The Alcohol 'Problem' Podcast

Lockdown drinkers? COVID-19 and alcohol use

January 29, 2021 Season 1 Episode 4
The Alcohol 'Problem' Podcast
Lockdown drinkers? COVID-19 and alcohol use
Show Notes Transcript Chapter Markers

In this episode guests talk about the effects of COVID-19 pandemic on alcohol use.

Guests include:

  • Dr Sadie Boniface and Habib Kadiri from the Institute of Alcohol Studies (IAS) who provide an overview of some of the key indications from the research and importance of looking beyond media headlines.
  • Dr Emily Nicholls and Dr Dominic Conroy talk about their research based on interviews with a number of drinkers reflecting on their alcohol use in response to the pandemic. 
  • Dr Gillian Shorter talks about British Psychological Society guidelines to support healthcare proffessionals in addressing alcohol issues.
  • Daren Lee, a counsellor at a national addiction service and trainee psychologist currently researching the experience of people previously engaged in face to face recovery groups and have tried their online equivalent during the COVID-19 pandemic. 
  • Rosy and Martin, who offer their insights into their relationship with alcohol over the last year. 

See here for the latest IAS report on alcohol consumption during the pandemic.

See here for COVID alcohol support resources from Alcohol Change UK.

James Morris:

Hello, welcome to the alcohol problem podcast. I'm Dr. James Morris, an alcohol researcher interested in harmful drinking and addiction issues. This stems in part from my own experiences. So the show aims to explore a range of left and academic perspectives relating to the question of what really is an alcohol problem. In this episode, I talk to a range of guests about alcohol use and the pandemic. I asked researchers, policy advisors, and people have lived experiences of changing reflecting on their relationship with alcohol about the effects of COVID, nearly one year on. I started off by talking to Dr. Sadie Boniface. And Habib kaduri, at the Institute of alcohol studies, I asked them to tell me a bit about the survey data.

Dr Sadie Boniface:

So far, your listeners have probably heard, there's been quite a lot of talk of alcohol and people drinking more drinking less in the news throughout the whole pandemic, really, the surveys do generally tend to find that some people are drinking more, and some people are drinking less. And generally, that's kind of about between a quarter and a third of people in both of those categories. So that on the surface doesn't sound maybe that interesting, or maybe that concerning or relevant in sort of health terms. But there are some things that do make us concerned one of those is that the people that are drinking more, there's some evidence that they were heavier drinkers to begin with. And so that's obviously something of concern, thinking about health further down the line.

James Morris:

Yeah, absolutely. And that's kind of understandable picture in a in a sense that if you already have a kind of moderate relationship with alcohol, you drink to maybe within the guidelines are not massively over it, then that's suggestive that you kind of reasonably healthy relationship with alcohol, and you're not using it as a kind of potential coping mechanism. Whereas, you know, heavy drinkers, we know, there's so many comorbidities in terms of mental health issues, you know, stress, anxiety, those kind of things. So it's not surprising in some ways that people have pre existing problems, including with alcohol that might have been exacerbated a bit.

Dr Sadie Boniface:

Yeah, there's a lot of unanswered questions as well. So what we really don't know is whether the sort of changes that we've seen to drinking, are they just temporary while we're living in these repeated sort of lockdowns? And they'll go away when things start to move back to some sort of normality? Or are those kind of new patterns? Are they here to stay? And it's probably not even that simple, because we've got all of the economic and wider social things going on with furlough and people being made redundant and in recession, that they all impact on alcohol too. So it's a really messy picture. And it's definitely something that one poll or one survey on its own can't really tell us very much. There's a lot of piecing together different pieces of data to make sense of it. Yeah, I think so. And I'm sure many people who've produced survey data will be continuing to do that and kind of track it over time. And it's just something we're going to have to keep paying attention to and keep delving into,

Habib Kadiri:

I think, what's important, there's an implied, let's take this figure in the aggregate, and maybe see that the whole nations drinking less than 100, nations drinking more, and it's important to actually notice that the split is really what you need to be looking at. And from that split, you need to work out what people's behaviours are, because it's less about what's happening in total sum and more about pockets, where people's behaviours come together in kind of minority groups where it's having an impact on, say, the health services that provide alcohol treatment, I think there was some data that came out, I think, was the level unit, actually, at King's College Hospital, there was a nearly 50% increase in admissions rates between June 2019 and 2020. And, and, you know, it might not be a huge figure in the aggregate, but it's definitely something less impacted to some degree because of because of COVID. And the pressures on the health service, and trying to admit people for alcohol treatment, because COVID is taking over those spaces that would otherwise be reserved for those people. So those are, that's just one example of the places in which I guess people were affected or alcohol displaced because of the circumstances we're in. I think those figures from the liver unit at King's College Hospital, they are kind of an early warning sign in a way because we don't have complete data on the whole country. It's not been released yet. And it's kind of also complicated further, by the fact that people are not accessing health services anymore in the way that they used to. You've heard, I'm sure about people being afraid to go to the doctor's or to go to a&e when there's something wrong with them because they're concerned they're going to catch COVID I think

Dr Sadie Boniface:

