As spring’s national lockdown was announced, professionals troubled over how such unparalleled change might affect people in recovery. The lack of connection, loss of routine and pause on vital coping mechanisms would surely shake the resolve of even the most resilient service users.

With the support of Welsh Government, drug and alcohol providers across Wales were determined to uncover lockdown’s impacts. Here, Rondine Molinaro, Service User Involvement Lead at Kaleidoscope, shares the data-supported insights collected from a peer-led and Wales-wide survey, and the sad reality that lies behind the numbers.

The pandemic forced drug and alcohol agencies to re-design service provision at speed, and the implications of this were vast. Clinical interventions such as BBV testing, urine testing and sexual health screening ceased, starting people on prescriptions became challenging, and service users who were self-isolating depended on community staff home delivering their prescriptions. All psycho-social interventions had to be reimagined in a movement to online and virtual support. Our workforce had a lot to contend with, and the struggles faced by our teams were visible to us all. Less visible though was how all of these changes were impacting the everyday lives of the people we support, and it was imperative to us to find out. To prepare for any future lockdowns, as restrictive measures threatened to become the norm, we enlisted the help of engaged peers with lived experience of drug and alcohol addiction from across Wales. They spoke with more than 200 service users to uncover how lockdown conditions and the resulting changes to service delivery impacted on their mental and physical health, family life, finances and employment and other important areas such as relapse prevention, community connection and harm reduction.

Our peers were able to gather impartial evidence of how the people we support were coping. They had no agenda and a wealth of their own experience to draw from. They understood the challenges isolation and uncertainty could create and reported that many of those they spoke with felt glad to have a listening ear. In fact some were kept on the phone for over an hour. Significant insights were concluded from the research, one of the most concerning being that 25% of those surveyed had suffered a lapse or relapse during the lockdown. When accounting for those respondents receiving support primarily for alcohol use, this figure rose to 34%.

In more extreme examples, relapse occurred irrespective of time spent in abstinence. In one particularly candid service user testimony, the individual had been sober for 2 years and 7 months prior to lockdown. They began self-isolating in March and had maintained sobriety until July. However, they shared that the loss of their coping mechanisms, including peer support groups, voluntary work, daily exercise and daily contact with parents had left them at a loss, bored, agitated and angry. This was a sentiment echoed by many respondents, who depend on purpose, structure and face-to-face support to maintain their recovery. When asked about their preferred method of support, only 8% cited telephone contact, and no respondent preferred video support.

At a time when so much of our daily activity has been moved online, it’s important to remember that online interventions alone do not do enough to support our most vulnerable service users, and where possible and in line with social distancing, people in recovery should be given the opportunity to have face-to-face contact with key workers. During the initial lockdown there was much excitement among service providers in Wales at how quickly we had moved interventions online and offered support uninterrupted. The way in which services have embraced technologies is of course positive, but it was important to review how effective online interventions were truly received by our service users. Upon reflection, 60% were either unable to, or chose not to, access online support interventions, and 69% did not access online support or community groups.

Of those who did, 58% did not find them effective. This raised the issue of digital inclusion as service users in more rural areas such as Powys at times struggled with connectivity, and many respondents did not know, or have a desire to learn, how to use devices, apps and online meeting software. Among respondents with decreased mobility, severe anxiety or negative mental health, and those having to commute long distances to make appointments, a more flexible and virtual approach to contact was welcomed. However the majority wanted to see face-to-face support, recovery hubs and drop-in services resume. Moving forward, we believe that services should consider a more permanent blended approach of phone, video and face-to-face support, and offer choice as standard at the point of referral. However we are resolute that there can be no replacement of face-to-face support.

During a time when even the most resilient among us struggled to find our way in the new normal, we were not surprised to learn that 73% of those who took part believed their mental health had been impacted by lockdown, and that 63% experienced negative family impacts as a consequence. Critically however, 95% managed to maintain contact with their key worker and receive ongoing support, albeit from a wholly transformed service.  Our hope is that the recommendations made in our COVID19 Impact Report will help prepare us and other service providers for any future lockdowns and we are grateful to our peers for their collective effort, insight, passion and above all – their personal time that it took to undertake this project.

The Peer-Led COVID19 Impact Report, part-funded by Welsh Government, involved drug and alcohol services across Wales, including Kaleidoscope, Barod, G4S, Platfform, WCADA and Cais. And the survey’s creation was guided by Prof. Katy Holloway of the University of South Wales’ Centre for Criminology. You can download the full report, filled with service user testimony and stats here.

This piece was written by Rondine Molinaro, Service User Involvement Lead at Kaleidoscope.

 

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