The Hidden Impact: How COVID-19 Transformed Substance Use and UK Rehab Trends

The COVID-19 pandemic caused major changes in how people in the UK used drugs and alcohol, revealing the ways individuals responded to stress, isolation, and uncertainty. When public spaces such as pubs and clubs closed, many people turned to substances at home as a way to manage their emotions and routines.

The link between mental health and the pandemic created serious challenges for addiction services across the country. Healthcare professionals reported shifts in both the types of substances being used and how people accessed support. These changes have left a lasting impact that continues to shape the landscape of substance use in Britain in 2025.

This article takes a closer look at how the pandemic reshaped patterns of substance use across the UK, starting from the early lockdowns through to the recovery period. It outlines shifts in consumption habits, updates to treatment delivery, and the long-term pressures on healthcare systems.

Substance Use in the UK Before COVID-19

Even before the pandemic, substance use in the UK was a major concern. The illegal drug trade was worth close to £10 billion annually and involved around three million users.

Common Substances and Usage Trends

Cannabis was the most widely used illegal drug, with 7.8 percent of adults aged 16 to 59 reporting recent use. Powder cocaine followed, used by 2.6 percent of people in this age group. Alcohol misuse was another major issue, with an estimated 586,780 people in England living with alcohol dependence. Only 18 percent of these individuals were receiving treatment.

Among adults seeking support, four main categories emerged. The largest group were opiate users, accounting for 51 percent of those in treatment. Alcohol-related treatment made up 28 percent. Men made up the majority of all groups in treatment, although the gender split for alcohol-related issues was closer, with women representing 42 percent.

Regional Differences

Substance use patterns varied significantly between regions. Northern England saw higher levels of cannabis, ecstasy, and over-the-counter drug misuse. In the South, Brighton became a hotspot for cocaine and ketamine use. Merseyside recorded the highest drug offence rate, with 9.2 offences per 1,000 residents. There was a strong link between poverty and drug harm. People in the most deprived areas were five times more likely to be admitted to hospital due to drug-related issues compared to those in wealthier areas.

Limitations in the Treatment System

The UK’s addiction services were already under pressure before the pandemic began. Since 2013, drug and alcohol treatment funding in England had fallen by 27 percent after inflation adjustment. These cuts hit several key services, including:

• Detox facilities for inpatient care

• Residential rehabilitation centres

• Youth-specific programmes

• Treatment options for stimulant and cannabis use

  
  

The system could not meet the demand. Eighty-two percent of people needing help for alcohol dependence received no treatment. The same was true for 58 percent of opiate users and 47 percent of crack cocaine users.

There were also issues with staffing. Addiction psychiatry training positions had fallen by 60 percent since 2006. A shrinking, overworked workforce led to reduced service quality and fewer available appointments. Local authorities, which had been responsible for commissioning services since 2012, often had fewer resources. For example, Birmingham cut its addiction services budget from £26 million to £19 million in just one year.

Immediate Effects of Lockdowns (2020 to 2021)

The first year of the pandemic brought rapid and wide-ranging changes in how people used substances.

Alcohol Sales Spiked at the Start

When lockdown was introduced in March 2020, alcohol sales through supermarkets rose by 22 percent. Sales in off-licences increased even more, jumping 31.4 percent. In just four weeks, spending on alcohol passed £1.1 billion. However, with bars and pubs closed, overall alcohol consumption decreased because around 73 percent of drinking usually occurred in those venues.

Drug Supply Disruption and the Rise of Online Buying

The supply of illegal drugs became unreliable. Social distancing limited contact with dealers, and getting access to substances became more difficult. The number of users unable to reach suppliers grew from 34 percent at the beginning of lockdown to 41 percent after restrictions began to ease. More than 10 percent of drug purchases shifted to darknet platforms, and 13 percent of those buyers were using them for the first time. Cannabis continued to be the most purchased drug, making up 70 percent of all buys.

Misuse of Prescription Medications Increased

Due to reduced access to healthcare and fears about infection, more people started self-medicating. Benzodiazepines were the most commonly misused prescription drugs, followed by codeine and tramadol. Use of fentanyl also increased during this time.

Coping with Anxiety, Isolation, and Mental Health Strain

Lockdowns caused widespread stress and emotional fatigue. People dealing with high levels of COVID-related anxiety were more likely to misuse alcohol, drugs, or engage in gambling. Over half of survey respondents said they used these methods to deal with mental health challenges. Prescription drug misuse rose in people under 25, while those aged 25 to 35 reported a decrease. Pharmacies blocked around 80 percent of suspected inappropriate purchases. Issues such as withdrawal symptoms and needle sharing also became more frequent, while services quickly moved to online formats.