That's less of a problem now than it was, say six months ago and the height of the first wave, but what's worrying is that problems might be getting stored up for the future, and people not accessing health care, you know, these problems might not be so visible as they otherwise would have been. I think it's a really important point because alcohol related conditions is so many in which the effects are longer term. And we know this from minimum pricing studies that there are in often cases very long term lag effects from changes to things like pricing. So you know, liver disease amongst heavy drinkers often develops over decades. So a changing consumption at one point might not manifest or show in two decades down the line. So I think it's fair to say that we will be seeing these effects for decades to come. Yeah, that's definitely true. Some changes are immediate with things like minimum pricing, you can see an impact on alcohol sales and some health indicators. But other things and the whole kind of benefit of policies like that will be seen much further down the line. Definitely. Also, it's January, there was a lot of excitement, I think about this being the biggest dry January, ever. But then with the circumstances in this third lockdown in the UK, I've read reports that there's been a lot of people dropping out of dry January, more than kind of visually would be expected. And I think that really highlights as a country, we have a very strange and unhealthy relationship with alcohol. Yeah, I mean, that's good, interesting point. Because Yeah, I've certainly seen a lot of the memes around dry January playing to the idea of why would you want to make it even worse, or whatever. But I do sort of thing that, you know, there is an importance in recognising the reasons people drink and they do it as a coping mechanism, because alcohol might help you to feel better in that moment. And it's important to not kind of lose sight of of that. But at the same time, of course, we want to be encouraging people to recognise that that might be counterproductive, because I think that's the issue just a lot of people just don't realise that knock on consequences of that. And of course, the social norms that that's I think one of the pros about increase in popularity in January is just kind of normalising not needing to drink or being expected to drink, even if it is just a January that it's becoming more socially accepted. And the other thing that is a really worrying longer term impact is the shift to home consumption. And when we know that that's been the longer term shift anyway, that obviously, the big rise in consumption, certainly from the kind of 1960s until around 2004 was that shift to off trade is mainly supermarket sales. But you know, what's the effect and a half on kind of maybe in bedding new heavy home drinking patterns, and you know, how many pubs are actually going to survive, be able to reopen as what many might argue a kind of more safe and controlled regulated drinking environment?

Habib Kadiri:

The thing that concerns me, and this is the hole that the industry seem to want to have on this narrative, the idea that alcohol sales, in the aggregate have they seem to have fallen, but it's because the pub trades been decimated, the hospitality trades been decimated. And a lot of the slack has been taken up by off licences supermarkets in particular. And home drinking is the knock on effect of this, but seems to be what I've seen in recent weeks, especially and I think, in the run up to the budget, I think is the plan is for many alcohol industry players to say, well, we're being batted here, we need cuts in tax to make up for it. I think it's quite dangerous, actually. Because, again, it's the idea that they're seeing things in the aggregate and the decimation of the pub trade is obviously a bad thing that is definitely worth the industry shouting about and saying, Well, how do we recover post pandemic, but it's quite telling, but not a lot of noise has been made about the fact that it's a relative Bonanza for supermarkets. And home deliveries is also an issue, something that's been possibly swept under the carpet, and could prove to be quite a big proportion of sales going forward. So I suppose you know, it's the volume that people buy, you could when you're doing your shopping by huge amounts of alcohol that you can get if you get a whole house full of people very drunk on and they wouldn't have any way of knowing or controlling that.

Dr Sadie Boniface:

I really agree with what you said that this is part of a longer term shift. So there has been a big move towards more and more of people's drinking being done in home over the last couple of decades. But obviously the pandemic has really, really accelerated that. I think that there's a couple of other things that that that raises red flags for me for is around children and families so our children being more exposed to alcohol in the home than before and also things to do with domestic violence and abuse.We've seen a lot of reports that calls to domestic abuse charities have really risen a lot over the past year. And I'd be surprised if alcohol didn't have some sort of role in that and the increase in home drinking and where there aren't other people there to see what's happening so much else.

James Morris:

I spoke to Dr. Emily Nichols, Dr. Dominic Conroy, who I asked to talk about their research on drinking during the pandemic, based on a number of interviews,

Dr Emily Nicholls:

I guess, to start by saying, one of the reasons we were interested in doing this research is because we've noticed the the kind of headlines that were coming out around people drinking more around people purchasing more alcohol, you know, this kind of quite simplistic idea in the media that people were just, you know, drinking more, and that there wasn't any kind of nuance in that. So Dom and I were quite interested in actually speaking to people in the UK, who were current drinkers and understanding, you know, what were their relationships with alcohol actually, like during lockdown, and we certainly found evidence of some people talking about perhaps drinking more in lockdown, and others drinking less. And then a few who said that actually, they tended to be home drinkers anyway, so their drinking practices hadn't really changed that much. So in terms of the people who talked about drinking a little bit more, a lot of this was around using drinking as a way to carve up time during the day to market transition to the evening, for example, or starting drinking, perhaps earlier in the day to tackle boredom. And a lot of people had obviously lost their normal routines and regimes around their daily practices, particularly if they'd been furloughed, for example. But then for other participants locked on particularly the first lockdown represented what we might call almost a sort of teachable moment for people where they took a step back from their drinking, and there was a period of reflection on their relationship with alcohol. So actually, they were using this opportunity to experiment or change their relationships with alcohol, because they weren't experiencing these social pressures to go to the pub, or to drink socially or to go out with friends. So there was definitely quite a lot of nuance, and quite a lot of variation in the way people talked about their relationship.

Dr Dominic Conroy:

Yeah, we were going into this quite sort of open minded really, I mean, and exactly as M says, you know, we were really interested in these different media reports coming out thinking about, you know, increased hits on to alcohol support websites, so more people concerned about their drinking value during that first spring lockdown, 2020 period, people buying more alcohol in it, some evidence, supermarkets or other outlets might be having some particular kind of strategy in response to things in terms of alcohol sales. So I mean, that there was all this stuff coming out. And then and I was just really interested in having these conversations with all about drinking, and you know, conversations with drinking about people are always going to be that bit different and that bit more spontaneous. And then having people complete these anonymous surveys where they could be, there could be all sorts of issues involved. And we were really interested in sort of having having these conversations through these focus groups, and these drink diaries that some of our participants, you know, very kindly completed. So thinking about sort of home drinking is a lot of emphasis about sort of drinking out on, you know, Friday nights out, and that kind of thing, and, you know, images that that sort of conjures up, there's very little sort of research conducted about alcohol consumption in the home. So this was really sort of a unique opportunity to be to be thinking about that, like I was saying, you know, in terms of how alcohol might play this symbolic role, in terms of carving out different sections of the day. And that's one feature of this paper, we were sort of particularly interested in this idea of the symbolic role of alcohol in the home, you know, this idea of a finished work, I don't have all of those environmental or contextual kind of markers to say, right, you finished your day's work, pulling a beer out of the fridge at five o'clock, that was, you know, had a real kind of symbolic power to sort of shifting the different different parts of the day. And there were some there were some problems with that for some people, I mean, but some reflective opportunities as well. We definitely had a couple of participants who described the kind of trajectory where at the start of lockdown, they noticed that their drinking had increased. And this had kind of been triggered a period of reflection where they thought about making changes to their drinking.

