In Scotland the COVID-19 pandemic is exacerbating the long standing alcohol problem in the country. While the landmark minimum unit pricing (MUP) policy was able to drive down alcohol consumption, new data is showing that the pandemic is reversing this hard won progress. Alcohol harm is rising across the country and the deficiency in alcohol services is adding fuel to the fire.
The hard won minimum unit pricing (MUP) policy in Scotland was just showing promising results when the pandemic hit the world, Britain and Scotland.
As Movendi International previously reported, according to NHS research, in the one year of MUP implementation the volume of pure alcohol sold in shops fell by 3.6%, from 7.4 to 7.1 litres per adult. New data in May 2020, from research by Public Health Scotland collaborating with the University of Glasgow showed the positive effect of reduced alcohol consumption was continuing due to MUP. The study findings suggested MUP resulted in a 4% to 5% net reduction in alcohol sales from supermarkets and off-licences, per adult when compared with England and Wales – where per adult alcohol sales increased in the same period – who do not have MUP policy.
Alcohol consumption and harm during COVID-19
Unfortunately, the pandemic hit the world soon after this progress resulting in increasing alcohol harm in Scotland again. Experts say the problem is with how much COVID-19 will widen health inequalities in the country.
The results for increased alcohol consumption in Scotland during the pandemic are mixed. In May, 2020 Alcohol Focus Scotland (AFS) and Alcohol Change UK reported results from a poll conducted in mid April. The poll found that more than a million adults (29%) in Scotland were consuming more alcohol than they were before lockdown measures were introduced. However, the same proportion reported a reduction in how often they were consuming alcohol or had gone alcohol-free.
Dr Peter Rice, one of Scotland’s leading experts in alcohol-related problems and one of the architects of minimum unit pricing, has confirmed the polarization of alcohol use in Scotland during COVID-19, where heavy alcohol users are consuming more alcohol while lighter alcohol users have reduced or gone alcohol-free during the pandemic.
A trend noted by experts is people using alcohol as an unhealthy coping mechanism to cope with pandemic related stressors. The World Health Organization has clearly advised not to use alcohol to cope with the pandemic considering that alcohol negatively affects mental and physical health. Science has found that using alcohol to cope during COVID-19 is related with the development of alcohol problems.
One of the things we hear again and again is that where people are increasing their [alcohol use], it’s very much linked to stress,” said Aidan Collins, the engagement and partnerships manager at Alcohol Focus Scotland, as per The Scotsman.
It’s used as a coping mechanism, and it risks setting a dangerous pattern of consumption which can lead to very real harm.”Aidan Collins, Engagement and partnerships manager, Alcohol Focus Scotland
The situation is worsened considering the pervasive alcohol norm and inequality in Scottish society which adds to the Scottish alcohol burden.
The data gap due to the current pandemic makes it more difficult to ascertain how alcohol use during COVID-19 is affecting Scotland’s disease and mortality burden disease and death in the country. It is hard to gauge consumption levels during COVID-19 itself, as off-premise alcohol sales data is rarely publicly available.
One of the few data sets available, HMRC’s tax take from alcohol sales in the three months from April compared to the same period last year, indicates that there has been a 2 to 3% drop in alcohol sales. However, according to experts this would only account for on-premise sales such as pubs and restaurants which have been closed due to the pandemic.
In Scotland, about three-quarters of our [alcohol use] is done at home, and there will have been an increase in off-sales and home deliveries, but we have none of that data,” said Dr. Peter Rice, chair of Scottish Health Action on Alcohol Problems (SHAAP) and one of the leading experts in alcohol-related problems in Scotland, as per The Scotsman.Dr. Peter Rice, Chair, SHAAP
Alcohol services falling apart
The minister for public health, sports and well-being Joe FitzPatrick issued guidance in April making it clear to health boards and social care partnerships that alcohol and other drug services should remain open during the pandemic. However, the reality on the ground is very different.
The Scottish Families Affected by Alcohol and Drugs (SFAAD) charity, which offers services on alcohol and other drugs, reports that home alcohol use has made things worse, impacting many families. Most other stress relieving activities such as going to the gym or the park have been suspended, exacerbating the problems. Connection is key for recovery and physical distancing has largely affected this, leading to reports of people in recovery relapsing.
