Bismarck — By sheer area, Williquors in east Bismarck is the largest liquor vendor in North Dakota. At 28,000 square feet, it has the fluorescent sheen, the line of clicking cash registers and the bustling staff of a big city supermarket.

And for the past three months, Williquors' wide aisles have been crammed with shopping carts — customers packing in bottles of wine, handles of rum and vodka, and cases of beer. Three times in May, customers bought Williquors beer by the pallet—a hefty 2,304 cans at a time.

In a business that typically sees its biggest returns during the Christmas season, Williquors charted its best sales months ever in April and May.

“Williquors is always busy. But now, now it’s crazy,” said Peggy Roehrich, an evening supervisor at the store. “From 8 a.m. on Monday through Sunday.”

Have North Dakotans turned to alcohol to outlast the coronavirus? For Williquors and other liquor stores, the pandemic has brought an unprecedented windfall. But the full economic picture, as well as its mental health implications, is trickier to nail down.

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Even as liquor retailers have watched their profits balloon, total alcohol sales in the state have fallen during the pandemic.

Liquor store sales in March were up 29% compared to 2019, according to data from the North Dakota Tax Commission, but total alcohol purchases were down by more than 20% in the same month because of the massive losses at bars and restaurants. The total losses were even starker in April, the only month completely consumed by pandemic closures, down 44.4% compared to 2019, while liquor store sales continued to go up.

But a disparity in alcohol purchases and alcohol consumption makes this data difficult to parse. Liquor store alcohol costs a lot less than bar or restaurant alcohol, and if North Dakotans have shifted to buying in bulk, the predictably steep decline in bar and restaurant sales does not necessarily indicate the same sharp drop in actual alcohol consumption.

“I’m guessing people were stocking up at the end of March, not knowing what businesses were going to be open in April,” said North Dakota Tax Commissioner Ryan Rauschenberger. “Just like people were stocking up on essentials like toilet paper, people were stocking up on liquor.”

Still, the convincing net drop in alcohol sales suggests that a large population of primarily social drinkers has downed significantly less alcohol during the pandemic.

Rauschenberger noted North Dakotans buying their alcohol at liquor stores are getting “more bang for (their) buck,” but also concluded that the much larger change in sales for bars and restaurants means “it’s safe to say that less was purchased and consumed” in the first months of the pandemic.

The shift toward bulk alcohol purchases in North Dakota seems to mirror a national trend that spiked most dramatically in late March, when total alcohol sales were up by 55% across the country.

National studies suggest a widespread change in how customers have bought alcohol during the pandemic, but North Dakota has sustained its reputation for heavier drinking. Situated squarely in what economists have named “the beer belly of America” — a swath of the upper Midwest with more bars than grocery stores — North Dakota has held its place at the top of the pile.

A recent study by the National Institutes of Health, which looked at the 10 states already reporting alcohol purchase data from March and April, found North Dakota bought more beer and spirits per capita than any other state during the pandemic.

“It’s often people that come from other places that get here (and) go, like, ‘What is up North Dakota?’” Pamela Sagness, director of Behavioral Health at North Dakota’s Department of Human Services, said of the state's drinking culture. “The binge drinking is really surprising for a lot of people who come here from other places.”

Many mental health specialists have sounded the alarm that the pandemic could leave an unprecedented mental health crisis in its wake. Even if less alcohol is being consumed during the pandemic, Sagness said the shift from drinking in bars to drinking in social isolation could exacerbate mental health concerns, an outcome that may prove more severe in a heavy drinking state like North Dakota.

“Even if someone doesn’t have an addiction today, if they start dealing and kind of coping by drinking more, it’s a slippery slope,” she said.

When it comes to the mental health implications of the pandemic, it’s still too soon to draw conclusions. Some indicators suggest surprisingly positive side-effects. The reduced traffic at bars in April led to a sharp decrease in DUI arrests, 68% below the recent spring high in 2016, according to data from North Dakota’s Department of Transportation. But DUI arrests surged back in May, suggesting it may be premature to diagnose long-term behavioral shifts.

How, precisely, will the pandemic change drinking in North Dakota: for better, for worse, or not at all? Mental health experts expect the dust won’t settle around these questions until the imminent threat of the pandemic is in the rear view.

Sagness noted that mental health is rarely the first priority in periods of catastrophe, as people tend to focus on physical health first and leave the psychological effects to "spring up months after the disaster." Mental health providers in North Dakota aren't yet handling overwhelming demand, and Sagness noted that the primary challenge for her department now is locating the people who need help as much of the state remains in social isolation.

"When is the mental health part really going to hit us, and when are we going to recognize the impact of that?" Sagness asked. "I don’t think we’re there yet."