Published April 7, 2020 on Medium.com
https://medium.com/@lvchris/liquor-stores-as-essential-businesses-during-covid19-a-silentaffirmation-of-alcohol-dependence-29b979957cfb
Christopher Caulfield
Rensselaer Polytechnic Institute
Department of Science and Technology Studies
Troy NY
Liquor Stores as ‘Essential Businesses’ During COVID19: A Silent Affirmation of
Alcohol Dependence Brings the Stigmatization of Opioid Use into Sharp Relief
According to reporting by Reuters on March 20, 2020, liquor stores are considered “essential
businesses” under New York State emergency regulations, even while most retail and service
businesses are closed with exceptions for grocery stores, pharmacies, and limited others. The
exception carved out for liquor stores has received substantial press attention. According to
Reuters, “Liquor stores were not specified in Cuomo’s announcement, but New York’s State
Liquor Association quickly clarified: ‘Liquor stores have been deemed an essential business and
may remain open,’ the governing body posted on its website. ‘You do not need to reduce your
workforce’” (Kretser and Wu 2020). What are the silences implicit in these announcements, and
the implications for drug studies?
New York Governor Cuomo did not actually mention liquor stores in his announcement
of which businesses will be allowed to remain open, perhaps because it would have been
politically uncouth. The muted approval of liquor stores as ‘essential business’ is telling. New
York Government has defined an ‘essential business’ as “any business providing products or
services that are required to maintain the health, welfare and safety of the citizens of New York
State” (New York State Empire State Development 2020). How might liquor stores fit this
description of maintaining the health, welfare, and safety of citizens?
In this paper I suggest that the key unspoken premise of these announcements and silences is that
there is a large population who are dependent on alcohol and would go into withdrawal without a
steady supply. They would cause social disruption and emergency room visits during our current
moment of mass disruption by COVID19. Also unspoken is that New York State government
acknowledges people with alcohol dependence, and thinks it is ‘essential’ to keep those people
supplied. This author agrees with classing alcohol as essential business since alcohol withdrawal
is potentially lethal and the healthcare system needs all its resources focused on the COVID19
pandemic. The US demand for alcohol was demonstrated in the week ending March 21, 2020,
Nielsen reports, when alcohol sales rose 55% year-on-year, and sales of spirits like tequila, gin,
and pre-mixed cocktails rose 75%, as people stocked up before anticipated closures of liquor
stores in some states (CBSLA/AP 2020). Keeping the alcohol dependent out of withdrawal, and
out of already overburdened hospitals, is sound public policy.
Yet, another muted topic implicit in these announcements and silences is a dangerous
disconnect, ongoing for decades, with the way that opioid (and other substance) users are treated
in terms of their potential to go into withdrawal with potentially fatal consequences, in
comparison with the social attitude toward alcohol users. Opioid users too would require
medical care for withdrawal, or overdose, in an already overburdened healthcare system. The
stigmatization of people who use opioids is brought into sharp relief, as is the stigma associated
ith going to prison.
A refreshed look at public health, leveraging the urgency of the COVID crisis, supports a
policy of “safe supply” of drugs for opioid users (could be limited to persistent users over age 35,
as in the Netherlands) would protect people from accidentally overdosing on synthetics like
fentanyl (Bula 2020). Fentanyl, 50-100 times more potent than heroin, has caused a spike in
overdose deaths (CDC 2020). Fentanyl has been found laced into drugs sold as cocaine and
ecstasy, causing deaths amongst “party” users who do not intend to use opioids at all . Safe
supply would protect such casual drug users from accidental overdose, as well as those who
intentionally use opioids. Opioid users (and users of other substances) should have access to safe
supplies with safe places to use where they are protected from overdose and death, thereby
reducing burdens on our healthcare systems already struggling to address the COVID19
pandemic (Drucker et al. 2016; Epstein, Heilig, and Shaham 2018; Hood et al. 2019).
Echoing the American Society of Addiction Medicine, reducing the stigmatization of
opioid use is a key step to addressing an ongoing opioid crisis which claimed over 67,000
American lives in 2018 (Association 2015). The ‘war on drugs’, which is enacted as a war on
drug users, is a key driver of the construction of stigmatization of people who use drugs
chaotically (Buchanan and Young 2000). In a recent op-ed, harm reduction leaders Frederique &
Sue note how the war on drugs makes the COVID pandemic worse (Frederique and Sue 2020).
Overcrowded prisons are a disaster waiting to happen in the midst of a global pandemic. This
week of early April 2020 has seen several people die of COVID19 while in Federal prison for
drug offenses. This despite their having known underlying conditions and guidance to release
non-violent prisoners to reduce the risk of spreading COVID19 in overcrowded prisons. For
these individuals and their loved ones, action was not taken quickly enough.
Efforts to help people must do more than illustrate the world we want; we must also
address the structures of the world we don’t want. In order for us to do that, we need to upend a
war on drugs that has cemented the stigmatization of people who use certain substances, while
leaving users of alcohol normalized.
Joining Frederique & Sue, this paper calls for the adoption of evidence based harm
reduction policies like continued access to syringe services and naloxone distribution as essential
public health programs (Morgan and Jones 2018). Low-barrier access to drugs like
buprenorphine and methadone (Thomas et al. 2014). Deprioritize low-level drug enforcement so
fewer people are entering a justice system that is deeply racially biased (Mendoza, Rivera, and
Hansen 2018). Invest in housing policies that help people access the services they need by
expanding housing and shelter options paired with supportive wrap-around services (Greenwood,
Stefancic, and Tsemberis 2013). The confluence of the COVID pandemic and a war on drugs
that exacerbates the pandemic provides an urgent impetus for making substantial changes in drug
policies that would both destigmatize drug use and alleviate the opioid crisis for years to come
while mitigating the damages caused by the pandemic.
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