Ms Paula Leonard:

I thank the committee for the opportunity to appear before it and for placing this issue on the agenda. I am here to reflect on some of the concerns of staff and volunteers and on the experiences of individuals and families who have been supported by Alcohol Forum Ireland over the past 18 months. Alcohol Forum Ireland is a charity that provides a range of supports and services to individuals and families across the Border counties of Cavan, Monaghan, Sligo, Leitrim and Donegal. We also work at the wider level to support communities across Ireland in changing and challenging Ireland's problematic relationship with alcohol. As such, I will also reflect on the work of the Irish Community Action on Alcohol Network, ICAAN, which comprises member organisations from 14 regional and local drugs and alcohol task forces, including some of the colleagues appearing from Ballymun.

The theme of this meeting allows us to reflect on and, I hope, respond to the challenges that have been faced by those struggling with alcohol and other drugs during the pandemic. They have struggled considerably, largely in silence, throughout the past 18 months. That cannot be overstated.

There is little doubt that alcohol is a major public health issue in Ireland. Before we all go to bed tonight, at least another three people will have lost their lives as a direct result of alcohol-related harm. Alcohol is implicated and present in more than 50% of all completed suicides in Ireland and in more than one third of all self-harm presentations. As a carcinogenic substance, it is a risk factor for at least seven different types of cancer. Unfortunately, we have the dubious record of being among the top five countries internationally for foetal alcohol spectrum disorders, which are lifelong and permanent disabilities that result from exposure to alcohol during pregnancy.

I will focus on a small number of areas. Since it is difficult to point to a significant health or social issue in Ireland in which alcohol does not play a role, I will limit myself to the impact of Covid-19 on alcohol consumption, the challenges that have been faced by family members, including domestic violence, and the increased challenges for those living with alcohol-related brain injuries and their families.

In terms of the wider picture, we are seeing emerging research that acknowledges that alcohol is an immunosuppressant and that people with substance use disorders are particularly vulnerable to contracting Covid, more likely to suffer from a greater psychosocial burden, and at a greater risk of worse Covid-19 outcomes in the long term. At grassroots level, we were hearing early on that local services were concerned by the volume of alcohol that was being consumed by clients, which was associated with anxiety, isolation and deteriorating mental health.

We were also concerned about the proliferation of drink delivery services and how deliveries, particularly those from 24-hour drink delivery services, were contributing to high-risk drinking occasions and about youth access to alcohol.

According to the Revenue Commissioners, alcohol consumption in Ireland decreased by 6.5% during 2020. That is a relatively small decline when one considers that on-trade sector was fully closed for five months and wet pubs were closed for nine months. Off-licences were classified as an essential business and remained open throughout the most strict period of Ireland’s lockdown. There was a steep increase in off-trade alcohol sales with sales data from Nielsen showing that within the first four weeks of lockdown we spent €158 million on take-home alcohol. That was an increase of 44% on the same period in 2019. What is important to highlight is that there was no single one way in which people’s drinking behaviours were impacted by the pandemic. Some evidence is emerging that many reduced their consumption or stopped drinking entirely. What we have seen emerging is a worrying picture of increased bingeing and increased consumption among certain groups, although it is too early to say what the long-term impact on our drinking behaviours in Ireland will be. In my written statement I outlined a number of studies which estimate that between 20% and 30% of people reported either reducing their alcohol consumption or stopping drinking entirely during the pandemic. Therefore, questions arise about those who were drinking and drinking significantly more.

In April 2020, the CSO carried out a survey which reported that 22% of those who consume alcohol said their consumption had increased. The highest increases were reported among those who felt downhearted, depressed or lonely at least some of the time in the previous four weeks. In May 2020, the Irish Community Action on Alcohol Network, ICAAN, and the Alcohol Forum Ireland undertook a Red C poll. We found one third of adults reported they had increased their consumption. Most worryingly, 37% of those with children said they had increased their consumption and 9% of those, roughly one tenth of families, said that they had increased their consumption significantly during this period. That raises concern about children's increased exposure to alcohol consumption in the home and what the long-term impacts of the period will be on their health and well-being.

