Background: Studies show drinking to cope and mental health problems have increased during the COVID-19 pandemic, however, their samples have been limited by convenience sampling or lack of a pre-pandemic measure. We examined the early impact of the COVID-19 pandemic on mental health, drinking to cope and their association using a probability-based sample of the US adult population.

Methods: Data was drawn from the probability samples of the 2019-2020 National Alcohol Survey (N = 7,233) to examine differences in drinking to cope and symptoms of depression and anxiety. Analyses compared participants who responded to the survey just prior to the widespread onset of the pandemic to those who responded after March 2020, in the total sample and by sex.

Results: Respondents in the early- vs. pre-COVID-19 period had a 1.48 higher odds (p = 0.03) of higher agreement with drinking to forget one's worries and problems, with a significant association observed among women only. Respondents with symptoms of depression and anxiety had a 2.94 and 1.56 higher odds, respectively, of higher agreement with drinking to forget one's worries. We observed significant associations between early- vs. pre-COVID-19 period, depression and anxiety symptoms, and drinking to forget one's worries among women only; however, moderation by sex in the total sample was not statistically significant.

Conclusions: We observed higher prevalence of depression and anxiety symptoms and greater drinking to forget worries in the early months of COVID restrictions relative to the period just prior, with some effects more prominent among women. These observations call for sustained monitoring of and support for the mental health of the general population, and of women in particular during the course of the pandemic.