Dr Emily Nicholls:

So one participant I talked to, in particular, Allison, music, a student in there, I should say, she talked about this initial increase in her drinking. And then she engaged in this kind of period of change and reflection, where she actually stopped drinking for a period of a month or two and embarked on a new exercise regime and made changes to her diet. And I'm not saying this came completely out blue. Certainly for participants like Alison, they talked about kind of reflecting on their relationships with alcohol, even pre lockdown and perhaps having some, even some concerns and anxieties about regularly going to the pub or regularly drinking to access. I think the key takeaway here is that lockdown created the space for participants like Alison to say, Actually, I can play with abstinence or sobriety I can take a break from a step away from my drinking, and I can use this period to stop drinking but without the kind of pressures or triggers or social cues that would come with going to the pub for example. So I think something else to add here that's that's quite interesting is we know from other research that there's this idea that periods of sobriety and abstinence are sometimes associated with kind of moral and ethical processes of almost kind of creating the self. And there was some evidence of this as well. So Allison talked about, you know, I don't want to come out of lockdown being that person who drinks a bottle of wine, it's a, I want to come out a better person. So there was certainly this interesting narrative emerging around this idea that you could somehow use lockdown to become a better version of yourself. And I think we see this more widely, don't we this idea that in the first lockdown, we should all have been learning a new language and developing all these new skills and making the most of it. So there was definitely some evidence of that this process of kind of forming the goods or the ethical or the moral self through some through sobriety or abstinence during the initial lockdown period. That's really interesting, because as you said, in terms of why you wanted to perhaps do this paper was these more stereotypical media narratives about drinking to cope, and I did find some of that in the interviews, the new around that, understandably, people might be using alcohol in a way to deal with some of the issues presented by the lockdown.

Dr Dominic Conroy:

But on the other hand, you know, not everybody responded in that that one way, certainly not even amongst just heavy drinkers. I mean, I think people were sort of talking at different points about sort of tricky to cope. And that, you know, I think that there wasn't just from an individual's perspective, sometimes it was, well, you know, there's that person on the other, you know, on the other end of a zoom call, and you know, that we're having a difficult time before lockdown. And you know, it's important, I'm there for them. So we're going to have this regular zoom call, and in the absence of being able to actually meet with each other, and yeah, we're going to have a drink on that zoom call, you know, that's, that's what we do when we meet up, you know, alcohol could sometimes provide that kind of constant, it could provide that sort of ongoing thing, you know, you weren't there, you couldn't be in that person's front room, you couldn't see that person or shake their hand or give them a hug or anything. But you could sort of connect with them through through having an alcoholic drink with them. Sure. But I mean, the the sort of internet based parties or connections and drinking that people obviously adopted is really interesting in itself. I mean, I certainly heard about some people saying, you know, after experimenting with a kind of internet based drinking occasion, that Gosh, the Xoom party hangover was like a new sort of feature in their life. So I think, you know, some of it was trying to explore this new way of for certainly people maybe that you were used to going out in shared drinking spaces trying to make up for that in the home sense. It was a bit of a learning process. But you did touch on, you know, negotiating the home as a space for drinking, when that wasn't maybe what they were used to doing.

Dr Emily Nicholls:

Yeah, absolutely. I think there was definitely a lot of variation for some of our participants, particularly parents with young children, for example, you know, they talked about how regularly drinking at home was a very normal practice for them, and actually going to the pub going out and drinking socially was something that had declined for them in recent years since becoming parents anyway. And for other participants, it was quite a different story. So some of our participants, perhaps who'd have done their own work purely social drinkers. And for them, it was very much about going to the pub about meeting friends in that social space. And there was a bit of kind of hesitant, some reluctance for Sal about transferring their drinking, you know, to the home. So one of our participants in particular said, you know, that she was felt quite uncomfortable with drinking at home on her own, and the drinking for her was very much a shared experience in the pub. And it was often about, you know, experiencing what it feels like to drink a nice round of beer together. So for some of the shift to home drinking had to had not really taken place or something that they have quite an ambivalent relationship towards. I think for others as well, this idea of of the pub as actually in some senses, having a moderating influence on people's drinking behaviours. So we often tend to think about drinking environments as being consciously designed to encourage people to drink more, you know, everything from the layout to happy hour drinking promotions, to the music to the lighting can be used in some ways to encourage more alcohol consumption. However, I think one of the things that we found was that home drinking is in quite a few ways, kind of unbounded and uncontained. So the pubs, for example, with their limited opening hours do play some restraints on people's drinking. Whereas for some of our participants, they were remarking how it was easier to perhaps start drinking earlier at home than they would do before lockdown. And the idea that the pub is a kind of social space where people might mingle and mix with others there might be gaps in their drinking, where they go and talk to others. And of course, even the physical act of having to get up and go to the bar and purchase and pay for another drink. So a lot of these kinds of checks and restraints, if you like on people's drinking, were absent in the domestic context. And some people reflected a little bit more and felt a little bit cautious. Almost they were aware that there was more alcohol in the fridge and that there were in some ways, less constraints and less things to stop them. They also commented that you know, the pub has a restraining influence and that we often don't want to appear drunk or messy or out of control in those public spaces. So the drinking at home again, it was perhaps easier to slip into drinking more without really thinking about it. That's really interesting because it relates both to some of the broader policy debates about pricing and availability and rising trend in consumption through the second half of the last century as supermarkets and began to sell alcohol and affordability increased. But also, you know, that idea you're talking about of people having a sense of well, actually drinking at home alone, there often signifies if for many people, the stereotypes of having an alcohol problem means drinking alone or at home and suddenly locked down was kind of well required a reevaluation of that, because you didn't have the opportunity to go and drink in a traditional social space or pub. Yeah, I mean, it's just, this was some of the really interesting parts of the data. And, you know, I mean, m&r did our separate interviews, but some of these consistent bits did sort of come out, and both of them and it's exactly what you're talking about there, actually, I mean, it was these phenomena like solitary drinking, and drinking at home, or these, these are things that immediately sort of carry those sorts of the sort of associations, you know, the there is this particular sort of layer of stigma around some of these things, even as we use the expressions. And I think a lot of people, you know, on the one hand, they were talking in those sorts of more kind of concrete ways around, well, I have this drink, you know, at home on these days, and this is how I have it with and this is when I don't have a drink, but there was just that sort of general sort of way in which talk around solitary drinking, sort of worked in some of these interviews. And the role of you know, just you know, having alcohol drinks home amongst some of our participants who would never normally have an alcoholic drink at home, there was, you know, a real sense of sort of ambivalence to drinking at home, in some of the interviews, you know, real sort of lack of interest in that as sort of something to do I mean, alcohol might have played a really important role in some people's lives three lockdown, because it was there for socialising. But that idea of will

