Feature: Addiction services not equipped to treat the 8m people drinking at high risk during pandemic

Addiction services in England are not equipped to treat the soaring numbers of people drinking at high risk during the pandemic and must receive a multi-million-pound funding boost in the upcoming spending review, says the Royal College of Psychiatrists (RCP).

The College’s new analysis of Public Health England’s latest data on the indirect effects of Covid-19 found that over 8.4 million people are now drinking at higher risk, up from just 4.8 million in February.

Rachel, whose addictions resurfaced during lockdown, said: ‘I’d been free from tranquilisers and used alcohol responsibly for a few years, but I’ve really struggled during the pandemic, particularly lockdown.

‘The stresses of caring for my daughter, alongside work-related anxiety, led to me slipping back into old ways of behaving.

‘Taking tranquilisers and daily drinking became the norm and I know of many people, people you wouldn’t think have a problem, who have swapped their afternoon tea for gin and tonics.

‘I’m back on the road to recovery now, but addiction services are key to giving people the support they need to get their lives back on track.’

A spokesman for RCP said this surge in higher-risk drinking comes at a time when more people addicted to opiates are seeking help from addiction services.

Reverse the cuts

Statistics from the National Drug Treatment Monitoring System (NDTMS) show 3,459 new adult cases in April 2020, up 20% from 2,947 in the same month last year, the highest numbers in April since 2015.

But the deep cuts made to addiction services since 2013/14 mean the estimated 8.4 million higher risk drinkers and the hundreds of additional people with an opiate addiction needing help could miss out on life-saving treatment.

Psychiatrists are calling for the Government to use the upcoming Comprehensive Spending Review to reverse the cuts and enable local authorities to work towards investing £374 million into adult services so they can cope with the increased need for treatment.

Dr Adrian James, president of the Royal College of Psychiatrists, said: ‘Addiction services have been starved of funding in recent years meaning many are not able to treat and care for the huge numbers of people who are drinking at high risk.

‘More lives will be needlessly lost to addiction unless the government acts now and commits to substantial investment in public health, including adult addiction services, in the Spending Review.

‘I urge the government to implement the recommendations in our report which would see mental health services expand to be the biggest in Europe, with a much-needed focus on tackling inequalities.”

The RCP’s recently published Next Steps for Funding Mental Health Care in England: Prevention report also makes the case for an additional £43m for children’s drug and alcohol services and £30m for new buildings and updates to existing ones – also known as capital projects.

Latest data shows there were 4,359 drug-related deaths in England and Wales in 2018, the highest on record, while the 1.26 million alcohol-related hospital admissions in 2018/19 were also the highest on record.

Prof Julia Sinclair, Chair of the College’s Addictions Faculty, said: ‘Covid-19 has shown just how stretched, under-resourced and ill-equipped addiction services are to treat the growing numbers of vulnerable people living with this complex illness.

‘There are now only five NHS inpatient units in the country and no resource anywhere in my region to admit people who are alcohol dependent with co-existing mental illness.

‘Drug-related deaths and alcohol-related hospital admissions were already at all-time highs before Covid-19. I fear that unless the government acts quickly we will see these numbers rise exponentially.’

The report warns that people with alcohol use disorder are more likely to develop serious complications if they catch Covid-19, including acute respiratory distress syndrome. People using drugs such as heroin and benzodiazepines are also more vulnerable to the virus.

Responsibility for the delivery and funding of addiction services was taken out of the NHS and given to local authorities following legislative changes in 2012.

Following the move to local authorities, funding for addiction services in England for adults and young people combined fell by £234m (25%) in real terms from 2013/14 to 2018/19.

The most recent data from Public Health England on the wider impacts of Covid-19 shows nearly 1 in 5 (19%) adults drinking at higher risk in June, up from 1 in 10 (10.8%) in February.

The College calculates that when applied to the population of England some 8,410,045 people are now drinking at higher risk.

Significant and sustainable investment

Denise, a 52-year-old retired nurse from Bristol, said: ‘In the evenings, anxiety about my breathing problems and the fear of a medical emergency kicks in.

‘I keep having visions of not being able to breathe and healthcare staff in PPE suits coming to take me to hospital.

‘I drink to manage these feelings, but it disrupts my sleep and has ruined my days. I am struggling but I’m not confident that I can get the help I need to stop.’

PHE defines higher risk drinking as those people scoring eight or more on the AUDIT, a 10-question clinical questionnaire that assesses the amount of alcohol consumed and frequency, and levels of harm and dependence.

Responding to the Royal College of Psychiatrists analysis, Cllr Ian Hudspeth, chairman of the Local Government Association’s Community wellbeing board, said:

‘Councils are absolutely committed to ensuring that all those who need help with alcohol and drug addiction get the right support and treatment, but as this report states they need long-term government investment in public health services to do so.

‘This includes helping vulnerable people being given another chance to find work, rebuild relationships, improve their physical and mental health and find safe and secure accommodation.

‘It is clear that public health funding for councils, which provides drug and alcohol prevention and treatment services, represents value for money and helps to relieve pressures on other public services such as criminal justice and the NHS, further down the line.

‘The forthcoming Spending Review needs to see significant and sustainable investment in public health, including a reversal of councils’ £700 million grant funding reductions since 2015, to keep providing the essential services which help people stay healthy and free of addiction.’

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