A qualitative exploration of triggers for alcohol use and access to support during the COVID ‐19 pandemic among people identifying as problem drinkers in the United Kingdom

Introduction
A polarisation of drinking behaviour was observed during the coronavirus disease (COVID-19) pandemic, with some people reported to be drinking more alcohol and others less. We aimed to understand how and why the COVID-19 pandemic and associated restrictions impacted alcohol use and access to support and services during this time.

Methods
We conducted semi-structured qualitative interviews with 27 participants, including 20 people identifying as problem drinkers and seven alcohol service providers. Data were analysed using thematic analysis.

Results
We identified two main triggers for alcohol use during the pandemic: (i) loss of daily routine and activity resulted in drinking to cope with social isolation and boredom; and (ii) drinking alleviated feelings of fear, anxiety and anger over the imposition of pandemic restrictions. Regarding access to services, two main themes were generated: (i) remote service provision was perceived as inferior to in-person services; and (ii) the need to offer choice and flexibility in how services were provided, with service providers reporting more positive experiences of online and telephone service delivery than service users.

Discussion and Conclusions
This study provides new insights into potential triggers for alcohol use among people identifying as problem drinkers during the COVID-19 pandemic. The acceptability of remote forms of service provision were dependent on service user access to, and comfort with using technology. Hybrid delivery models may therefore be suitable in some but not all circumstances, and efforts should be made to promote equitable access to services.