Dr Dominic Conroy:

What's this for then, but also a real sense of kind of discomfort. In some of the interviews a real sense of well, I'm almost sort of positioning myself to be understood as someone with some kind of difficulties with alcohol, if I'm having a drink on my own, you know, if my partner doesn't want a drink, for example, and that was the case in a few of our interviews, and just that whole thing about, you know, having a stock of alcohol at home, that was something that people often weren't comfortable with. So it's just quite interesting how things that have those kinds of associations with them anyway, like drinking on your own drinking at home, how that sort of came out of this lockdown drinking project, like say, they're the kind of stigma that that kind of makes people often aware of, you know, what the social norms or expectancies are, but both in terms of drinking and so many other things like working from home or exercising, and so on, it's just presented challenges that maybe have prompted us to reflect or behave in different ways. And some of that may be positive, and some of it may be less so. So first thing briefly on on where next, a couple of the things we've been thinking about,

Dr Emily Nicholls:

I guess, drawing on on our background, we've both kind of looked at issues around gender in the past, there's some interesting stuff starting to come out around kind of motherhood, and this phenomenon that is called mummy wine culture, you know, this kind of the ways in which alcohol is often bound up with motherhood now in the alcohol industry, and the kind of things that circulate through social media that kind of promotes drinking as a kind of reward for parenting or, you know, a kind of compensation for the challenges of motherhood. I think that's quite interesting. And so I think, really, we need to get to grips more with what started to come through and all this interesting data, and then where we can go next with some more research.

James Morris:

Next, I spoke to Dr. Julian shorter, who asked to talk to me about British Psychological Society guidelines that she'd helped to develop to support health care roles in their response to the health challenges presented by COVID.

Dr Gillian Shorter:

The briefing is really to try and support those who are working in health to help the general population keep within those 14 units that the chief medical officers have put in their guidelines. The idea behind this is that so much of our life has changed. The way in which we were trying to implement the guidelines before maybe just doesn't apply. So the way in which we think about policy and the way in which we think about trying to support individuals has to change. And of course, our healthcare systems more generally, not just the alcohol treatment side of things, or online, self help, or whatever, everything has changed so much, that we really want to be making sure that we look after our NHS, we look after our health systems, and all those sort of long term risks that we know occur from alcohol, we try and prevent some of those from occurring to minimise our pressure on the NHS. And it's really interesting in terms of the shifts that's happening and certainly worrying you could say in many ways, but we've seen this kind of longer term trend towards home drinking or purchasing alcohol in the off trades, you know, promising figures from Scotland in terms of minimum pricing. You know, a lot of people say that pricing is the big kind of issue here as a policy perspective. Do you think that's ever more important now? Absolutely, James, and I think We kind of go back to the safer guidelines from the World Health Organisation, they're kind of five things we should really be focusing on from a policy perspective right now. So things like marketing, making sure that we're not marketing to children and young people that we're being responsible. But how we communicate, alcohol and alcohol branding, talk to others, prices, obviously a big one, a minimum unit pricing is showing a big difference in Scotland be great if we could get those gains right across the UK, and more widely. availability. So this is a big one, things like drunk driving countermeasures are really, really very important. And then, of course, the treatment side of things, the brief interventions, or the self help that you might get online, that's also really very important. And one of the other things is, it's really very vitally important that we don't have the alcohol industry at the policy table. And that remains really important, whether we're inside a pandemic or outside of one. And what about trying to encourage people to stick to the guidelines, because net remains a bit of a tricky issue in the sense that people who tend to drink above the guidelines tend to be quite dismissive or resistant to thinking about them. And that's understandable from, you know, obviously a perspective of alcohol being very culturally normalised people using alcohol as a coping mechanism. How do we try and maybe mitigate that issue or risk of the guidelines really not having the kind of resonance we maybe want from a public health perspective, you know, James, I think you've kind of hit the nail on the head there, you know, there's so much has changed for so many people. And we've got to be really open and honest and have conversations about our alcohol use, our routines have been completely abandoned, we may have gone into work, so we wouldn't be drinking during the day. Or maybe we didn't drink during weekdays. And now our routines have completely changed. We're stuck at home, we're stressed out about our jobs, or livelihoods, friends, our loved ones, some folks have been homeschooling for the first time, that's a big pressure on parents, you're bored, you're stressed, it's so easy to open a bottle of wine when the routine is gone. And also things like our tempers are frayed, where we're with our partners and our families. 24, seven were cooked off and so much is going on. Although there has been guidance and support to help people drink within the guidelines before now, we have to really respect the fact that our opportunity to drink particularly has changed enormously in terms of our social environment and our physical environment. But as part of the honest conversation, I feel James, I have to be honest here and myself that, you know, there came a point quite early on in the pandemic, when I had to have some harsh conversations. My husband and I, we had some conversations when we were noticed we were drinking during the week, which we wouldn't do. Normally, we were feeling the stress of extra alcohol. And we were drinking above the guideline. So we had to have a word with ourselves and to try and think about how we could get our drinking back in under those 14 units. So I want to be absolutely clear to your listeners that, you know we do alcohol research. But sometimes we need to look at ourselves too, and that it's so easy for alcohol to creep up. And it is a stress reliever. It's pretty instantaneous. But of course, we do know that a couple of days down the line. And of course, our listeners who've heard your last episode will know that, you know, anxiety is one of the big things that comes out after a hangover. So, so many open and honest conversations need to be had about drinking or culture and where it fits into our everyday life. I totally agree. And yeah, you know, good for you for having that that conversation is certainly not always easy. And what about the kind of psychological approach to trying to change behaviour in the briefing, it talks about the Kombi model? Can you tell me a little bit about that, please. So the Kombi model is basically at three different elements that influence behaviour. So capability is about what we know and what we do. Opportunities are about the people around us and our physical environment. And then our beliefs are what we want maybe how we see ourselves how we regulate our emotions, our habits, those are kind of motivations, we think that these three elements influence behaviour. So for example, if we're thinking about COVID, particularly, there's been a lot of a shift around our environment, both social and physical. You know, if we're thinking about changing our alcohol, we might want to set some boundaries around our consumption, like substituting lower alcohol products or no alcohol products, during social situations, having alcohol free days, or planning or alcohol consumption with these very different routines.

