DDN April 2021 Aprl 2021 | Page 6


Hartmut Schmidt / Alamy


Buying alcohol for people with severe dependence during lockdown in Bristol has been a lifesaver , says Rachel Ayres

On 26 March 2020 our city streets changed dramatically . Shops shut overnight , people went home and the world retreated . Bristol ’ s outreach workers became concerned at the speed with which vulnerably housed or homeless people with hazardous levels of alcohol consumption were catapulted into withdrawal , and unable to meet their drinking needs in the usual ways – nowhere to beg , shop or shoplift . As services retreated , retail outlets vanished and social distancing was enforced , people were left high and dry .

In Bristol , the government ’ s Everyone In scheme saw 427 people moved into emergency accommodation . Needs assessments indicated 35 requiring immediate alcohol treatment , 115 needing drug treatment and 24 with concurrent drug and alcohol dependency , and by April outpatient and inpatient detox facilities had closed , and GP appointments dried up . Dr Mike Taylor from Bristol ’ s Homeless Health Service and Dr Ben Watson from the ROADS alcohol and drug treatment service agreed that medically assisted detox within the new accommodations could not be managed safely – elective alcohol detoxification would not be possible for the foreseeable future and emergency admissions for delirium tremens would increase . In an attempt to reduce the inevitable impacts , a simple alcohol harm reduction information sheet produced by the South London and Maudsley NHS Foundation Trust was adapted and distributed across the city via all available channels . However , severely dependent people remained chronically unwell , and some outreach workers confided to buying alcohol in small quantities as a life-preserving intervention . Something had to change . A donation of £ 5,000 to Bristol Drugs Project and a decision was made to provide the essential items needed to enable ‘ at risk ’ individuals to follow the harm reduction advice – to not stop drinking .
Two experienced outreach workers led the Essential Items Project – Darlene Wheeler from the Bristol Street Intervention Service ( SIS ) and Nicky Auguste , diverse communities link worker from BDP . The idea was to identify the highest risk guests from the Everyone In accommodation , and provide the alcohol needed to prevent precipitous withdrawals during lockdown .
Something more surprising emerged , however – a small cohort of people whose severe dependence on alcohol had previously been a barrier to secure accommodation found themselves with a safe place to live , round-the-clock support , food , and their alcohol needs met . Strong relationships with project workers and hostel staff , and reliable supplies of alcohol fostered autonomy and a desire for change , and the unexpected outcome was successful alcohol detox for 12-13 project participants .
The principles of the project were to buy people ’ s alcohol of choice and to use person-centred and trauma-informed approaches and the usual harm reduction tools to promote stable drinking