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Drug and alcohol use under quarantine – Expert Reaction

The nationwide lockdown raises questions on how New Zealanders will consume both legal and illegal substances during Alert Level 4 restrictions for at least three more weeks.

The NZ Drug Foundation has advised regular consumers of alcohol or other drugs to consider taking a break, as the effects of alcohol and drug use on users and those around them are different while the nation stays at home in lockdown. People are advised to keep an eye out for withdrawal symptoms, ranging from difficulty sleeping to confusion and disorientation.

The SMC asked experts to comment on how limitations on alcohol sales will affect New Zealanders, and what the lockdown measures mean for those who use cannabis and other illegal substances.

Associate Professor Chris Wilkins, SHORE & Whariki Research Centre, College of Health, Massey University, comments:

“Illegal drug markets present unique challenges in the context of the COVID-19 outbreak and related shut down. Illegal drug markets already operate covertly beyond the authorities and general public and consequently may well continue to operate largely unseen and without precautions. One drug dealer may have face-to-face contact with many buyers involving exchanges of cash and drugs that have the potential to transmit the disease. Addicted drug users suffer significant psychological craving to continue to buy and use drugs but have no control over the safety of the supply chain or retail contact. Drug dealers focused on avoiding police may not adhere to social distancing and travel restrictions as they seek out financial lucrative opportunities and the needs of addicted customers.

“A further issue in the New Zealand context is we are in the harvest months for cannabis and growers may seek to travel to crops and also sell cannabis to many customers, with potential for transmission. The online NZ Drugs Trends is currently in the field and will provide valuable data on the impact of COVID-19 on drug use and supply (with my colleagues Dr Marta Rychert and Robin Van der Sanden). The Drugs Trends survey has sections on social media and darknet drug supply that may be increasing utilised to avoid face-to-face physical drug markets and related virus risk.”

No conflict of interest declared.

Dr Marta Rychert, Senior Research Officer, SHORE & Whariki Research Centre, College of Health, Massey University, comments:

“The current lockdown and related restrictions on movement imposed to contain the spread of Covid-19 will undoubtedly create some disruption in the illegal drug markets, including cannabis market.

“Some cannabis users will be affected more than others, particularly those who use cannabis more frequently and this includes people who use cannabis for medical and therapeutic reasons (estimated 5% of New Zealand population, i.e. approximately 200,000 people use cannabis medically).

“People who self-medicate with cannabis are among most vulnerable in the context of Covid-19. They are older than recreational users and often suffer from multiple health problems. We recently surveyed over 3,500 medicinal cannabis users (article in press in the New Zealand Medical Journal) and found that while oral ways of administration (e.g. tinctures and oils) were popular, smoking was the most common was of administering cannabis. Smoking presents unique risks in the context of Covid-19 due to the impacts on lung function.

“Recreational cannabis users who are more likely to use cannabis ‘for fun’ during the lockdown, need to pay attention to the hygienic practices they normally may not think about. This is because sharing of cannabis joints, bongs or vapes, also create risks for Covid-19 transmission. If dependent cannabis users are forced to reduce their consumption, it may lead to an increased demand for health services and an increase in use of other drugs.”

No conflicts of interest.

Associate Professor Andy Towers, School of Health Sciences, Massey University, comments:

Unprecedented situation for alcohol sales in Aotearoa New Zealand

“With bottle stores classed as a non-essential business, the only alcohol available for New Zealanders comes from stores such as supermarkets who focus on beer, wine and cider. In effect, the lockdown has prohibited the sale of spirits throughout Aotearoa New Zealand, which is only available from bottle stores. The only exception to this rule is in special ‘Licensing Trust’ areas such as West Auckland, where alcohol is only ever sold at bottle stores (not supermarkets). Furthermore, with stores such as Countdown limiting supplies to customers to 2 similar items maximum (e.g., 2 bottles of wine) we are seeing an unprecedented restriction on all alcohol sales in Aotearoa New Zealand.”

Concerning situation for those with alcohol dependency

“The lockdown presents a seriously concerning situation for those with alcohol misuse and dependency issues. This is a population of New Zealanders who do not simply choose to drink – they are chemically and behaviourally addicted to alcohol and are likely to experience significant (and potentially life threatening) withdrawal symptoms in the absence of alcohol. While many are known already to support services, there are still more in the community who have not sought help but might be in need.

“There are two clear reasons to be concerned: First, with spirits no longer available and supermarkets specifically placing limits on the number of similar items people can currently buy (i.e., often a limit of two items per customer), this places severe restrictions on the amount of alcohol available for those with alcohol dependency. This places them at risk of experiencing significant withdrawal symptoms in a time when support may not be available to them. Second, this lockdown is a serious cause for stress for every Kiwi, but especially for those who suffer from dependency. Alcohol is very likely to reflect a key coping mechanism for these Kiwis. The increased stress of the current lockdown is likely to result in an increased drive for alcohol.”

United Kingdom adds off-licences (bottle stores) to ‘essential services’ list

“Although the United Kingdom has not implemented as strict a lockdown as seen here, they have still seen a significant number of people stockpiling alcohol to the extent that supermarkets shelves have been stripped. As a result bottle stores (off licences) in the United Kingdom have been identified a ‘essential businesses’ in order to alleviate the pressure on supermarkets to supply alcohol to the population.”

Options for Aotearoa New Zealand

“I don’t think for a minute that bottle stores are an ‘essential service’ for New Zealanders in this lockdown. In fact, the current situation offers most Kiwis an opportunity to consider their relationship with alcohol. We have a culture of drinking and, for those finding themselves drawn to a drink, it might be a perfect time to talk to others about how to cope without drinking. However, for the very small minority of drinkers at the severe end of dependency, we need to consider all options for support, up to and including medically-prescribed alcohol for those with recognised dependency.”

No conflict of interest