Qualitative insights on alcohol and other drug consumption during COVID-19.

The novel coronavirus, COVID‐19, identified in January 2020, quickly spread around the world [1]. Measures adopted to minimise transmission of the virus have varied widely between and within countries, generating a range of unprecedented social and economic transformations. These have led to abrupt and significant changes to people's everyday lives, with profound implications for health and wellbeing. Of interest, and in some cases concern, to public health commentators and researchers has been the effects of the COVID‐19 pandemic on alcohol and, to a lesser degree, other drug consumption practices.

Since the pandemic began, a substantial body of scholarly literature on alcohol and other drug (AOD) consumption during COVID‐19 has been published (see, e.g., Drug and Alcohol Review's special collection, ‘COVID‐19 Research’, available from the journal homepage, https://onlinelibrary.wiley.com/journal/14653362). Within the research‐focused literature in particular, the majority has addressed quantitative shifts in consumption at the population level, as evident in a recent systematic review of empirical studies examining individual‐level changes in consumption in the early stages of the pandemic [2]. Acuff et al. [2] found 128 quantitative studies from 58 countries, with the authors concluding that the pandemic differentially affected drinking based on multiple individual and contextual level factors. At the time we conceived this special section (in early 2021) on qualitative insights on AOD consumption during COVID‐19, a Google Scholar search of ‘(alcohol or drug use) and COVID and qualitative’ yielded only 10 relevant peer‐reviewed articles. While the number of published qualitative research papers on AOD and COVID‐19 has since increased, quantitative research approaches remain overwhelmingly dominant. This special section was thus driven by a desire to redress the imbalance between quantitative and qualitative research on this topic, as well as to extend knowledge on COVID‐19 and AOD consumption relations and effects (see also [3, 4]). Moreover, noting the capacity of qualitative studies to provide the depth and nuance required to understand and better govern AOD consumption, we argue that illuminating complex experiences and providing context for quantitative observations is vital. Qualitative approaches especially allow us to critically examine taken‐for‐granted assumptions, unsettling tendencies and problematisations in ways that reveal new potentialities, complexities and constraints. As such, the five articles gathered in this special section attend to a diverse range of AOD consumption situations and contexts—drinking occasions, consumption within home settings, parents' perceptions of their children's awareness of drinking, the use of video conferencing services for AOD consumption social events during lockdowns, and service access for people who use or inject drugs. Together, these analyses enhance understanding of the effects of COVID‐19 on AOD use, and the multiple intersecting factors at play in shaping AOD consumption patterns and effects.

The paper by Caluzzi et al. [5] draws on data from an Australian study to provide a fine‐grained analysis of transformations in the constitution of drinking occasions under COVID‐19. Social changes brought on by the pandemic, they find, have ‘led to shifts in the temporal boundaries and contexts that would otherwise shape people's drinking, meaning drinking practices may be less bound by structures, norms, settings and rituals’ [5, p. 1267]. They use these observations to critically interrogate the widely deployed and static epidemiological concept of ‘drinking occasions’ that denotes ‘segmented period[s] of time where alcohol is consumed’ [p. 1267]. Through the contextual lens of COVID‐19, they show how the conventional constructions of ‘drinking occasions’ are limited in their ability to capture the intricacies and instabilities of drinking. This permeability of responsibilities, practices and boundaries is echoed throughout the studies described in this special section. It remains to be seen whether the transformations revealed by Caluzzi et al. will continue alongside other changes to routines and practices wrought by the COVID‐19 pandemic, but their analysis suggests considering drinking as a practice (following social practice theory) as an interesting avenue for future research.

Conroy and Nicholls' [6] exploration of changing and enduring drinking practices in the home during the pandemic attends to, and shows how engaging with, assemblages of human and non‐human actors can be generative in (amongst other things) addressing some of the constraints identified by Caluzzi et al. [5]. Their work demonstrates the significance, symbolic meanings and agency of the home—a place where most alcohol is known to be consumed in societies like present‐day Australia and the United Kingdom [7, 8]. Through analyses of alcohol's capacity to craft new atmospheres and environments, Conroy and Nicholls [6] show how human and non‐human assemblages encourage or mitigate different forms of consumption, with alcohol consumption shaping an array of possibilities within domestic spaces. They find that the proximity, accessibility and availability of alcoholic drinks in the home during lockdown prompted consumption as a means of re‐imagining domestic spaces as pleasurable and social. However, these same spaces could also be an inescapable reminder of consumption, encouraging reflection on drinking practices and potential decreases in consumption. As they suggest, although the COVID‐19 pandemic may be a unique and specific moment in time, these findings are ‘likely to illuminate wider trends’. As researchers give greater consideration to the affective and spatial affordances of the home, this may better inform future research and health promotion strategies.

