Alcohol, COVID-19 and the smell of relapse: a case report

The global pandemic lockdown created a risk factor for increased alcohol consumption in people with alcohol use disorder and relapse for those who were previously abstinent, with evidence suggesting that pre-lockdown abstinence status is not protective against lockdown-related relapse. We report a unique case of a middle-aged male with alcohol use disorder who experienced alcohol cravings and a fear of relapse due to exposure to disinfectants. A 54-year-old public transportation company worker, previously treated for an alcohol use disorder three times, and abstinent since his last treatment in 2017, reported anxiety, irritability, and constant fear of relapse due to increased exposure to sanitizers during the pandemic. He explained that while the diluted disinfectant made him think of alcohol, the now ever-present undiluted disinfectant makes him constantly crave alcohol and it makes it harder for him to work. Although he started group therapy treatment and had several follow-up visits, his poor performance at work and the fear of relapse resulted in him requesting a position change to work in open spaces and avoid the smell of disinfectant, which helped him remain abstinent. Disinfectants are a part of the "new normal," and their increased use is likely to be continued in the years to come, even after the pandemic resolves. Introducing a new behavioral pattern, such as the daily use of disinfectants in the general population, should prompt us to explore all possible consequences regarding its propagation.