In September 2020, the Global Drug Survey indicated that half of people had been drinking more frequently, earlier in the day and had increased the number of days on which they drank. Some 20% of those people said that was because they felt lonely or depressed and 30% said they were drinking more as a way of coping with the pandemic. While it is still to early to tell the full impact of this what we are seeing emerging is an increase in home drinking, which is unregulated with no closing hours and increased exposure to children of alcohol consumption in the home. Very worryingly, we are seeing an increase in drinking that is associated with stress, loneliness and isolation.

Drink deliveries have been a concern in Ireland, even at a policy level, for more than a decade, but the speed with which this practice grew during the pandemic could not have been predicted. During the past year, ICAAN network members have raised concerns relating to underage access, with young people having alcohol delivered to lockdown parties, parks and beaches without any effective age verification. Concern is also growing about the use of these services by people who are drinking alone and by those who have alcohol dependency issues.

It is important for members to note there is no definition of drink deliveries in Irish licensing law and while on- and off-licences can legally deliver alcohol to customers there are loopholes in the existing code, which mean age verification and the responsibility of licence holders not to sell to those who are so intoxicated they could be a risk to themselves and others are difficult to ensure in a drink delivery situation. Section 9 of Public Health (Alcohol) Act states clearly that alcohol must be sold, paid for and the contract completed before it leaves the licensed premises, which means, in effect, licence holders have to sell the alcohol before they have eyes on and can verify the age or lack of intoxication of the customer. While Irish licensing law is very clear on the hours when alcohol can be sold, there is no stipulation in alcohol licensing law around the hours at which it can be delivered. Within this unregulated environment, we have also witnessed the growth of unlicensed 24-hour dial-a-drink services that are widely advertised online, operating outside the law and hiding in plain sight. It is very easy to look at Facebook or a range of other social media platforms and find quite a number of these on any given day in Ireland.

I wish to refer to the impact increased alcohol consumption has had on families. When parents misuse substances it can and does cause serious harm to children and it is extremely important parents experiencing difficulties receive timely, compassionate and non-judgmental support. Not all parents who misuse substances experience difficulties with parenting capacity and not all children exposed to parental substance misuse are affected adversely either in the short or long term. However, most children exposed to parental alcohol misuse will need some form of support. Unfortunately, children are often the silent witnesses to domestic violence. Lockdowns and social restrictions came with heightened risk of children witnessing, experiencing and, very worryingly, perpetrating violence and abuse. Alcohol is a factor in one in three of the most serious domestic violence cases in Ireland. It is not the cause of domestic violence, but it can act to remove inhibitions in carrying out the abuse and can be used by perpetrators as an excuse for their behaviour, a way for denying responsibility. There is also international evidence that alcohol use increases both the frequency of violence and the and severity of intimate partner violence. While we do not have any Irish research in this area to date, a study in Australia found that 51% of its support services working with victims of domestic violence reported increased involvement of alcohol as a stressor in family violence situations since restrictions were introduced. In Ireland there has been much concern about the increase in reported domestic violence incidents during Covid but the role of alcohol has received relatively little attention.

In our family programmes we saw the duration of time family spent together increased during the pandemic, substance use increased, peers, friends, colleagues and other professional support was limited to virtual or to no support. The primary reasons for referral to our family support services during the pandemic were substance use, violence and mental health. Particularly prevalent was parent to parent violence but also significant was child to parent violence. Alcohol Forum Ireland has been using the non-violent resistance response, NVR, since 2018. NVR is a brief, systemic and cognitive behavioural response to child to parent violence. During Covid we have also seen that the isolation and shame parents who are experiencing violence from their children increased.

in 2020, Parentline noted a significant increase in the number of calls in which it was reported that anger and aggression from a child was the main reason for the call.