Remaining in the domestic sphere, the paper by Cook et al. [9] takes an intimate look at the family unit during the lockdowns across Australia to showcase the intergenerational relations between changing drinking practices and developing knowledge. Through interviews with parents and carers, the authors explore how COVID‐19 influenced environments and situations where children were exposed to adults' alcohol consumption, and draw out the changes to children's alcohol‐related knowledge as a result. This work shows the depth and nuance of children's alcohol‐related knowledge from young ages, and how the home, and behaviours within the home, shape knowledge. Here, as with other papers in this section, context, space and proximity affect practices and relationships, leading to new observations and moments of learning for children, and new moments of reflection for parents. Like Conroy and Nicholls, Cook et al. [9] highlight the role of materials, including bottles and glassware, as an important part of the environment that people observed and interacted with. A central finding of this work is parents' concerns about the normativity and omnipresence of alcohol and the implications this has for children's engagements and knowledge of alcohol—a finding which merits further investigation.

Challenging narratives that problematise consumption while considering the capacity for AOD use to facilitate pleasure and signal a reprieve from responsibilities is a unique contribution of several articles in this special section. None more so than the contribution from Duncan et al. [10], which explicitly calls for ‘research and policy approaches that are sensitive to the affirmative potentials of digitally‐mediated AOD encounters’ [p. 1293]. Drawing on data gathered through ‘unfocused group discussions’ with three sets of friendship groups in Melbourne, Victoria, their analysis explores how video conferencing services became enmeshed in the making and remaking of AOD consumption routines under lockdown conditions. As part of the transformations brought about by social restrictions, digitally mediated AOD consumption events emerged as key sites in the (re)production of sociality. Here, drugs, digital technologies and the home were playfully woven through participants' efforts to re‐connect, foster wellbeing and produce pleasure. Such analysis foregrounds the affirmative potentials of digitally mediated AOD consumption while also highlighting the differential ways in which AOD practices transformed (and were transformed by) pandemic experiences.

Finally, shifting focus, the paper by Efunnuga et al. [11] considers the availability and distribution of resources in the context of COVID‐19 for people who use/inject drugs in Melbourne, Victoria. The authors observe that restrictions designed to reduce the spread of COVID‐19, in particular restricting travel to within 5km of home and night‐time curfews, had unintended consequences for people who use/inject drugs. These consequences included reduced access to sterile injection equipment and health services. The authors find that positive effects emerging from restrictions, such as increased takeaway doses of therapeutic prescriptions, have wide‐reaching potentialities; however, poor or disrupted communication processes emerged as constraints on service access. Efunnuga and colleagues' work [11] highlights variable effects of COVID‐19 restrictions on drug consumption patterns, which were intertwined with changing quality of available drugs and financial instabilities. As with other articles in the special section, the authors point out lessons to be learnt and applied more broadly (outside the context of COVID‐19), especially in light of the likelihood of social disruptions and crises in the future [12].

CONCLUSIONS

Taken together, these contributions provide detailed accounts of AOD consumption during the pandemic, extending quantitative studies and contributing to broader conversations on the sociocultural dimensions of AOD consumption. The research in these papers has explored the diverse ways AOD consumption has been implicated in and by the vast social, cultural and economic transformations occurring since the COVID‐19 pandemic began. More than a simple adjunct to quantitative research findings, however, the papers assembled here provide necessary and novel insights into the shifting dynamics and everyday experiences of AOD consumption under pandemic conditions. In this, they push us to conceive of AOD consumption in pluralistic ways—AOD consumption emerges across these accounts as an intimately and intensely social practice, a practice shot through with diverse meanings, affordances and effects. An example of this is alcohol helping to craft new atmospheres and environments in a time of distress through interactive networks of human and non‐human elements and forces. Such might be understood as exemplifying the critical contribution and potential of qualitative research approaches. By (re)situating AODs within their various social worlds, such approaches generate new modes of attention and deliberation. These in turn challenge us to re‐think and re‐configure how we problematise, intervene in and research AOD consumption, both during and beyond the COVID‐19 pandemic.

This body of research adapted to the existing COVID‐19 social restrictions by making use of technology and non‐traditional methodologies to obtain these insights. The home is cast as the site of primary focus in several of the included papers, although, as the studies find, the material space of the home may be mediated by technologies and relationships and transformed by the affordances offered by AOD use itself. It is worth acknowledging that the studies on which these papers are based do not focus on consumption spaces other than the home, nor do they reflect the experiences of non‐consumption/abstinence. They also only draw on experiences of AOD consumption within Australia and the United Kingdom, and do not explicitly focus on the implications of policy.

Although restrictions continue to ease and we are encouraged to ‘return to normal’, the pandemic will likely have lasting economic, social, environmental and health effects which may only be exacerbated by future crises and social disruptions [12]. Qualitative methodologies have a unique capacity to map these transformations and their implications for how we consume, experience and govern AOD consumption. Foregrounding these capacities through the qualitative research gathered here illustrates the multiple and complex relations and effects of AOD consumption during this unique period of social change. We hope that this special section will further provoke, inspire and cultivate efforts to engage in AOD knowledge production qualitatively.

AUTHOR CONTRIBUTIONS

MC led the manuscript writing. CW, GC, TD and RD provided critical feedback and assisted in revising the manuscript for publication.

CONFLICT OF INTEREST

None.