by David Barbour, SCSN Communications Officer
The Covid 19 pandemic has implications across all policy areas and alcohol and drugs is no different. There are numerous issues that have and will arise for those working with people with alcohol or drug issues, on people who use alcohol and drugs (whether they already use alcohol and drugs problematically or whether the current crisis might lead to problematic use) disruption to drug markets, and in the area of law enforcement around drugs.
This article aims to pull together some of the main developments and issues arising from the Covid 19 outbreak.
Those with current problematic alcohol use will often have health co-morbidities that make them even more vulnerable during the Covid 19 epidemic. People with alcohol problems will often suffer from mental health problems including anxiety and depression, and may be more likely to suffer from numerous physical health problems – both of which weaken the immune system.
Alcohol continues to be marketed in shops, in the media and on the internet and suppliers will make home deliveries during the current crisis. Many people already drink more than the recommended low risk guidance of no more than 14 units per week. The fact that alcohol may no longer be consumed in public places, increases risks related to home drinking, where alcohol is cheaper, compounded by the stress that the current situation is causing. Most people who experience harms from alcohol are not in touch with alcohol services. Opportunities for statutory authorities to identify people who may be most at risk from the current situation are limited, unless that person has been receiving treatment. People with the most severe alcohol-related problems are often multiply disadvantaged, in their living contexts as well as in experiencing stigma and discrimination, including in their access to public services.
New Guidance on Covid 19 and people with alcohol related problems: recommendations for services
Scottish Health Action on Alcohol Problems has put together guidance for those working with people with alcohol related problems during the Covid 19 epidemic.
It provides recommendations for Alcohol and Drug Partnerships (ADPs), Commissioners, Alcohol Service Managers, Community Services and Mutual Aid and Support Groups, to enable them to reduce risks and ensure continued support for people with alcohol-related problems in the context of COVID-19.
You can download this guidance here.
Alcohol messaging for services
The following messaging on alcohol use during the Covid 19 epidemic has been put together by NHS Greater Glasgow and Clyde and may be useful for dissemination to service users via websites or other communication channels. Suggested tweets are also given.
Please feel free to copy and paste the text below into any channel you wish to use it.
Has your alcohol use been one of the things that’s changed recently?
2020 will definitely go down in history. It’s an unprecedented way of life that many of us are struggling to adapt to. Life as we know it is changing, for a while at least, and the way people are reacting to this is mixed.
For many of us, the loss of routine is making it feel like a never-ending weekend and this can lead to an increase in alcohol consumption for some. The chief medical officer’s advice for adults aged 18 and over is:
- To keep health risks from alcohol to a low level it is safest not to drink more than 14 units a week on a regular basis.
- If you regularly drink as much as 14 units per week, it is best to spread your drinking evenly over 3 or more days.
- If you have one or two heavy drinking episodes a week, you increase your risk of death from long term illness and from accidents and injuries.
- The risk of developing a range of health problems (including cancers of the mouth, throat and breast) increases the more you drink on a regular basis.
- If you wish to cut down the amount you drink, a good way to help achieve this is to have several drink free days each week.
If you want to find out more information or are looking for advice or support, visit https://www.nhsinform.scot/healthy-living/alcohol
Suggested Social Media Posts
- Do you know what the advice is to keep your risks of alcohol related harm to a minimum? Visit https://www.nhsinform.scot/healthy-living/alcohol for more information
- Has your drinking pattern changed recently? To find out more on the health advice visit https://www.nhsinform.scot/healthy-living/alcohol
- Does working out alcohol units seem complicated? Visit https://www.nhsinform.scot/healthy-living/alcohol for more information
- Has self-isolation changed how much alcohol you drink? Visit https://www.nhsinform.scot/healthy-living/alcohol for more information
- Is working from home changing your routine and changing how much alcohol you drink? Visit https://www.nhsinform.scot/healthy-living/alcohol for more information
- How does your drinking add up? Visit https://www.nhsinform.scot/healthy-living/alcohol for more information
- Alcohol can be part of a healthy lifestyle if you follow the advice. Visit https://www.nhsinform.scot/healthy-living/alcohol for more information
- ‘Everything in moderation’ as they say. To help moderate your drinking, visit https://www.nhsinform.scot/healthy-living/alcohol for more information
- It’s best for pregnant women or those trying for a baby to avoid alcohol. Visit https://www.nhsinform.scot/healthy-living/alcohol for more information
Covid 19 and drugs
There are particular challenges in relation to Scotland’s population of people who have a drug problem.
