Why working from home is causing an explosion in problem drinking (2024)

Deaths from drugs and alcohol are soaring in England and Wales, according to latest figures from the Office for National Statistics.

In 2022, fatalities from substance abuse rose to almost 13,000 in England and in excess of 800 in Wales. Both figures represent significant rises compared with pre-pandemic figures, when the numbers were 10,511 and 667 respectively. The reason? Covid. Or, rather, lockdown.

Many doctors, including myself, warned that the effects of banning us all from meeting and mingling would stretch out years into the future, and this is one of them. The whole pandemic nightmare seems a million years ago now. I think many of us have consciously tried to put it behind us and out of our minds.

But when you think back, it was an extraordinary and stressful time. Many people struggled mentally, and rates of drug and alcohol use soared. I remember working in A&E in central London and seeing patient after patient come in with drug overdoses, many of them students who were stuck in halls, away from home, lonely and isolated.

For some it was the first time they had taken anything, and they were only experimenting because they were bored. Others were regular users but had significantly increased their intake.

But it wasn't just students.

A toxic combination of office closures and long evenings of enforced isolation at home meant plenty of older people had the time and money to go to extremes. And while many recovered and never touched an illegal drug or a bottle of vodka again, for some it triggered a more serious enduring addiction that might not otherwise have surfaced, meaning they now need long-term treatment.

Indeed, when the pandemic ended, I was astonished at the numbers of people in my clinics telling me that their drinking habits had spiralled out of control during lockdown and that they were now effectively alcoholics.

People who were just about managing found themselves in the grips of addiction, struggling to know what to do or how to stop. In the early stages, they got used to pouring a glass of wine every night. Then – with no work the next morning to restrain the habit — that glass led to another one, and another, then a bottle.

Now what we're seeing in addiction clinics and hospitals are the people who couldn't put the brakes back on when lockdown ended. Friends who work privately in mental health are being inundated with patients desperate for help. Indeed, one colleague has had to resort to operating a waiting list, which he has closed because of demand.

In the service where I work, which caters for people with severe mental health problems, we still get referrals almost every week where lockdown is cited as an exacerbating factor or even the reason itself for a patient's problem.

Alcohol misuse can be a slow burn, taking many years until people acknowledge its impact on their health. I suspect the spike in deaths we are now seeing will be just the tip of the iceberg, as those who fell into addiction never manage to climb out of the quagmire.

But there's another problem here too. For lots of people, lockdown isn't quite over. Of course, we can now go about 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 working-from-home culture which I believe is still fuelling a rise in substance misuse and alcoholism. When your boss isn't watching you, and you're working at the kitchen table in sight of the wine rack, people get used to a post-work drink or three. They don't have to go to the pub and risk getting stuck with Brian from accounts, but can unwind 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? Starting mid-afternoon means you're more likely to glug an extra bottle too.

The frequency increases —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 can log on in your pyjamas, does it matter if you have a hangover?

The reality of lockdown is that it opened a Pandora's box, but then that box failed to close when the pandemic was over. Instead, it was propped open by our refusal to go back to the office.

It has shown us how people teetering on the edge of a problem with substances can fall headlong into it without the structure of working life. Who knows when we will see the extent of the folly of lockdown? To evaluate the human cost of this social experiment, I suspect we will have to wait for years.

What we do know is that unexpected, unpredictable and deeply troubling consequences for the health and wellbeing of the nation continue to reveal themselves.

In a speech last week, Labour health spokesman Wes Streeting urged the NHS not to 'slam the brakes' on the recruitment of Physician Associates – healthcare professionals who see patients and work alongside doctors but don't have the same years of training. Doctors responded by saying 'he's living in a fairy world'.

The row erupted after the Royal College of GPs announced it was halting the employment of PAs in GP surgeries until the profession is properly regulated later this year.

My concern is that if Labour 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 sticking plaster solution is to employ more of these 'cut-priced medics' , which is why he is choosing not to listen to doctors' concerns.

Wills is lucky to have Carole

Lots of women will have seen Carole Middleton, the Princess of Wales' mother, get her heel stuck in the grass at Royal Ascot last week and sympathised with her predicament.

But how lovely that the person who came to her rescue was her son-in-law, Prince William, who, hand outstretched, helped her steady herself as she got her shoe free. We all know how tricky life with in-laws can be. And yet sometimes they provide an alternative type of family to ours which is welcome.

It's said William considers Carole a second mum. Of course, he lost his own at a tender age, so Carole may represent that maternal figure he's lacked.

The Middletons also give him a glimpse of the kind of normal life he's never had. The embrace of a new family, with its different perspectives and traditions, can be very healthy and help us to flourish.