Think before you drink...

The lifting of the prohibition of the sale of alcohol 

The South African Network of People Who Use Drugs (SANPUD) note with alarm the significant size of the crowds that have gathered outside of retail liquor outlets and the celebratory atmosphere accompanying them. On 1st of June 2020, South Africa moved from ‘level 4’ to ‘level 3’ restrictions promulgated by the government in response to the SARS-Cov-2 pandemic. ​

Principle among the regulatory changes accompanying the shift in levels is the hiatus on the temporary prohibition of the purchasing of alcoholic beverages, which has been in force for the last two months. While the prohibitionist framework that was suddenly put in place with the declaration of a national disaster by the President on the 15th of March 2020 was in itself extremely problematic, the unstructured and seemingly uncontrolled suspension of the prohibition is equally as dangerous. This danger can be both witnessed socially in the vast crowds of people that have gathered at the doors of many liquor outlets, thus enabling the transmission of the SARS-Cov-2 virus, and may well result in several individual cases of over-consumption and alcohol poisoning.

Concerning the first danger; despite the efforts of some retailers to enforce social distancing procedures, the mass gathering of people enables the spread of the SARS-Cov-2 virus. Pictures and videos in the media reveal the large crowds surrounding many liquor retail outlets, making it difficult if not impossible to accurately maintain the distances required to limit infection. The crowds also impact on retailers ability to ensure the levels of sanitation required are upheld. It is almost certain that infection rates will increase as a direct result of this, all of which will be indicative of the simplistic manner in which the government has both prohibited and now allowed once more the sale of alcohol. ​

Secondly, there is significant danger in the sudden availability of alcoholic beverages leading to cases of alcohol poisoning. With the length of the prohibition in mind, many individuals have likely lost their tolerances to alcohol consumption. Suddenly allowing unbridled consumption once more will impact on the ability of individuals to metabolise the alcohol and loss of functional tolerance leading to increased levels of drunkenness, and as mentioned, potentially vast numbers of cases of alcohol poisoning. Loss of tolerance and the simultaneous lifting of the curfew and the ban on alcohol will undoubtedly lead to a rise in motor vehicle accidents. Such unnecessary demands on the health care system at present are obvious.

oncerning the first danger; despite the efforts of some retailers to enforce social distancing procedures, the mass gathering of people enables the spread of the SARS-Cov-2 virus. Pictures and videos in the media reveal the large crowds surrounding many liquor retail outlets, making it difficult if not impossible to accurately maintain the distances required to limit infection. The crowds also impact on retailers ability to ensure the levels of sanitation required are upheld. It is almost certain that infection rates will increase as a direct result of this, all of which will be indicative of the simplistic manner in which the government has both prohibited and now allowed once more the sale of alcohol. 
 
Secondly, there is significant danger in the sudden availability of alcoholic beverages leading to cases of alcohol poisoning. With the length of the prohibition in mind, many individuals have likely lost their tolerances to alcohol consumption. Suddenly allowing unbridled consumption once more will impact on the ability of individuals to metabolise the alcohol and loss of functional tolerance leading to increased levels of drunkenness, and as mentioned, potentially vast numbers of cases of alcohol poisoning. Loss of tolerance and the simultaneous lifting of the curfew and the ban on alcohol will undoubtedly lead to a rise in motor vehicle accidents. Such unnecessary demands on the health care system at present are obvious.  

The COVID-19 restrictions on alcohol may have been well intended. Past research shows alcohol consumption leads to more severe lung diseases, like adult respiratory distress syndrome (ARDS) and other pulmonary diseases, including pneumonia, tuberculosis, and respiratory syncytial virus.
However, the immediate ban on sales of alcohol, and the rapid resumption of sales have both caused harm. A unique opportunity to reduce alcohol consumption in a sustainable way was, we believe, missed.
 
Rather than ban the sale of alcohol out-right, a step that placed alcohol dependent people at risk of delirium and death, fuelled the production of unregulated alcohol and profits for criminal enterprise; the sales of alcohol could have been restricted to certain times and volumes, the sizes of containers reduced, the advertising of alcohol banned and help-lines and support services for people wanting to reduce their drinking established.  
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For people who are resuming their alcohol consumption, we offer the following advice to reduce the potential harms:

1. Be aware that your tolerance has decreased and your risks increased. You cannot resume previous patterns and volumes of alcohol consumption without potentially endangering yourself and others.
2. Switch to beverages with lower alcohol content.
3. Never drive after consuming any amount of alcohol.
4. If you are drinking, remain vigilant and aware of your behaviour and adhere to the COVID Best practice guidelines regarding hand hygiene and sanitizers
5. Drink a glass of water between each alcoholic beverage, this helps the body remain hydrated and assists the kidneys to filter the harmful ethanol from the body. 

SANPUD has put together some resources to stop change your patterns of alcohol use here.

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