James Morris:

Next, I spoke to Martin, who contacted me after the Adrian Charles episode about how his drinking had changed throughout the pandemic. So thanks for joining me. Can you just tell me a bit about how you saw your kind of relationship with alcohol before lockdown?

Martin:

Yeah, I think before lockdown It was a case of drinking more socially because obviously you could you could mix with people. Yeah, particularly a weekends by golf. Go to the gym, see a few people and having a drink sociably at weekends, I think since the pandemic has arrived, and with the winter evenings and the kind of you can't meet people, and you can't go anywhere, and drink, why alcohol becomes a different perspective in your life. And that's something that I've I've really had to deal with. So after kind of locked down a saying that your kind of alcohol use crept up a bit, it definitely did initially, on the first lockdown, it was tougher, it didn't feel like a real lockdown, you had the sunshine and everything else, it just felt very different. I think since you know, those dark evenings, alcohol can be or have been a bit of a Crux, in terms of something to reward yourself with, for getting through the day, or dealing with work issues, or dealing with relationship issues, and helping you in inverted commas feel better at the end of the day. So in a way, the sort of summer locked down, drinking sort of felt like just enjoying the summer, whereas now everything's a bit more tiresome. And with the weather and the darker nights and stress of it all, I felt a bit more that the drinking has become not necessarily positive life enhancing thing but more of a Crux, is that what you're saying? Yeah, but I mean, somebody like myself is very aware of the dangers and the addictive qualities of alcohol. And something I've kind of learned to manage in this lockdown is that I've changed my drinking behaviour, definitely. Because I knew it was becoming a slight, slight issue in the summer, because it was easy to have a drink at the end of the day with those beautiful temperatures. In the lockdown since winter, I say I've changed my drinking behaviour. I don't drink wine now, because that is a very high alcohol content. And I left me feeling tired in the morning. And I've trained I've changed much more to just drinking less at the weekend and changing it to beer, which obviously is less strengthen doesn't give me the same kind of health implications. I think the wine did you say to the frequency of your drinking maybe crept up, but then you reflected on that and have cut down and change from less strong drink to bear. But what was the kind of thought process as you kind of made that decision to cut down or put those kind of strategies in place, health and well being to be honest. Also, I have a partner who's a sister in the hospital who sees the effects of alcohol and you know, both from an ad perspective and a longer term health issues that people have coming into hospital. So it's always been there in the forefront of my mind. And just basically, I needed to change my relationship with alcohol, and make it less of a Crux, and more of just just something occasionally that's nice to do. And do you feel different for that? You mentioned sort of feeling so tired in the mornings? And do you kind of have any strategies that you have used to kind of replace it in a way? Yeah, I think exercise has always been important for me, and you're watching your weight, we all know that alcohol is very calorific, you just tried to change, I wouldn't say I have a strategy. It's just, it's just learning to deal with our column in a different way. And knowing the effects that it has on you from a health perspective, and just just changing your behaviour, and making it less of a reward, as it were. And just more of a an occasional nice thing to do at the weekend. Not a set not turning into a session drink anymore. Yeah, I kind of like the 5% stuff, anything below 5% did give me that quick alcoholic kit that I wanted. So I've kind of I've changed now from 12 13% wines down to beer, and less of it. And I think it makes me feel better. Yeah, I'm in my mid 50s. Now, and I see people all around me and in society, where alcohol is a big issue. And I'm not saying that I'm much better than those people, I'm just trying to do something about it and be much more aware of it, because it affects you mentally, definitely, in terms of anxiety and depression. And we for myself, I know that if I drink too much, I get depressed and anxious, far more. And I'm also highly aware that from a weak point of view, the effect it has on you, and from a longer term perspective, what it does to you. So it's it's just trying to balance all those things with something that feels like it's really good at the time balancing it against what the longer term effects are. Absolutely. And it sounds like you're doing doing pretty well with that now, so do better. I don't wanna say it was a problem before but it was an issue. Sure I'm doing doing better. Let's get a place there. And hopefully, yeah, hopefully as the kind of weather starts to improve and are kind of situation overall starts to improve, you know, you'll kind of maintain that balance and we'll be able to kind of you know, use alcohol socially rather than as a kind of Crux and talking about ways in kind of collectively as a nation. You know, as we've had on with some of our other speakers on this episode of three the pandemic that people have really had a heavier drinking patterns already that appear to be drinking more and using it as that using it as that kind of coping mechanism way. So Hopefully, you know, I think we'll be seeing some of the negative effects of increased consumption for some time to come. But I think, yeah, definitely. And I think we also have to all just acknowledge we do. We, as a society, UK society do have an issue with alcohol. And I think it's just something that isn't spoken about enough is people people do have a lot of issues with alcohol. It's just seen as this really social thing that you can do. There's not a problem, but we can all see the effects of it. You know, whether young people in their binge drinking their binge drinking makes me sound like a real old fogy. Because let's face it, as well, middle class and middle England and older people also binge drink at the weekends, probably just with wine. Yeah, it is an issue, an issue that society needs to deal with, we need to talk a lot more about it. And I'm really grateful for programmes like yours, and, and someone like Adrian Charles coming on he's high profile and talking about his issues with alcohol, and related with it, because I'm a big football fan as well. And he talks about how it affects him socially around his football and other things. And I feel like I'm in that category, as well, as the kind of cultural expectancy isn't there, if you go to the football, or if you're kind of Aladdin with your mates, then there is that social pressure isn't there just implied that you that you've got to drink and and again, as agent Charles says, alcohol is the only drug that you have to apologise for not taking. So yeah, I think the cultural shift is happening. It's just, you know, it's a slow burner. These things don't happen overnight, as we saw with smoking, and so on. So I think it's a work in progress, and we're possibly heading in the right direction, even if perhaps knock downs put us back a bit because of the pressures on many people. But yeah, I think I think you're right, it's just about keeping the conversation going. And so that no overtime, bring, bring the relationship back into balance a bit more. Definitely. And it's like all relationships, there has to be that balance, and sometimes you alcohol companies, I used to work for one, by the way. Interesting. A big Brewer. And, you know, they have lots of lots of power and lots of advertising. It's seen as we all know that alcohol is a drug. And it's how do you deal with that drug? And how do you control that drug, and whether that's the alcohol reducers themselves, and how they market it to us taking individual responsibility for our own actions? That's certainly how the alcohol industry wants to frame it, you know, that it's an issue of individual responsibility, some of the people we've had on on this show earlier. And I would argue that that helps them avoid the legislation that might hurt their pockets. So I think, you know, no one disagrees with personal responsibility. But I think there is also a strong case that it shouldn't just be unlimited advertising. And there are problems with being able to sell alcohol really cheaply in supermarkets around the clock. So again, as you say, it's about that balance, what is enough or too much, or the right amount of advertising availability or difficult questions, and whichever no one necessarily agrees. 100% on but it is about finding that balance. Definitely. Definitely. Well, thanks so much for coming on the show. That's been really interesting. And best of luck with it. Thank you.

