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1/ A disturbing trend during this time of isolation has been an increase in domestic violence reports. This piece argues that a solution to this would be to close liquor stores. I'll detail in this thread why I think that's a bad idea: https://www.bostonglobe.com/2020/04/02/opinion/ban-alcohol-sales-during-pandemic/
2/ First, closing liquor stores would overwhelm the healthcare system at the worst possible time. The piece minimizes the healthcare impact of closing liquor stores by noting that only 5% of people with alcohol use disorder would suffer life-threatening withdrawal symptoms.
3/ That 5% seems low to me and there's no citation for it, but let's go with it. Studies estimate that about 15-40 million American have alcohol addiction. Let's be conservative and go with the lowest number: 15 million. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics and https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2647079
4/ 5% of 15 million is 750,000. That means we'd need 750,000 hospital beds to treat just the most severe alcohol withdrawal if we stopped alcohol sales. The COVID crisis is expected to require 260,000 hospital beds, already leading to a 90,000 shortage. https://covid19.healthdata.org/projections
5/ That's not to mention all the people with mild/moderate withdrawal who'd need outpatient care at a time when clinics are closed. What's more, just treating someone for withdrawal doesn't cure alcohol addiction. Many would turn to moonshine or other drugs leading to more harm.
6/ The second reason this is a bad idea is that it'd hurt victims of violence. Victims of violence have high rates of substance use. One study found a 50% higher rate of substance use among victims of domestic violence compared to a matched control group. https://psycnet.apa.org/record/2006-22487-004
7/ Stopping alcohol sales may reduce use by perpetrators of violence, but it would also disproportionately harm victims of violence who at higher risk for addiction. Fortunately there are plenty of policy options to decrease domestic violence without these risks and downsides.
8/ Last point: we have better policy options available. Financial strain is a risk factor for both substance use and violence. Expanding financial, housing, and food assistance may be more effective at reducing domestic violence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973802/ and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3211962/
9/ We can and should also expand programs that address violence directly. Let's expand shelter capacity, ensure shelters can maintain physical distancing, develop innovative ways for victims to report abuse from home, and check in with known victims and known perpetrators.
10/ Domestic violence and risky drug use are urgent and intertwined problems that require thoughtful and comprehensive approaches. There's unfortunately no quick fix for either. Extreme changes in a time of crisis could risk harmful unintended consequences. We can do better. end