How the NHS Responded

To continue supporting people during the crisis, the NHS made several key changes to addiction services.

Remote Support Became Standard

Healthcare delivery shifted to online platforms. Although many staff had no previous experience with virtual care, telehealth allowed stable patients to stay engaged. Group sessions were still possible online, but the lack of body language and limited access to devices made building connections more difficult for some.

Updated Rules for Opioid Prescribing

To reduce the need for face-to-face visits, new guidelines gave patients more flexibility when accessing methadone and buprenorphine. These were prescribed following risk assessments. Buprenorphine was found to be safer, while relaxed methadone rules led to a rise in overdose deaths.

Staffing Shortages Created Service Gaps

Important services such as supervised medication use and hepatitis screenings were paused due to staffing shortages. Many organisations did not have emergency plans in place, and struggled to reassign staff or train replacements. By April 2020, staff sickness related to mental health had reached the highest level in a decade.

The Recovery Period (2022 to 2023)

As lockdowns ended, new patterns emerged in substance use across the UK.

Social Drinking Returned

With bars and restaurants reopening, around 40 percent of adults said they planned to go out more often. Young adults were especially likely to return to social venues. However, the rising cost of living during 2022 and 2023 reduced overall alcohol sales despite this renewed interest in going out.

Changes in Drug Use Among Youth

Cannabis remained the most common reason for young people entering treatment. Use of ketamine increased among youth, and in some cases, more people were being treated for it than for cocaine. Mental health issues were also being reported more often. Nearly half of all young people in treatment had a mental health diagnosis, with girls reporting issues more often than boys.

Long COVID and the Pain Management Crisis

People with long COVID developed new and ongoing pain issues, including joint pain, nerve problems, and fatigue. Those with chronic pain before the pandemic saw their symptoms worsen, especially if their sleep was disrupted. At the same time, pain services became harder to access, creating delays and complications in treatment.

The Current State of Substance Use in 2025

New data gives a clearer picture of how the pandemic’s impact continues to play out across the country.

Alcohol and Drug Trends

There were 8,274 alcohol-related deaths in 2023, most linked to liver damage. This figure represents a 63.8 percent increase compared to 2006. Around 2.9 million people aged 16 to 59 said they had used drugs in the past year. Cannabis remained the most commonly used substance, with 6.8 percent reporting use. Drug-related deaths reached 5,448 across England and Wales. Between April 2022 and March 2023, 291,000 people entered treatment for opiate or alcohol issues.

Shifts in User Demographics

Although drug use remained most common among those aged 16 to 24, older adults showed rising rates as well. Alcohol-related deaths were more common in men. Among younger people entering treatment, girls were more likely to report co-existing mental health concerns. The average age for starting treatment was 16.

Key Differences Compared to Pre-COVID Period

Hospital visits and deaths caused by alcohol have increased. More people are being treated for ketamine use than for cocaine. Inhalant misuse, including substances like nitrous oxide, is also on the rise. Many young people in treatment are being referred by schools. Mental health concerns are more common than before the pandemic.

Why UK Rehab Clients Are Seeking Help Overseas

Many people are now looking beyond the UK rehab system for addiction treatment. Long wait times and under-resourced NHS services have led individuals to explore international options for faster, more comprehensive care.

At The Beekeeper House, we have seen a growing number of clients from the UK choosing our residential treatment services. Located in the quiet mountains near Chiang Mai, Thailand, our facility offers a calm and private setting for those looking to escape everyday stressors. We provide evidence-based care for mental health and substance issues, delivered by an experienced and compassionate team.

People choose The Beekeeper House because we offer tailored treatment, deep psychological support, and a setting that promotes true healing. Our programmes are often more affordable than private care in the UK, even with travel

expenses included. Our focus on holistic well-being, trauma-informed therapy, and long-term recovery makes us a trusted choice for individuals ready to take a meaningful step toward a healthier life.

Final Thoughts

COVID-19 changed the face of substance use in the UK. Alcohol deaths have reached historic highs, and mental health problems are playing a greater role in substance use among the younger population. While some social habits have returned to normal, drug misuse at home and the misuse of prescription medications have become more common.

The NHS adapted quickly by using telehealth and flexible treatment models, but challenges remain with staffing, access, and mental health support. Ketamine-related cases now exceed those linked to cocaine, and inhalant misuse continues to grow.

Looking ahead, the UK must modernise its approach to addiction and mental health. That means improving mental health services, ensuring treatment is easy to access, and securing reliable funding to keep up with demand.