James Morris:

I also spoke with Rosie stopped drinking shortly before the pandemic about how it affected her.

Rosy:

I mean, my relationship with alcohol prior to lockdown was I would say it's very unhealthy. I work in the music industry. And prior to lockdown, I was also one of the Booker's at a club in in London. And so my weekends would be made up of kind of starting at say, like 8pm and finishing any anywhere past 8am, the next day in a club, surrounded by lots of intoxicated people. And yeah, I mean, I would drink through my shift. And then I think the interesting thing was the, like, whilst I was working, I never felt very drunk. But as soon as I finished my shift, that's when I would kind of want to relax a bit. And suddenly, I felt a lot more drunk and would want to continue that. So yeah, it wasn't, it wasn't a healthy relationship at all. I was also going to the pub, most weeknights, to kind of decompress from what I perceive to be the stresses of the day. So it was very much kind of crutch. And so would you say your relationship just developed over time and you know, because alcohol is kind of normalised and accessible, and lots of your peers and friends presumably just drink regularly that was easy to kind of fall into and I suppose within the music industry as well, maybe it's even easier to kind of get into perhaps less than healthy ships of alcohol. Yeah, being totally I mean, my whole industry is kind of based around nightlife and in that, yeah, I mean, booze is kind of at the fore. Part of it all and you socialise in like pubs and clubs, which are like the main, the selling point, apart from the music is a place to let go. And yeah, kind of let loose and alcohol was involved in that. And it was very much involved in my day to day, whether that was also like meeting artists or other professionals in the industry, it was all based around going for a drink.

James Morris:

Because I guess the music industry is one of the industries where you know, because of the association with club nights or festivals or whatever that the use of alcohol one kind of procedure of Hedden ism is so entwined in the way that it's not in other industries on the whole.

Rosy:

