Are your clients drinking more or less alcohol during lockdown?

Alcohol Change completed a survey in April 2020 which showed that 21% of individuals in the UK were drinking more as a result of the lockdown, while 33% were drinking less or had stopped altogether.1  Why the difference?  While they didn’t specify in the report, I would expect that it depends on the reasons why people were drinking in the first place.  If people were drinking to socialise or due to peer pressure, then alcohol intake likely decreased during lockdown when social opportunities became much more limited.  But if people were drinking to “reward” themselves after a hard day or as a strategy to cope with negative emotions, then alcohol intake may have increased.

The best question to ask is, “Is this level of alcohol consumption something he/she wants to reinforce and continue into the future?”

If not, early intervention may be needed because habits can be incredibly difficult to change once established.

The World Health Organisation wants to dispel the myth that consuming alcohol somehow prevents people from getting COVID-19.2  It doesn’t.  They are also advising people to completely abstain from consuming alcohol at the moment (during the pandemic) for the following reasons:2,3

• alcohol weakens the immune system;
• heavy alcohol use increases the risk of acute respiratory distress syndrome; and
• alcohol exacerbates health vulnerability, risk-taking behaviours, mental health issues and violence.

In spite of this, the UK’s Chief Medical Officer does not appear to have changed the advice around alcohol in the UK and they are still saying up to 14 units per week is low risk.4  “Units” of alcohol relate to the size of the drink and the alcohol strength.  Click HERE for a great chart which lists the units of alcohol in popular drinks.

Even outside of pandemic times however, it’s worth considering that alcohol affects the potency of certain medication and it can impair liver function, negatively impact mental health, lead to dependence and have a negative impact on someone’s weight.5, 6  Clients with a brain injury really should check with their neurologist to see if this is even a safe option for them.

Here are my top 5 tips for helping clients reduce (or eliminate) their alcohol intake during the COVID-19 pandemic:

 1. Help clients rethink their access to alcohol

• Stockpiling – Being home all of the time and having easy access to a stockpile of alcohol can certainly encourage a higher intake.  The obvious answer is to just not buy it (or buy minimal amounts), but if clients will just go to the shop more frequently to get more (which increases their risk of exposure to COVID-19), then you have to weigh up which of these options presents the fewest risks.
• Income – If someone has limited income, you also need to watch that healthier food isn’t being compromised in order to buy more alcohol.  Vegetables and fruit, for example, boost the immune system, whereas alcohol does not.
• Location, location, location – For alcohol already purchased, it often works to put it in the most out-of-the way, inconvenient location in the house so someone isn’t repeatedly reminded that it is there.  Lack of easy access also means it will take more effort to consume alcohol and sometimes that is just enough of a deterrent to get people to drink less.
• Buy smaller glasses/bottles – Having to get up to make a drink multiple times will act as a slight deterrent and give someone just enough time to pause and think about what they are doing.

2.  Help clients investigate why they are drinking.

What is driving this behaviour?  If someone is drinking because they are depressed, how you manage that issue will be very different compared to someone who drinks because they love to explore the flavour of wine/gin/ale.  The solution will be different again for someone who drinks because they are thirsty and a beer happens to be the first thing they see in the fridge. Dig deeper.  Could this need be met in some other way?  Sometimes it’s the sensory elements the person is craving (eg. ice, colour, fizz, flavour) as opposed to the alcohol itself.

3.  Encourage clients to consider non-alcoholic beverages (there are lots of options!):

• alcohol-free beer and lagers
• non-alcoholic wine
• alcohol-free spirits
• mocktails
• pure fruit juice (alone or mixed with sparkling water)
• tonic water or sparkling water

4.  If someone’s weight is an issue, consider drink size, alcohol content and calorie content.5, 6

A large glass of wine or pint of beer will obviously have more calories than a smaller glass.  You can also shave off a few calories by alternating between alcoholic and non-alcoholic beverages or choosing beer with 4% alcohol (instead of 5%) or wine with 11% alcohol (instead of 13%).  Note that while no- and low-alcohol options may have fewer calories, they still have SOME calories so you need to be careful.

Lower calorie options (under 100 calories per drink):

• 25mL spirit (37.5%) mixed with slimline/diet mix – 50 calories
• 175mL glass non-alcoholic wine – 30-40 calories
• 250mL low alcohol G&T – 40 calories
• 250 mL low alcohol, reduced calorie G&T – 12 calories
• 330mL bottle/tin non-alcoholic beer – 50-80 calories

Higher calorie options (over 100 calories per drink):

• 50mL spirit (40%) mixed with regular mix – 170 calories
• 50mL cream liqueur (17%) – 175 calories
• 175mL glass of wine (13%) – 160 calories
• 275mL bottle alcopop (4%) – 170 calories
• 568mL cider (4.5%) – 216 calories
• 568 mL beer/lager  (5%) – 245 calories
• 750mL bottle wine (13%) – 686 calories

5.  Make alcohol-free days part of a client’s routine.

Habits are very easy to establish and clients may come to link alcohol consumption with certain situations, people or even days of the week.  But if drinking can become a habit, so can NOT drinking.  Encourage clients to consistently have multiple days each week where they don’t consume alcohol at all and let this become a habit instead.

For other resources on helping clients reduce their alcohol intake, go to DrinkAware or AlcoholChange.  If you have clients who need support from a specialist rehab dietitian, get in touch at 0121 384 7087 or info@specialistnutritionrehab.co.uk.

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