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Addiction services not equipped to treat the 8 million people drinking at high risk during pandemic, warns Royal College

Sep 14, 2020, 23:02 PM by RCPsych Press Office
Addiction services in England must receive a multi-million-pound funding boost in the upcoming spending review, says the Royal College of Psychiatrists.
  • New analysis finds nearly 8.5 million adults drinking at high risk, while number of people addicted to opiates seeking help in April at highest level since 2015
  • Years of cuts mean addiction services are ill-equipped to cope with post-pandemic surge
  • College calling for multi-million-pound funding package in upcoming spending review

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.

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.

This surge in higher risk drinking comes at a time when more people addicted to opiates are seeking help from addiction services. 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 College’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 5 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 £234 million (25%) in real terms from 2013/14 to 2018/19.

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.”

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.

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 8 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.