So, yeah, I mean, it's also after the ticket sales, it's the biggest source of income for a lot of these places. I mean, now it's kind of changing, but the thinking to change that approach and to think about other ways to provide ourselves with income, its alcohol has just been at the forefront of all of that. And so prior to lockdown, he actually stopped drinking. Is that right? Yeah, it was just before, it's actually just coming up a year now. So it was at the beginning of February 2020. And it was, yeah, it was after one big night. Things just got kind of out of hand. And it was me and my partner decided that it was really time to stop when he decided to stop with that, you know, just for a bit. Did you have any ideas or goals in terms of, you know, stopping indefinitely? Or just seeing how it would go? Yeah, I mean, I think I think we kind of thought six months to a year at first. But as time went on, it's now just, it's really changed who we are. And we're very happy with who we are as individuals as a result of giving up drinking. And, and so that just became more of the norm. And now it's just I don't think I'll ever drink again, to be honest, I don't feel the need to you know, I think that one thing that kind of kept popping up was like, how do you celebrate if you if you're not drinking, and now that we don't drink and it's not part of our lives, like we don't need that drink in the in our hands to celebrate? we're much more content that's really good. And, you know, how do you think lockdown affected, it didn't make it harder or easier in any ways. I think lockdown made it a lot easier. To be honest. The one thing that I really missed, like in the kind of first few months of giving up drinking was going to the pub, and it definitely helped that I knew that no one else could go to the pub, you know, it was something that the whole country was missing out on. And so, you know, it wasn't even possible to do that. I think had we not been in lockdown? I think that would have been a lot harder to interesting, because I suppose you know, you're drinking mainly took place in social contexts outside the home. So you know, those are the situations where you might have faced more pressure or discomfort from other people by you saying, Oh, I'm not drinking, you know, that's, that's when people can kind of get a bit defensive. So yeah, perhaps people are more established home drinking habits, perhaps finding it harder overall, or as people yeah, who predominantly drank like yourself in more social context outside of the home? Maybe you're finding it easier to cut back? Yeah, I would say so. I think the other thing is, like there are so many more places now like when locked down East that we found that we could go for a non alcoholic drink and be in a social environment where where we still feel like we're drinking a pint, but it's not. It's alcohol free. And that was really that was really helpful in those initial months. What do you think that was about? Do you think it was about blending in? Or was it the quenching the sort of thirst for an alcoholic drink virus sort of placebo effect? Or a bit of both? Yeah, I'd say a bit of both. I think also just like, I really enjoy being in those environments, even if it's just like with one other person, like just being in a social environment. And yeah, the the feeling of that drinking a pint was really nice. And it was something that I missed. And to do that, yeah, it just kind of in an enjoyable atmosphere was something that it was just really good to be able to do that without actually drinking alcohol. Yeah, so would you have a drink? Or have you ever drunk alcohol free drinks at home then? Yeah, we did for a while. We found a really good delivery service that had loads of different options. I mean, that's, that's what's been amazing. I think in the last couple of years is that like alcohol free drinks have become so much more popular. And there's there's such a bigger variety now. So yeah, we would like to order in the drinks that we liked, especially over summer, I think, but to be honest, recently, it's we haven't even wanted to do that anymore. That feeling of like of like realise that there isn't there just hasn't it's completely diminished. Do you feel as just as times past that you've, you know, those kinds of cues or expectations that might lead to wanting a drink have just kind of subsided over time? Yeah, absolutely. I think in general, basically, my brain has like rewired slightly. And so by not drinking, I'm feeling less anxious. And therefore I've broken that cycle of like, I'm feeling anxious, I want to forget about my woes and worries, and how would I do that? I'd usually have a drink, but because I'm less anxious now, I don't even feel the need to do that.

James Morris:

Yeah, absolutely. I think sort of virtuous cycle is definitely a real thing in terms of people who are drawn maybe to the effects of alcohol on a physiological basis, it's often because you know, in the moment, it will alleviate anxiety, but further down the line, it might or commonly will make it worse. So yeah, when you when you stop kind of using it to alleviate anxiety, then yeah, has that kind of virtuous effect in that you might not feel so anxious as much as a result. So yeah, I think that marries up to the evidence and lots of people's experiences. So that's great. Is there anything in particularly you know, you've replaced alcohol with other than, you know, alcohol free drinks? Do you think it will? or certainly looking forward to the future and hopefully, when knockdown eases? Are there other things that you think you might be able to do more often, I think we've locked down in general,

Rosy:

like it's just bought myself and bought me a lot more like inwards and feeling a lot more kind of focused on myself and being at home. I play a lot of video games now. I don't know if that's like something that's replaced there. I don't really know. I mean, I'm not sure. Well, thanks so much talking to me.

James Morris:

That's that's a really interesting insight. And I'm really glad that you're kind of reaping the rewards of kicking the booze. Thank you. Next, I spoke to Darren Lee, a counsellor at a national addiction service and trainee psychologist. Darren is currently researching the experience of people previously engaged in face to face recovery groups and have switched to their online equivalent during the covid 19 pandemic. So thanks so much, Darren, for joining me, can you tell me a bit about your research and any key themes that are emerging in terms of the effect of the pandemic on people who did use face to face recovery groups, but are now using kind of the online equivalent.

Daren Lee:

