Addiction, Covid

It's (virtual) happy hour again

Does alcohol have an essential psychological function during isolation? Emma Davies and James Morris on the arguments.

30 March 2020

The news last week that off licences had been added to the list of essential retailers, was met with relief by many people who drink alcohol in the UK. As a nation of relatively heavy drinkers in global terms (WHO, 2018), alcohol is intrinsically woven into the fabric of UK society. We drink in order to celebrate, commiserate, and cope.

Yet, is alcohol really an essential product during a national crisis? For a small subsection of severely dependent drinkers, continued access to alcohol is essential without professional detoxification support. Sudden withdrawal can cause many unpleasant side effects, and even lead to death (Scottish Health Action on Alcohol Problems have produced guidance on alcohol related problems and COVID-19). In England, over half a million drinkers are classified as dependent and in need of treatment, not all of whom will need detoxification support. However, there have been ongoing debates over the numbers who receive help. Continued cuts to public health budgets has seen numbers fall, whilst very few alcohol-specific services have survived (Morris, 2019).

But what about other drinkers? Whilst most drinkers usually do so within the low risk guidelines, around 24% drink above them without meeting criteria for dependence (NHS Digital, 2020). Whilst in reality drawing a line between 'dependent' and 'non-dependent' drinking can be a highly questionable distinction, can we really class alcohol an essential product for the non-dependent majority during a crisis?

YES: Almost immediately, normal social drinking occasions have been replaced by home and online activities including virtual pub nights, wine and whinge sessions, and quizzes. As many news articles have reminded us, we need to retain social activity, even though we cannot be physically close. Sharing a drink with friends over the internet may be one way to preserve some sense of the normality that has been left behind. Parents have suddenly found themselves having to home school and entertain children all day, whilst keeping in touch with work, and trying to obtain household essentials. Having a simple pleasure at the end of another frantic day may be entirely deserved in the eyes of many. Research shows alcohol makes us feel 'happier' in the moment (Geiger & MacKerron, 2016), energised, relaxed, sexy, and confident (Ashton, Bellis, Davies, Hughes, & Winstock, 2017). Alcohol can therefore offer us a temporary escape from the rolling news coverage, with its uncertainty and bleakness. For many of us, alcohol facilitates humour and an opportunity to bond… just as one of us sat down to write this a meme popped up on the new neighbourhood WhatsApp group – it reads: For the third time this week, I'm buying booze for the next two weeks.

NO: On the other hand, we should surely be mindful that our thirst for alcohol may have an impact on the safety and wellbeing of others. Alcohol no doubt plays a role in domestic violence, and sombre predictions of rises are already evident. Technically, selling and distributing alcohol is also increasing the number of opportunities for spreading the virus. Is it ethical to expect drivers and supermarket workers to risk catching and spreading Covid-19 so that we can enjoy a drink? It is also likely that some of us are drinking a bit more to cope with the anxiety and fear of this unprecedented and uncertain time, and this may be counterproductive, as Dr Aiysha Malik from the WHO has highlighted. We may also be putting our health at risk if we start to increase our drinking, albeit we can only speculate on what the short and longer terms effects will be. However, this may mean added pressure on the NHS now and in the future – should we hold this thought in mind when we clap to show our appreciation?

Turning our attention to the alcohol industry's response to this crisis, should we also give praise to the producers who have made hand sanitiser? Some critics may say that in fact we should be wary that this may in part be a further attempt to cement their brand (and boost their corporate social responsibility activities) within the public consciousness, in readiness for the big parties that will surely follow the lifting of sanctions.

It is worth noting that again, issues of inequality are likely to be of paramount importance. Whilst higher socio-economic groups will have more income at their disposal for alcohol purchasing, lower income groups are already disproportionately affected by alcohol harms, in part due to the clustering of other risk behaviours (Bellis et al., 2016). Huge numbers of people have already lost their jobs, and it remains to be seen how some of the least advantaged in our society will fare.

For many, deeming alcohol as essential may be seen as a pragmatic choice at this time of crisis; we need every little lift we can get. The freedom to have a drink, or two, is still an embedded part of our culture. But alcohol remains a drug with many individual and societal costs. All we can do at the moment is speculate and make sure there are high quality sources of support available for those who need them. But when the dust settles, there may be important lessons about the pros and cons of alcohol as a culturally endorsed 'coping mechanism'.

If you would like to read more about reducing drinking at home then the following links may be of interest:

NHS: https://www.nhs.uk/live-well/alcohol-support/tips-on-cutting-down-alcohol/

Club Soda: https://joinclubsoda.com/how-to-avoid-drinking-at-home/#

Drink Coach: https://drinkcoach.org.uk/tips-for-cutting-down-all

Vice: https://www.vice.com/en_uk/article/dygek7/drinking-alcohol-covid-19-self-isolation

Guardian article: https://www.theguardian.com/lifeandstyle/2018/mar/16/losing-the-booze-five-ways-to-drink-less-without-missing-out

- Emma L Davies, Senior Lecturer in Psychology, Oxford Brookes University

- James Morris, Director of the Alcohol Academy, PhD student, London South Bank University