Alcohol services post lockdown - have we arrived at a ‘new normal’?

Martin Blakebrough | June 2022 | 8 minutes

Martin Blakebrough, CEO of drug and alcohol charity Kaleidoscope, shares the trends emerging from a post-lockdown landscape and what they mean for the future of services.

Just three weeks after lockdown began, our alcohol referrals dropped to just 30 per cent across Wales, compared with the same period in 2019. And yet a fifth of people who already drank alcohol were revealed to be drinking more, while sales of alcohol had risen by a third.

Looking at our in-house data more broadly, we see that the number of people entering our services for alcohol support who were previously unknown to us had been declining steadily since 2015. This trend has reversed since lockdown however, and now the opposite is true. The number of new alcohol clients has been increasing since June 2020. When we think about what’s caused this trend, it is certain the pandemic made online promotion of our services more important than ever. Traffic to our social media platforms, and emails sent directly from people concerned, exploded. The combination of difficulties seeing a GP or attending hospital and alcohol support agencies promoting their services more proactively led to more people reaching out for the first time. The number of people referring themselves into services has continued to rise steadily, from 46% pre-lockdown, rising to 47% during lockdown, and currently standing at 48%. The drop in the number of hospital referrals during lockdown has since returned to pre-pandemic levels. However, the large fall we saw in GP referrals is yet to recover.

Interestingly, the profile of the person entering Kaleidoscope’s services has changed in terms of age. Both during and post-lockdown we have seen a rise in the proportion of clients who are aged between 20 and 39, and a fall in the number of clients aged between 50 and 69. I wonder if this increase also reflects the increase in people contacting us via our website and social media.

"The combination of difficulties seeing a GP or attending hospital and alcohol support agencies promoting their services more proactively led to more people reaching out for the first time."

The way in which services have embraced technologies is of course positive, and enables what can be a less intimidating first step into services. The stigma people experience when getting help still acts as a barrier, and virtual support can offer more privacy in those early stages.

For those we had been supporting for some time however, the picture was quite different, and professionals troubled over how such unparalleled change might impact people in recovery. The lack of connection, loss of routine and pause on vital coping mechanisms would surely shake the resolve of even the most resilient service users. With the support of Welsh Government, we determined to gather data-supported insights on the lockdown’s impact on alcohol use, collected from a peer-led and Wales-wide survey. One of the most concerning stats was that 25% of those surveyed had suffered a lapse or relapse during the lockdown. And for those receiving support primarily for alcohol use, this figure rose to 34%.

In more extreme examples, relapse occurred irrespective of time spent in abstinence. In one particularly candid testimony, the person had been sober for 2 years and 7 months prior to lockdown. They shared that the loss of their coping mechanisms, including peer support groups, voluntary work, daily exercise and contact with parents had left them at a loss, bored, agitated and angry. This was a sentiment echoed by many respondents, who relied on purpose, structure and face-to-face support to maintain their recovery. When asked about their preferred method of support, only 8% cited telephone contact.

"As services move forward our frontline workforce knows just how critical their role can be to treatment outcomes, and how valued their face-to-face support is."

It was important to review how online interventions were truly received by people we had been supporting on a long term basis. Indeed 60% of those surveyed were either unable to, or chose not to, access online support interventions, and 69% did not access either online support or community groups. And so our research revealed that online interventions alone do not do enough to support our most vulnerable service users, and wherever possible and in line with social distancing, we endeavoured that people in recovery were given the opportunity to have face-to-face contact with key workers. We wanted to get our frontline services as close to fully operational as we could, while of course prioritising staff safety, and this was a tough balancing act.

Our research also raised the issue of digital inclusion as people in more rural areas such as Powys at times struggled with connectivity, and many respondents did not know, or have a desire to learn, how to use devices, apps and online meeting software. Among respondents with decreased mobility, severe anxiety or negative mental health, and those having to commute long distances to make appointments, a more flexible and virtual approach to contact was welcomed.

As services move forward our frontline workforce knows just how critical their role can be to treatment outcomes, and how valued their face-to-face support is. As recovery hubs, drop-in services and events steadily resume we feel relief, but we’re equally proud to be offering more choice for our community, and ensuring our services are easy to access, whether online or in-person.