Over half of the 60,000 people with drug problems are over the age of 35 and have multiple morbidities, often including COPD – a group of lung conditions that cause breathing difficulties. People can also have a temporarily lowered immune system due to use of different drugs even where they do not have significant underlying conditions.
As a result, they are a very vulnerable and high risk group in relation to COVID-19.
Guidance has been produced on contingency planning for people who use drugs and COVID-19 and has been shared with all Alcohol and Drug Partnerships and all drug services in Scotland.
This Guidance has been produced by Scottish Drug Forum and partners including the Sexual Health and BBV Prevention Leads Group with support from Scottish Government. The intention of the Guidance is to support local areas and services in their contingency planning for COVID-19 in relation to people who use drugs and particularly the provision of opiate substitution treatment and injecting equipment provision.
The Guidance is not meant to replace local contingency planning but to aid further development with regard to meeting specific challenging issues that areas are likely to be faced over the coming months.
Download the guidance here.
The Scottish Drugs Forum has also produced a flyer on Covid 19 for People Who Use Drugs which you can access here.
Market Disruption for illegal Drugs
The Covid 19 pandemic is also having an impact on the market for illegal drugs with implications both for drug users and drug enforcement.
Closed borders have meant disruption to supply and distribution of most drugs, especially those that are imported from overseas such as heroin and cocaine. However, even drugs like cannabis or ecstasy, which can be produced in the UK, are subject to disruption in supply for reasons including currency fluctuations affecting the willingness of online dealers to accept Bitcoin payments. This has led to some darknet dealers being put out of business.
The government order to stay at home will also affect the ability of ‘county lines’ dealers to get their product into towns and rural areas.
As we have seen with other goods, people are likely to ‘panic buy’ or stock up on their drug of choice which will limit availability further – meaning there is the risk of abrupt withdrawal for those who don’t have the means to do the same – which could lead to serious health consequences or death.
Scarcity and price rises may also raise concerns over possible increases in crime or disorder where people are unable to acquire drugs via their usual means, including within the prison system.
Another major issue is that when there is a shortage of a particular product or drug, the market tends to simply replace it with another, with profit being the primary concern. As such, heroin shortages could see dealers replace it with the more readily available substitute fentanyl – 50 times more potent than heroin, which has been behind some of the staggering rises in drug related deaths in North America over the last few years, due to the vastly increased likelihood of accidental overdose. People may be sold what they think is heroin, but is in fact fentanyl.
The Government’s Advisory Committee on the Misuse of Drugs (ACMD) recently issued a comprehensive report on fentanyls in the face of growing evidence from law enforcement agencies that fentanyls were entering European markets.
Further argument for drug consumption rooms?
With the UK and in particular Scotland already having among the highest per capita drug related death rates in the world, these issues represent a serious danger to drug users safety.
Before the onset of the Covid 19 epidemic in the UK, the Scottish Drugs Forum backed plans by community activists to set up mobile drug consumption rooms in defiance of restrictions by the Home Office, which itself acted against the advice of its own scientific advisors in rejecting a Scottish Government request to allow their creation to tackle the national scandal of drug related deaths in Scotland.
With serious concerns now being raised about the safety of drug users during the Covid 19 epidemic, the need for the NHS to be freed up to handle cases of Covid 19 and the UK Government insisting that it is ‘following the science’ in Covid 19 measures, perhaps the time has come for the Home Office to reconsider its rejection of scientific advice on this issue.