So having done a literature review of a certain things, I always expected to see like group members talking about shared identity, connectedness that they feel in the group, you know, meeting people, so meeting, Pro, abstinent sort of social network. So I mean, what's been coming through just from sort of transcribing interviews, actually, is that online groups, I mean, to my surprise, have been really the favourable to lots of group members. And I mean, with some clients, they've been talking about how accessible they are. So rather than having to go to a sheduled group, which might be they might have one or two groups a week, because of the ubiquity of them. I mean, at any given moment, there is a peer support group going on. So I mean, for some people, they might be attending a group at one end of the globe in the morning, and then still attending groups in the evening at the opposite end of the globe. So that's really important, because it gives that sort of accessibility. But I mean, it's more than that, because it shows group members that their sense of connectedness transcends the connectedness they have with people sitting in a circle. So they're the same as people who might be the opposite end of the planet. And I think that sends a really powerful message to them. So online groups have been really, really important for people during the pandemic. I think there are some interesting differences in terms of face to face groups and online groups. And some of them are obvious, and some less so I think endings have have come up as being really interesting, because at the end of the face to face group, there's almost kind of a process of having a chat with other group members potentially, and and the group members have a chance to process some really important material they've been talking about. But obviously, with an online group, you click end meeting, and it's very, very abrupt. And I think that is perhaps one of the challenges that group members might have been experiencing, certainly for the people I've spoken to. I think in some ways, I think we could all probably relate to that, you know, ending kind of online meetings can sometimes just be a bit awkward and abrupt, as you say. But have you had any sense of people that do maybe feel that there's something face to face group does offer and that people miss at all, and that they'll continue to go or want to go back to for those other reasons? Sure. I mean, that's certainly been coming through, and I mean, off the participants I've spoken to and with qualitative data, you do want to use very small samples, but still you get this really rich data. And what people have been talking about is that there's a sort of intimacy and emotional connection that's difficult to replicate. So the knowing that you're the same as other people really comes across because you might have 50 people in an online group and You're all nodding and, and thinking and saying the same sorts of things. But that kind of the richness of that emotional experience is very difficult to replicate. And what I'm finding, as one of the sort of most homogenous findings, you know, everyone's saying the same thing is that they actually hope in the long term when the madness of the pandemic actually passes is that one of the positive legacies of the pandemic will be that online groups can carry on not to replace face to face groups, but to work in conjunction with them. So that way, they could have that sort of intimacy and emotional connection of being in a room with someone and really being able to empathise on that level that we can, as we're designed to do with people face to face. But also, they can have that accessibility of the online groups. So it could kind of be a win win situation. I mean, most of us have suffered in a pandemic. And this, this might be the sort of silver lining to the terrible clouds that we've all been under. Again, it kind of mirrors some of the things that are going on more broadly, both in terms of maybe no treatment services as kind of opportunities or potential for digital online mediated approaches to help and support but we don't want it to replace traditional treatment services. And similarly, you know, things with like home working, I think a lot of people have benefited and seen positive to that. But at the same time, I don't want it to replace their kind of office and face to face contact. So it's the kind of different ways in which they might slot in and have pros and cons. And, yeah, so more sort of client choice? And do you have any final thoughts in terms of kind of the sort of future landscape I suppose of online based recovery or mutual aid meetings? I suppose it, you know, it could be another kind of way of removing barriers, you know, I think going for the first time to a face to face group meeting could be quite intimidating or scary for a lot of people what obviously, stigma etc. Maybe online kind of removes that barrier a bit for some Yeah, I suppose. Because it gives people the choice of a if they want to attend the meetings, there were so many meetings, but also how involved they are, whether they have their camera on whether they have their camera off. So there's that much sort of greater choice, I suppose one thing that on a sort of more systemic level we need to think about is making sure that people have the technology, we were seeing the same thing in schools where, you know, children are being homeschooled, and they don't necessarily have laptops. So I mean, there's there's one point that I wanted to make about that actually, I something that didn't occur to me. But if someone's attending one of these groups on their phone, it really isn't like a group meeting. Because you can't see more than one face at a time. It's like a video call with an individual. And I think that the power of groups is the connectedness that comes with it. Like all of these people, we have a shared story, shared narrative, and when you're having a single video call, I think you really lose that. So I suppose I think it's a fantastic thing that online groups could and I think should be widely available post pandemic, but we're gonna need to make sure that people have the technology to access them back to say D and V.

James Morris:

Back to Sadie and Habib at the Institute of alcohol studies has some reflections on where next

Dr Sadie Boniface:

Definitely, there's some good news. Some people have cut down on their drinking, some people have stopped how long that carries on for that remains to be seen. But it's the people who are having health facing challenges and who's drinking has increased that need our attention, either now or in the future. And that's what we're trying to do with some of our work, I suppose continuing to advocate for those key policies that we know that are effective, that I'm really being utilised in terms of pricing, availability, and marketing, but also the need to be able to provide support services to individuals and families who have really experienced alcohol problems and other very interlinked arms is going to be more imperative than ever. Yeah, the Royal College of psychiatrists are worried that there's going to be a big surge in post pandemic demand for our code treatment, because people are not seeking help at the moment. And the services are so stretched at the moment and have been for years, and they're not going to be able to cope if there's a big increase in demand. So what's going to happen there?

James Morris:

absolutely, and we've seen negative effects of austerity for 10 years now, when abroad reflection, I think a lot of people are thinking about in terms of post pandemic is, you know, not to kind of run a system that's operating at the sort of bare minimum that you know, you really want to be able to be ready for increased demand and really just feel for for people at the frontline of all of this.

Habib Kadiri:

You mentioned pricing. And I think one immediate concrete thing that could be done is to raise the price of alcohol duty. And I think still, you need to raise taxes in that area, to at least have something to fund this potential rise in people who are going to need alcohol treatment, sad was saying post pandemic. So I think it'd be very important to for the Chancellor to raise alcohol duties and In the long run minimum unit pricing would be a really good measure to perhaps in trying to rebuild the portrayed find some kind of pricing parity with supermarkets. A lot of these measures their policies to increase prices, whether it's minimum pricing or raising alcohol duty action on marketing, having better restrictions or reducing availability of alcohol.

Dr Sadie Boniface:

A lot of these things don't have to have a negative impact on the hospitality trade. Some of them like minimum pricing can actually help pubs. So it doesn't have to be that action on alcohol harm, hurts the hospitality industry is a widening gap between prices in pubs and supermarkets has has been that driver of harmful consumption although it's very hard to prove cause and effect. I think it just makes sense in so many ways. So I'm in favour of kind of, as Habib says, parity, trying to close the gap in prices and encourage consumption in more regulated safer spaces and not to have such a kind of financial incentive to drink off trade where as we've discussed, you know, harms can be kind of exacerbated, you know, just summarising, it's just such a complex picture and we'll be trying to unpick it for years to come. But certainly there's some real causes for concern but some opportunities that we can capitalise on in terms of kind of policy and maybe more to help reach out to people.

James Morris:

Thanks for listening to this episode of the alcohol problem podcast. You can find us on Twitter and Instagram, at alcohol podcast, so please feel free to follow us or get in touch there.

Intro
Overview: Dr Sadie Boniface and Habib Kadiri (IAS)
Interviews with drinkers: Dr Emily Nicholls and Dr Dominic Conroy
Dr Gillian Shorter: BPS guidelines and policy responses
Martin: creeping up, cutting down
Rosy: adapting to being a non-drinker
Daren Lee: insights into using online mutual aid groups
Reflections and what next with Sadie and Habib