Background The restrictions introduced in response to COVID-19 present many challenges, particularly for vulnerable and marginalised populations. These include maintaining access to Needle and Syringe Programmes (NSPs) to reduce the harms associated with injecting drugs. NSPs effectiveness is coverage dependent, but lockdowns and social distancing limit NSP access and availability. The impact on NSP provision in England is explored using enhanced monitoring data. Method Data collected through an established comprehensive regional monitoring system from five four-week periods, centred on the implementation of restrictions in the UK in mid-March 2020, are examined. Weekly averages are compared to allow for public holidays and weekly variation in activity. Results The restrictions resulted in the number of NSP clients decreasing by 36%, visits by 36%, and needles distributed by 29%. NSP coverage for those injecting psychoactive drugs halved, declining from 14 needles per-week during the 4-weeks to 15 th March 2020 to 7 needles per-week by mid-April, and coverage has remained at this level since then. Conclusions Though it is currently unclear if there has been a decline in injecting, the decline in NSP coverage is so marked that it almost certainly reflects decreased utilisation among those in need, indicating increased equipment reuse and risk.

BackgroundAccurate measures of alcohol consumption are critical in assessing health harms caused by alcohol. In many countries, there are large discrepancies between survey-based measures of consumption and those based on alcohol sales. In England, surveys measuring typical alcohol consumption account for only around 60% of alcohol sold. Here, using a national survey, we measure both typical drinking and atypical/special occasion drinking (i.e., feasting and fasting) in order to develop more complete measures of alcohol consumption.MethodsA national random probability telephone survey was implemented (May 2013 to April 2014). Inclusion criteria were resident in England and aged 16 years or over. Respondents (n = 6,085) provided information on typical drinking (amounts per day, drinking frequency) and changes in consumption associated with routine atypical days (e.g., Friday nights) and special dinking periods (e.g., holidays) and events (e.g., weddings). Generalized linear modelling was used to identify additional alcohol consumption associated with atypical/special occasion drinking by age, sex, and typical drinking level.ResultsAccounting for atypical/special occasion drinking added more than 120 million UK units of alcohol/week (~12 million bottles of wine) to population alcohol consumption in England. The greatest impact was seen among 25- to 34-year-olds with the highest typical consumption, where atypical/special occasions added approximately 18 units/week (144 g) for both sexes. Those reporting the lowest typical consumption (≤1 unit/week) showed large relative increases in consumption (209.3%) with most drinking associated with special occasions. In some demographics, adjusting for special occasions resulted in overall reductions in annual consumption (e.g., females, 65 to 74 years in the highest typical drinking category).ConclusionsTypical drinking alone can be a poor proxy for actual alcohol consumption. Accounting for atypical/special occasion drinking fills 41.6% of the gap between surveyed consumption and national sales in England. These additional units are inevitably linked to increases in lifetime risk of alcohol-related disease and injury, particularly as special occasions often constitute heavy drinking episodes. Better population measures of celebratory, festival, and holiday drinking are required in national surveys in order to adequately measure both alcohol consumption and the health harms associated with special occasion drinking.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0337-0) contains supplementary material, which is available to authorized users.

Aim To explore the nature and magnitude of alcohol's harms to others (AHTOs), and associations with mental well-being. Methods Cross-sectional survey implemented amongst 891 randomly selected Welsh residents (aged 18+ years), via computer assisted telephone interviews. Questions established past 12-month experience of nine direct harms resulting from another person's alcohol consumption (e.g. violence) and five linked outcomes (e.g. concern for a child). The source (e.g. partner/stranger) and frequency of the AHTO were collected, and respondents' socio-demographics, drinking behaviours and mental well-being status. Results During the past 12 months, 43.5% of respondents had experienced at least one direct harm (45.5% at least one direct harm/linked outcome). In demographically adjusted analyses, the odds of experiencing any direct harm decreased sequentially as age group increased (Adjusted Odds Ratio [AORs]: 1.9 [age 65–74 years] - 4.2 [age 18–34 years]), and was higher amongst binge drinkers (AOR, 1.5, p < 0.05). Associations between age group and suffering the direct harms anxiety, disrupted sleep, feeling threatened, property damage and emotional neglect were found. Experience of feeling threatened was lower amongst females (AOR 0.6, p < 0.05). In demographically adjusted analyses, low mental well-being was higher amongst those who had suffered alcohol-related financial issues (AOR 2.2, p < 0.001), emotional neglect (AOR 2.3, p < 0.01) and property damage (AOR 2.2, p < 0.05). Conclusion AHTOs place a large, although unequal burden on adults in Wales. Individuals' drinking patterns are associated with experience of AHTOs. Critically, experience of some harms is associated with low mental well-being.

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BackgroundInternationally, there is growing recognition of the harms that an individual’s alcohol consumption can cause to those around them (i.e. alcohol’s harms to others). In the United Kingdom, whilst there is some evidence of alcohol’s harms to others, further understanding is required to inform policy and practice that aims to address and prevent the wide breathe of alcohol-related harms.ObjectiveTo explore the nature, extent and frequency of alcohol’s harms to others in Wales.MethodsA cross-sectional telephone survey with 1 071 adults (aged 18+ years) resident in Wales. The survey exploring 18 categories of harm.Findings59.7% of adults had experienced at least one harm from someone else’s drinking in the last 12 months (equivalent to 1,460,151 adults). The most common harms experienced included feeling anxious at a social occasion (29.2%); being kept awake due to noise/disruption (29.0%); having a serious argument (20.3%); being let down (19.2%); feeling threatened (17.7%); and suffering emotional neglect (17.3%). Of those experiencing any harm in the last 12 months, 16.9% reported doing so on at least a weekly basis. Most often, those causing the harm were known to those experiencing the harm (20.3% were friends; 19.9% were family members outside the household; 19% were cohabiting partners). The risk of experiencing any harm in the past 12 months was higher in younger age groups. The risks of experiencing individual harms also varied by socio-demographic factors.Conclusion and policy implicationsThis study provides an initial overview of experience of alcohol’s harms to others amongst adults in Wales. Including alcohol’s harms to others in assessments of the burden of alcohol is crucial to understanding its broad impact, and ensuring that policies, regulations and interventions seek to prevent the harmful effects of alcohol to both the drinker and those who may be affected by their drinking.