People with sight loss who have problems with drink or drugs struggle to cope with inadequate support, says new research, UK

People with sight loss who have problems with drink or drugs are unable to get adequate support because services, both for sight loss and substance use are not equipped to deal with both concerns, says a new study released today. Alcohol and other drug use can be a mechanism for coping with sight loss says the study: Alcohol, other Drugs and Sight Loss: A Scoping Study ⁽¹⁾, yet neither of the two services currently monitor for the 'other' concern.

"The individual practitioners we spoke to do their best but they are operating with systems and structures that do not routinely consider the 'other' issue as part of their remit," says Professor Sarah Galvani, from Manchester Metropolitan University, who led the research. "Until this changes, the services people receive are likely to be at best, lacking and at worst failing them completely."

The study, released by the sight loss charity Thomas Pocklington Trust ⁽²⁾ and Alcohol Research UK ⁽³⁾, combines the personal stories of people with sight loss with existing research to investigate the links between sight loss and the problematic use of alcohol and drugs.

In previous research the voices of people living or working with both concerns have rarely been heard, but in this study a clear picture emerged. Some people are struggling to cope with both sight loss and substance use with very little support; while professionals feel that they are not equipped with the knowledge or resources to deal with both issues.

The professionals were aware that a combination of sight loss and substance use worsened the challenges already being faced by the people they worked with, but most admitted ignorance about the 'other' concern. Many reported that working with sight loss and substance use was challenging and outside their remit, although most responded as best they could whenever it arose. It was found that many sight loss professionals did not, and would not, ask about a person's substance use unless it was obvious or the person raised it. Similarly, professionals working in the drug and alcohol sector did not ask about sight loss.

In evidence from around the world, substance use is repeatedly mentioned alongside sight loss: some people believe or have been told that their substance use, mostly alcohol, has contributed to their sight loss; others have turned to alcohol and drugs to cope with sight loss.

Currently there is not enough evidence to prove that substance use is the cause of some eye conditions. Whichever came first - alcohol or sight loss - the study shows that people struggling with both concerns need better support.

• Families and carers can be driven away by a person's use of drink or drugs, increasing the isolation already felt by people as a result of their sight loss.
• Access to services is made more difficult by the influence of drugs or alcohol. People sometimes feel too ashamed to seek help. Others may be denied services because, for example, they were not deemed able to take on board advice or to care properly for a guide dog. Professionals also said they worried about safety - both their own and that of the client.
• Access to services is particularly important as the study suggests that substance use could be a risk factor for some forms of sight loss when combined with smoking ⁽⁴⁾, or poor nutrition, for example, and that, where this is the case, early intervention is vital to maximise a person's chance of improving their sight.

The study found that people with sight loss tend to drink less than their sighted peers and that the number of people seeking support for combined sight loss and substance use is small. However, this small number poses disproportionate challenges for professionals, taking much of their time and energy. The report suggests that forming local partnerships could help services to meet these challenges and concludes that professionals in both services need the following:

• Education and training to understand and be able to respond to the combination of sight loss and substance use.
• Guidance on early interventions that might reduce harm.
• Mechanisms for routine monitoring so that substance use services screen for sight loss and vice versa.
• Resources and materials about the relationship between substance use and sight loss.

Dr. Catherine Dennison, Head of Research, Health and Wellbeing, Thomas Pocklington Trust says: "This study shows that there is a gap in the support provided to people living with both sight loss and substance use. Pocklington plans to tackle that lack of knowledge with new guidance and materials for professionals but we hope the study will also encourage services to work more closely together and plug the gaps this study has exposed."

Dr James Nicholls, Director of Research and Policy Development, Alcohol Research UK says: 'This important new study addresses a problem that can easily pass below the radar for both substance use services and sight loss specialists. It is clear that processes for identifying and supporting people with sight loss and substance use issues need to improved, and service providers need as much support as possible to achieve this. This report represents a significant step towards better understanding of these issues. It will provide a spur to both further research and the development of improved services and treatment where they are needed.'