While SFAAD and other organizations are still providing services via online resources such as video calls or chats, these efforts are not enough to keep up. Alcohol services were lacking in the pre-covid era in Scotland and have taken a hard hit during the crisis. Some detox centres and clinics have closed or reduced capacity and there is no data on which ones are working and which ones are not. This is making it hard for the charities to connect those who call helplines with local services.
There’s very, very limited alcohol treatment to start with. There’s not a lot of options for people, and that’s something the government, ourselves and other agencies are taking forward. It’s a pretty patchy picture at the moment,” said Justina Murray, chief executive officer of Scottish Families Affected by Alcohol and Drugs (SFAAD), as per The Scotsman.Justina Murray, Chief executive officer, SFAAD
In a country which has an acute problem with this issue, there has been chronic under-investment, and that lack of support is going to store up problems for the future,” warned Professor Linda Bauld, the Bruce and John Usher professor of public health at the University of Edinburgh, as per The Scotsman.
We’ll see more deaths, we’ll see other health consequences, such as domestic violence, and the pandemic generally has shown just how terrible we are at investing in public health.”Professor Linda Bauld, the Bruce and John Usher professor of public health, University of Edinburgh
Alcohol policy during the pandemic
Modifications to alcohol policy in Scotland during the pandemic have weakened public health protections for the most part. Following misleading economic arguments from alcohol industry the Scottish government relaxed regulations during the pandemic despite the World Health Organization’s advise to limit alcohol availability during COVID-19.
There’s a real risk we’ll see a regression with more relaxed approaches and changes in patterns of sales and consumption that we can’t keep up with,” said Aidan Collins, the engagement and partnerships manager at Alcohol Focus Scotland, as per The Scotsman.Aidan Collins, Engagement and partnerships manager, Alcohol Focus Scotland
At a time of crisis like this, you have governments intervening in people’s lives in unprecedented ways, which you might think would give policymakers courage to intervene into other public health areas, whether that be increasing taxes or reducing availability,” added Professor Linda Bauld, the Bruce and John Usher professor of public health at the University of Edinburgh, as per The Scotsman.
The opposite is happening: the government gives the licensed trade and companies more freedom because of economic considerations.”Professor Linda Bauld, the Bruce and John Usher professor of public health, University of Edinburgh
Big Alcohol exploiting the pandemic
Movendi International has previously reported how Big Alcohol is exploiting the pandemic around the world to safeguard their profit interest even midst the current public health crisis. Alcohol is known to weaken the immune system and to increase risk of infections with the coronavirus and worsen disease progression. But these considerations are of no concern to the alcohol industry.
This is true for Scotland as well. Alcohol retailers have used unethical pandemic themed marketing. For example, Morrisons launched a service with Deliveroo which promises customers will receive their alcohol order at their door within 30 minutes. The messages marketed to people via websites and social media include “Out of booze and got your reputation to loose?”, “Give us a call and we’ll be at yer door faster than you can say, ‘Where’s ma Bucky!?’”. These messages are geared to increase alcohol use and market on-demand alcohol delivery which increases alcohol availability.
The pandemic brought into sharp focus how the alcohol industry exploits gaps in alcohol policy systems. Alcohol marketing is self-regulated in the UK including in Scotland. The pandemic targeted marketing of Big Alcohol is clear evidence that self-regulation has failed.
The alcohol industry regulates itself on marketing, that’s been shown to be insufficient. Regulation needs to be revised and looked at from scratch,” said Dr. Peter Rice, Chair of SHAAP, as per The Scotsman.Dr. Peter Rice, Chair, SHAAP
Public health experts are calling for an overhaul of alcohol marketing regulation in the country.
Scotland has a positive outlook on prevention policy in general such as with the MUP policy implemented. However, there is room for improvement: Starting with alcohol marketing regulations, improving investments in screening, brief interventions and treatment services, and as Dr. Bauld suggests, considering a retail monopoly such as in Sweden. Prioritizing alcohol control can help speed up pandemic recovery for Scotland while reducing the heavy alcohol burden.