By Jane Lavery, Senior Occupational Health Nurse at Staywell Occupational Health – 16th April 2020

Alongside stockpiling of toilet roll and flour, we saw a similar impact in the alcohol aisle.  Maybe this behaviour was triggered by the closing of pubs and restaurants leading to a perception that alcohol would be less accessible for a while.  Interestingly, off licences have been deemed as an essential business and remain open.  Pubs and restaurants have moved to takeaway services which could include the provision of alcohol.  The supply of illicit drugs such as cannabis or cocaine may also be impacted by demand with a similar story of panic buying and stockpiling affecting supply.

It is natural to feel stressed during uncertain times but some of the population will use alcohol and non-prescribed drugs to self-medicate against these symptoms.  It is likely that some of those people will be your employees and this can raise some challenges for health, safety and wellbeing.  The hypothesis for self-medication, first identified in the 1980s, asserts that individuals choose to self-medicate with substances that have a desirable effect on their symptoms.  Symptoms such as mental distress, hypomania or low mood can be soothed by the drug of choice.

Why are we seeing an increase in Alcohol and Drug use?

For some, the use of alcohol or drugs may be a response to boredom or a lack of structure and activity that work provides and which is normally a barrier to drinking or taking drugs during a working day.  Stockpiling of supply may actually result in increased access rather than providing a steady stream over a long period of time as may originally have been intended. 

The World Health Organization advises that use of alcohol or drugs may be an ‘unhelpful’ coping mechanism for health care workers.  We know that the substances themselves may illicit symptoms of depression and anxiety or complicate existing symptoms.  The use of tobacco, alcohol or other drugs in increased quantities could lead to deterioration in mental and physical well-being in the long term.

Access to addiction treatment services may be reduced due to staff shortages affected by self-isolation and social distancing requirements.  This may lead to closure of treatment centres temporarily and for small services with minimal resources, they could be at risk permanently.  Reduction in access to opioid substitution through supply problems and pharmacy demands is a significant concern for those who depend on this service.  Clients may see functioning alcohol and drug users move to a state of not maintaining their addiction as they would wish to.

Alcohol or drug abuse can be one of a number of triggering factors for domestic violence.  The national domestic abuse helpline, run by the charity Refuge, has seen a 65% increase in calls since lockdown commenced.  Aggravation of socioeconomical factors affecting domestic violence, loss of employment, use of alcohol and drugs and split parental roles may also be compounded by the lockdown.  Some more authoritarian countries have stopped the sale of alcohol as a result of concerns about a rise in domestic violence. 

Advice for Individuals & Employers

Employees can be encouraged to keep track of their drinking, there are many free apps for this purpose.  Alcohol tracking may help an individual to assess their own drinking risk score in order to get a good idea of whether it would be a good idea to cut back on alcohol.  Some further tips on managing drinking habits and links to support during self-isolation or social distancing are available from Alcohol Change

Drink and Drugs News (DDN), a free monthly magazine for professionals in the drug and alcohol field, has collated a number of resources and articles that are likely to be helpful in supporting those who require access to specialist services.  An advice sheet has been published to help support drug users to maintain their health during this outbreak.

It’s important for our clients to understand the challenges to mental health at this time and ensure that employees have basic advice on self-care in order to help steer them away from unhelpful coping mechanisms.  Employees should be encouraged to exercise daily and to eat healthily.  There are lots of general resources available at the NHS Every Mind Matters website  Early signposting to these resources is recommended to our clients. 

Where a specific issue arises in relations to drug and alcohol use, Occupational Health can provide advice and support in order to help managers support their employees.  We would encourage you to refer when you need this advice from us.