Nursing in Practice Autumn 2021 (issue 121) - Page 16


Managing addiction in primary care

Allie Anderson looks at the soaring incidence of high-risk drinking during the pandemic , and considers how primary care can respond when services already pared to the bone face further pressure from the Covid backlog

I n September 2020 , the Royal College of Psychiatrists warned that health services were not adequately equipped to manage the rise in demand for alcohol addiction treatment that had resulted from the Covid-19 pandemic . The college conducted an analysis , which found that 8.5 million people in England were drinking at ‘ high risk ’, an increase of 77 % from 4.8 million in February , before the first lockdown . 1 It also reported that the number of new cases of opiate addiction in April 2020 was 20 % higher than in the same month in 2019 .

Six months after the RCP report , the picture remained equally concerning . Public Health England data revealed that , in the year from March 2020 , there had been a sharp rise of almost 59 % in the number of people who were drinking at ‘ increasing risk ’ and ‘ higher-risk ’ levels 2 ( risk is measured by the WHO ’ s AUDIT screening tool 3 , with a score of 8 to 15 indicating increasing risk and a score of 16 to 19 denoting higher risk – see table , opposite ).
General practice is typically the first port of call for people with addiction problems , whether they are substance related – like alcohol , drugs or tobacco – or behavioural , such as gambling . Nurses and GPs are faced with managing patients , whose addictions are often accompanied by other , often complex , mental health problems .
Tailored advice Practice nurses are ideally placed to provide brief interventions and advice for substance misuse , because they can screen patients opportunistically in the same way they do for smoking and weight . This works particularly well with patients who misuse alcohol . A patient who drinks alcohol at ‘ increasing ’ or ‘ higher ’ risk levels – as identified by recognised screening tools such as AUDIT – can often be counselled to lower their risk .
In some cases , education around alcohol
The early pandemic saw a rise of

77 %

in people in England drinking at ‘ high risk ’ nursinginpractice . com Autumn 2021