Alcohol treatment services during and after lockdown: Building back better

The COVID-19 pandemic has had a significant impact on our relationship with alcohol, with 3 million more people drinking at increasing or higher risk. Deaths from alcohol have now reached record levels, and treatment services are in high demand. In this blog, we speak to Humankind and Turning Point about the drug and alcohol support they provided during the pandemic, the challenges they faced, and what we can learn going forward.

Providing alcohol detoxes and brief interventions during COVID-19

During the height of the pandemic, treatment providers experienced an increasing demand for support from high-risk drinkers. Humankind reported a 34% increase in people visiting their DrinkCoach website, and delivered almost 50% more sessions during lockdown than in the 12 months prior to the start of the pandemic.

Social distancing measures forced many services online, throwing the issue of digital exclusion into sharp definition. It became significantly harder for alcohol treatment services to access more disadvantaged groups, such as those without digital access. In online-only support, there are also fewer opportunities to detect risks in people and assess whether a service user is suitable for detox. A lack of privacy at home, and the ongoing shame and stigma felt around alcohol dependency further complicated the ability to engage in digital treatment programmes.

With some residential detox units only accepting referrals from their localities (if at all), in-patient treatment was subject to a postcode lottery. This reflects the glaring health inequalities the COVID-19 pandemic, with alcohol-related deaths and hospital admissions already 60% higher for the most deprived areas compared to the least.

Furthermore, many people felt undeserving of healthcare support given the context of a global pandemic and the strain this put the NHS under. Humankind reported that a number of people didn’t seek treatment as they wanted to avoid burdening the healthcare system and believed that others had higher needs, despite drinking dependently or living with co-occurring conditions like mental health issues and other health conditions.

Drop-outs during and after the assessment stage also became increasingly common, according to Turning Point, whereas previously these were predominantly seen at referral stage. Humankind echoed this challenge, noting the difficulty in maintaining service users’ motivation to undertake the pre-work before a detox placement.

Lessons learnt

The ability of treatment providers to adapt to online delivery demonstrates the remarkable flexibility of these services, and their drive to support those in need.

While there will always be a place for in-person treatment, Humankind underlined the merits of digital support that should be embraced. The development of applications such as DrinkCoach facilitated access to anonymised advice, guidance, and coaching. One-to-one and group work on social media channels such as Zoom also provided increased opportunities to access services, vital for clients who don’t live close to centres but still want to engage in treatment. This is especially important as the cost-of-living increases. Turning Point also involved carers and community detoxes to a much greater extent as a method of monitoring progress and ensuring safety.

Moving forwards, both organisations are keen to offer a diverse range of treatment based on what service users want from their recovery journey, with patient voices and choices directly shaping how their treatment looks. By keeping in mind those who aren’t accessing support, it is important for treatment providers to also aim to reduce barriers in service design and delivery, and make the most of every contact with drinkers, including online.

The future of treatment services

Treatment services are entering a new era. Despite significant challenges, organisations were able to continue carrying out successful remote interventions at the height of the pandemic, exemplifying their determination to ensure the safety of those they worked with and indicating how new technologies and remote support can expand outreach in the future.

This alone, however, is not enough. For treatment providers to fully support those in need, they must be adequately supported in a new Government Alcohol Strategy. Although the release of extra funding for drug and alcohol treatment and recovery systems is incredibly welcome, this follows almost a decade of cuts with damaging consequences. Since 2012, a whopping £212.2 million has been disinvested from alcohol and drug treatment, and shame, stigma and other barriers to access means less than one in five dependent drinkers are predicted to be receiving support. A package of interventions including investing in treatment, better labelling of alcoholic products, and increased restrictions on alcohol affordability and marketing are all urgently needed to reduce the widespread harm caused to our society.

Thank you to Tom Wright, Phil Ransome and Angela Calcan for their contributions to this piece.

Written by Poppy Hull

If you are worried about your own or someone else’s drinking, there is help out there. Speak with your GP about what support might be available to you or someone you are concerned about. This is a great first step in finding help.

Drinkline is the national alcohol helpline. Calls are free and confidential. Call 0300 123 1110 (weekdays 9.00am to 8.00pm, weekends 11.00am to 4.00pm).

More information about organisations which offer help and support can be found on our support page.

This blog was published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Alcohol Health Alliance or its members.

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