alcohol consumed,” she says, adding that the use of alcohol to to cope with with anxiety, depression, and now social isolation is also a concern. “Now we are in this extraordinary situation where there’s no longer boundaries, and people are at risk for drinking on a daily basis.”

She also worries about the risk of people drinking without knowing the potential risks involved — such as developing chronic diseases, accidents or domestic violence.

“That is a real concern of mine at the moment,” says Paradis. “Alcohol directly affects cognitive and physical functions. It reduces self control and it leaves people less capable of negotiating non violent resolutions in relationships. These are definitely vulnerable people at the moment.” She advises that people to connect frequently with loved ones who may be at risk.

Now we are in this extraordinary situation where there’s no longer boundaries, and people are at risk for drinking on a daily basis

In fact, studies have shown that crisis tends to increase gender based violence. The World Health Organization (WHO) has also said that during a crisis (war, epidemics, or natural disasters), the risk of gender based violence increases. China has also reported that domestic abuse advocates there have seen a rise in cases during the country’s COVID-19 quarantine.

Also, we need to think of what happens when the pandemic comes to an end. “Once we’re out of this crisis, a lot of people will find it difficult and challenging to go back to previous lower risk drinking practices,” says Paradis.

She recommends that Canadians follow Canada’s Low-Risk Alcohol Drinking Guidelines, to ensure they are consuming safe amounts of alcohol. It is recommended that women consume no more than 10 drinks a week (meaning no more than two a day) and for men, no more than 15 drinks a week (meaning no more than three a day).