DR MAX PEMBERTON: Why working from home is causing an explosion in problem drinking
The number of deaths caused by drugs and alcohol is rising in England and Wales, according to the latest figures from the Office for National Statistics.
In 2022, the number of fatalities due to substance abuse rose to almost 13,000 in England and over 800 in Wales. Both figures represent a significant increase compared to pre-pandemic figures, when the figures were 10,511 and 667 respectively. The reason? Covid. Or rather: confinement.
Many doctors, including myself, warned that the consequences of the ban on meeting and interacting with all of us would continue for years into the future, and this is one of them. The whole pandemic nightmare now seems like a million years ago. I think many of us have consciously tried to put it behind us and put it out of our minds.
But when you think back, it was a special and stressful time. Many people were struggling mentally, and drug and alcohol use soared. I remember working in A&E in central London and seeing patient after patient come in with drug overdoses, including many students stuck in halls, away from home, lonely and isolated.
For some, it was their first time taking something, and they only experimented because they were bored. Others were regular users but had significantly increased their intake.
The legacy of the lockdown is a work-from-home culture that Dr. Max continues to fuel a rise in substance abuse and alcoholism.
But it wasn’t just students.
A toxic combination of office closures and long evenings of forced isolation at home left many elderly people with the time and money to push themselves to the limit. And while many recovered and never touched an illegal drug or a bottle of vodka again, for some it caused a more serious, lasting addiction that might not otherwise have surfaced, meaning they now require long-term treatment.
When the pandemic ended, I was amazed at the number of people in my clinics who told me that their drinking habits had spiraled out of control during lockdown and that they were now effectively alcoholics.
People who were only concerned with managing found themselves in the grip of addiction and struggling to know what to do or how to stop. In the early stages, they got used to pouring a glass of wine every evening. Then—without doing any work the next morning to curb the habit—that glass led to another glass, and another, and then a bottle.
What we see now in addiction clinics and hospitals are the people who could no longer put on the brakes when the lockdown ended. Friends who work privately in mental health are inundated with patients desperate for help. One colleague even had to resort to a waiting list, which he closed due to high demand.
In the service I work in, which focuses on people with serious mental health problems, we still receive referrals almost every week where the lockdown is cited as an exacerbating factor or even the reason itself for a patient’s problem.
Alcohol abuse can be a slow burn and it can take many years for people to recognize its impact on their health. I suspect that the spike in deaths we are seeing now will be just the tip of the iceberg, as those who have become addicted never manage to climb out of the swamp.
But there is also another problem here. For many people, the lockdown is not quite over yet. Of course, we can now live our lives as before. The days of social distancing, not sitting on park benches and queuing for groceries are a distant memory.
But the legacy of lockdown is a work-from-home culture, which I believe continues to fuel a rise in substance abuse and alcoholism. When your boss isn’t looking at you and you’re working at the kitchen table within sight of the wine rack, people get used to having an after-work drink or three. They don’t have to go to the pub and risk being stuck with Brian because of the bills, but can relax on the sofa instead.
People start drinking earlier in the day. Why not? If you end your day at 4pm instead of 6pm, who’s watching? If you start mid-afternoon, you are more likely to drink an extra bottle.
The frequency is increasing: instead of one or two drinks after work, once or twice a week, patients tell me they drink daily. If you don’t even have to get out of bed, but you can log in in your pajamas, does it matter if you’re hungover?
The reality of the lockdown is that a Pandora’s box was opened, but that box never closed when the pandemic ended. Instead, it was kept open by our refusal to return to the office.
It showed us how people teetering on the edge of a substance problem can find themselves headlong into it without the structure of work life. Who knows when we will see the extent of the lockdown’s folly? To assess the human cost of this social experiment, I suspect we will have to wait years.
What we do know is that unexpected, unpredictable and deeply troubling consequences for the health and well-being of the nation continue to unfold.
In a speech last week, Labor health spokesman Wes Streeting urged the NHS not to ‘pump the brakes’ on the recruitment of Physician Associates – healthcare professionals who see patients and work alongside doctors but do not have the same years of training. Doctors responded by saying he lives in a fairytale world.
The row emerged after the Royal College of GPs announced it would halt the employment of PAs in GP practices until the profession is properly regulated later this year.
My concern is that if Labor comes to power they will struggle to deliver on their promises to fix the NHS. I think Streeting knows this and is aware that a band-aid solution is to hire more of these ‘cheap doctors’, which is why he chooses not to listen to doctors’ concerns.
Wills is lucky with Carole
Carole Middleton pictured with her husband Michael as they attend day two of Royal Ascot earlier this week
Many women will have seen how Carole Middleton, the mother of the Princess of Wales, got her heel stuck in the grass at Royal Ascot last week and sympathized with her predicament.
But how sweet it was that the person who came to her rescue was her son-in-law, Prince William, who, with an outstretched hand, helped her balance as she got her shoe free. We all know how difficult life with in-laws can be. And yet sometimes they offer an alternative kind of family for us, which is welcome.
It is said that William considers Carole a second mother. Of course, he lost his at a young age, so Carole may represent the mother figure he was missing.
The Middletons also give him a glimpse of the kind of normal life he never had. The embrace of a new family, with its different perspectives and traditions, can be very healthy and help us thrive.
Sympathy for summer sneezers
Are you affected by hay fever? It seems bad this year. I’ve never had it before, but this year it has bothered me. As I type this, I have a box of tissues next to me because I can’t stop sneezing.
I admit I’m a little ashamed. My sister has suffered from hay fever for years and I have had little sympathy for it. But now that I have it, I know the misery it can bring. It shows that sometimes you have to experience something yourself to understand what it is like.