RESEARCH
GENDER IMBALANCE
The lockdown may be having a
disproportionate effect on female service
users, warns Gordon Hay
Tetiana Shyshkina
The coronavirus
pandemic and the
subsequent lockdown
impacts on all society,
and is likely to be
impacting more on groups such
as those in contact with drug or
alcohol services. Research studies
are being launched to explore how
COVID-19 and lockdown impact on
people who use drugs, and there is
a wider discussion about how levels
of alcohol use within the general
population have changed over the
last few months (DDN, May, page 5)
and issues such as the relationship
between domestic abuse and
alcohol use during the current crisis.
While new research studies are
being set up, existing monitoring
and surveillance systems can quickly
be augmented to highlight emerging
issues facing those in contact with
drug or alcohol services.
The Public Health Institute at
Liverpool John Moores University
has, since 2013, hosted the
Integrated Monitoring System (IMS)
which records activity at a range of
primarily low-threshold drug and
alcohol services across Merseyside
and Cheshire. Just as the UK entered
lockdown, six additional questions
were added to the monitoring
system to enable services and
commissioners to identify additional
issues facing their clients.
As services were not mandated
to ask the additional questions,
the numbers are relatively small
but large enough to highlight the
impact of gender. Two months
from lockdown, emerging findings
from 1,435 contacts with services
involving 468 clients suggest that
female clients are impacted more
than males. Overall, very few
clients (about 1 per cent) report
concerns about having symptoms
of coronavirus. Interestingly, only
a similarly small amount reported
problems accessing medicines,
healthcare or harm-reduction
supplies – however this finding
is unlikely to be representative of
all people who use drugs or have
problems with alcohol, as the
monitoring is being undertaken
in healthcare, particularly harmreduction,
settings.
‘Changes in the
clients’ alcohol,
drug or tobacco use
were explored...
15 per cent of
female clients
reported a change
compared to 6 per
cent of male clients.’
More clients report difficulties
in social distancing and accessing
basic needs such as food. While
social distancing was reported as
an issue for 22 per cent of female
clients, only about 10 per cent of
male clients reported difficulties.
For accessing basic needs, 6 per
cent of female clients as opposed
to 2 per cent of male clients
reported issues.
Changes in the clients’ alcohol,
drug or tobacco use were explored.
Although it cannot be assumed
that any changes are increases or
decreases, 15 per cent of female
clients reported a change compared
to 6 per cent of male clients. While
all of these differences are seen to be
statistically significant, the starkest
gender difference occurred when
considering mental health, with 23
per cent of female clients reporting
that their mental health had been
affected by the current environment,
compared to 10 per cent of male
clients.
Research typically shows
that women who use drugs face
additional challenges, for example
the European Monitoring Centre
for Drugs and Drug Addiction
(EMCDDA) suggests that women
are particularly likely to experience
stigma and social disadvantage and
to have less social support. They
may be likely to come from families
with substance use problems and
have a substance-using partner,
have faced Adverse Childhood
Experiences (ACEs) and may have
co-occurring mental disorders.
The emerging information
from this monitoring system is not
a replacement for more detailed
research, as we can only highlight
that there are differences and would
only be able to speculate on why
these differences are occurring, and
research is needed to examine why
females are experiencing lockdown
differently to males. Those working
in drug and alcohol services, and
commissioners of these and similar
services, should be alert to any
additional difficulties faced by
female clients and seek to explore
them in more detail during contacts
with female clients.
Gordon Hay is a reader at the
Public Health Institute, Liverpool
John Moores University
WWW.DRINKANDDRUGSNEWS.COM JUNE 2020 • DRINK AND DRUGS NEWS • 9