Covid-19 and mental health problems are two pandemics that have simultaneously collided.  The inextricable link between addiction and mental illness has been exacerbated by this pandemic.

Spring lockdown saw a surge in drug consumption. In the midst of a second national lockdown, it is important to consider what implications this has on vulnerable populations and how to best support them.

Unemployment, isolation, uncertainty – this pandemic is having an immense psychosocial impact on us with widespread challenges. Covid-19 has exposed our societal unpreparedness, magnifying social, economic and political inequalities

Though varied, lockdown has heightened people’s maladaptive coping with stress.

 

“There appear to have been marker differences in the way people have been impacted by the pandemic and lockdown. For some it has been an opportunity to learn a new language or try to play the piano, but for a significant sub-group of the population the experience has been very different. Survey data suggests that some people who were drinking alcohol at risky levels prior to the pandemic have increased their consumption further. What we don’t know is why but could make an educated guess it’s been a way of coping with the stress.” –  Ian Hamilton, Senior Lecturer in Addiction and Mental Health, University of York

Rising unemployment means vulnerable populations of a lower socioeconomic status have been disproportionately affected. Individuals with substance use problems have been particularly vulnerable, due to stigma, criminalisation, underlying health conditions and a lack of adequate support. 

 

“The release of analysis by the Northern Health Science Alliance suggests there are significant regional variations in the impact of Covid, those in Northern regions are 74% more likely to experience mental health problems than those living in the South. In parallel and paradoxically northern regions have seen significant cuts to services in comparison to the South, so they have faced a double blow.”  – Ian Hamilton

With deprived areas seeing higher rates of mental health problems and cuts to treatment services, Covid has reinforced a polarisation for various regions in the UK. 

During lockdown, individuals with substance use problems are likely to experience changes in their drug use – we often see an increase in reactive behaviours in times of crisis. This has increased the risk of overdose due to individuals isolating at home. The virus has impacted the drug market with a shortage of various drugs, driving up price and reducing purity. Low availability may increase risk of more at-risk drugs using behaviours such as more harmful delivery methods.

Though incomplete, available data from this year shows US drug deaths are on track to be record breaking – much like the trend we are seeing for UK drug deaths.

Why are drug deaths soaring? Covid-19 has left its mark on leaving our most vulnerable populations stressed and isolating – exacerbating the already devastating drug-related deaths crisis. This pandemic has further highlighted systematic health inequalities with widespread socio-economic insecurity feeding into addiction and mental health problems.

A report published by Kaleidoscope, examined how individuals receiving support from drug and alcohol services in Wales, were impacted by the spring lockdown. Some key figures coming out of the report:

  • 34% of individuals receiving support for alcohol use suffered a relapse in lockdown.
  • 25% of all survey respondents suffered a relapse during lockdown.
  • 73% stated their mental health was impacted during lockdown.
  • 60% were unable to or chose not to access online support interventions.
  • 26% began accessing treatment during the pandemic.
  • 63% experienced negative family impacts as a consequence of lockdown.
  • 9% experienced a nonfatal overdose scenario during lockdown.

These findings demonstrate mental health and addiction has been negatively impacted as a result of lockdown. We also see online interventions aren’t adequate for supporting this population.

“…as specialist drug treatment has been delivered largely online to comply with social distancing the lack of human contact at a critical point in people’s treatment must be having a negative effect” – Ian Hamilton

Social isolation as a result of lockdown has consequences for all of us, but especially individuals in recovery. Recovering from addiction involves connecting with others, sharing challenges and solutions – making in-person connection vital. 

Covid has increased the need to access drug treatment services, but these are disrupted by quarantine, social distancing and public health measures. There have been some positive responses, by being more flexible with take home medication treatment programmes and access to virtual support groups. However, this isn’t enough.

 

“Treatment has been shrinking for years so it is harder to access in a timely way than ever. Not everyone will respond well to remote or virtual treatment well. Added to this is the deprofessionalisation of the workforce as cuts to budgets mean providers can’t employ expensive consultant psychiatrists who specialise in addiction, this leaves those in need of help with a less than optimal offering” – 

Now more than ever we need to focus attention toward addiction treatment services along with interventions addressing the health and psychosocial effects of Covid-19. We need unimpeded access to harm reduction and treatment programmes.

 

“Investment in services is desperately needed, this would not only impact the record numbers dying prematurely due to drugs but would trigger innovation in the sector. We need to find ways of moving from a largely office based appointment system and culture to one that meets people where they are. Particular groups are underserved at the moment and that must change, for example what is offered to women means they are underrepresented in services.” – Ian Hamilton

We have a lot of work to do in regards to supporting individuals with mental health and addiction problems. Covid-19 is exacerbating a society which is ridden with a mental health pandemic. Now that we are in a second lockdown, with the current situation becoming a ‘new normal’ we are in desperate need of supporting individuals that need it the most and must learn from the mistakes we made in the first lockdown.

This piece was written by Katya Kowalski, European Stakeholder Officer at Volteface. Tweets @VoltefaceHub

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