Is there a rise in alcohol deaths during COVID-19 pandemic?
What to do when you're waiting for drug or alcohol services
High demand, COVID-19 delays and cuts to services have created huge obstacles to accessing treatment for problematic substance use. Experts with experience providing support explain how to cope when treatment takes time.
Newly published data this summer revealed that local authority spending on drug and alcohol misuse had been cut by 15% over the four years to 2019/20. Some local authorities saw real-terms budget cuts of more than 40%.
But in the wake of COVID-19, demand for support is higher than ever. A YouGov tracker last summer found that 17% of people reported increased alcohol consumption in the last six months. A DrinkAware survey found nearly half of adults who lost a job recently are drinking more than they did before COVID-19.
On the ground
Stephanie Chivers is a coach with 15 years' experience supporting people who want to cut back or stop drinking, and says she's now very familiar with the challenges people might face when seeking support via their GP. She often works with NHS GPs to support people using NHS services such as at-home detox, and also runs a group support programme.
"Most treatment services won't be NHS-based, they'll be charity-based," she says. "Waiting times will be different in each area, even within one county."
She says she recently worked with one client in his 60s who was referred to services by his GP only to be sent back to his GP by the treatment service after they disagreed about whether or not the man's drinking met the threshold for support. The man, who reported drinking a bottle of wine a day, was then managed on a detox at home by his GP, tapering his drinking over two to three weeks with a GP follow-up afterwards.
Chivers also warns that some patients might feel uncomfortable accessing detox services because of their feelings about sharing services with people who have different, or more developed, substance abuse problems such as people on methadone programmes.
But there's huge potential for people to feel better by seeking treatment, she adds.
"If we can reduce somebody and get them alcohol-free, or just even reduced, you know, they might no longer need blood pressure medication, they're not so much of a cancer risk, maybe they don't need antidepressants, they lose weight, stomach acidity goes away and their diabetes becomes manageable," she says. Given the advantages, it's no wonder that people think of getting help when drinking feels out of hand - even without facing a crisis.
It's not just the NHS that has resources for people hoping to change their relationship with alcohol. Club Soda is a UK social impact business that runs courses and communities for people who are sober, drinking less, or thinking of cutting back. Its courses, although not a substitute for treatment, are open to people who are waiting for NHS detox. In October they are running a global online festival with events on frequently-asked questions, like 'Why doesn't willpower work for me?'. Club Soda has been running for about seven years.
Dru Jaeger is one of the co-founders of Club Soda, and says he's seen more people than ever looking for help to change their drinking.
"If you're worried about your alcohol consumption, speaking to your doctor is always a good idea," he says. "But if you need support to stop drinking safely, the sad reality is that you could find yourself waiting to access treatment services. Communities like Club Soda are a brilliant resource of motivation, inspiration and support during the waiting time. Detoxing from alcohol is one part of changing your drinking, and our community and courses can work alongside treatment to support you to make long-term changes to your habits."
Club Soda's work aims to follow behaviour change research. In 2019, the business received funding from The Wellcome Trust to undertake research into its approach (available to read online), and now works with London South Bank University to evaluate the impact of its courses.
In its advice, the NHS recommends people to seek self-help or mutual aid groups in its advice, and Club Soda's Wellcome-funded research found that of the 280 people surveyed, 57% said social connection and interaction was the most important factor in enabling behaviour change. Over 16,000 people have used Club Soda's closed Facebook group to support them.
Jaeger agrees that changing your drinking isn't something you have to do alone: "Being part of a community like Club Soda builds your confidence, strengthens your resilience and increases your commitment. As well as helping you troubleshoot your challenges with alcohol, being part of a community means that you can share your successes too."
Am I drinking too much?
You can use clinically-approved tools online to measure drinking without seeing your GP - the tools offered by the alcohol charity Drinkaware are a good place to start. Drinkaware's unit calculator allows you to tot up your alcohol use as you go along, to get an accurate picture of your consumption.
Drinkaware also offers the AUDIT tool, which was developed by the World Health Organization and is used around the world to assess for risky or harmful drinking. However, Dr Sarah Jarvis, GP and medical advisor to Drinkaware, cautions that all calculator tools have their limits.
"Tools like the AUDIT tool are designed to provide a starting point for doctors giving advice," she says. "It's not just about how much you're drinking, but your pattern of drinking too. For instance, you could be drinking 14 units a week (the recommended upper unit limit), but if you're drinking it all on one night and putting yourself in risky situations when you're drunk, that's an issue."
Measuring your consumption is an essential step before making any changes, because if you are physically dependent then stopping your alcohol consumption can be uncomfortable and in some cases harmful. But your GP is the first place to seek support if you're worried about your drinking, particularly if you need to access detox.
If you'd like to talk to someone before or after using the AUDIT tool, or before seeing your GP, Drinkline (0300 123 1110) is a national helpline that specialises in supporting people who are concerned about how much they drink. (It runs 9 am-8 pm, or 11 am-4 pm at weekends).
If you prefer to chat online rather than by phone, the charity We Are With You (formerly Addaction) runs a chat service 9 am-9 pm (10 am-4 pm at weekends). And if your experience of substance abuse feels depressing or difficult to bear, Samaritans also aims to offer non-judgemental support through its volunteer-run phoneline (123 111, 24 hours a day).