The climate has changed – the last 11 years were the hottest on record, and each decade since the 1980s has been hotter than the previous one. The United Kingdom (UK) experienced its warmest ever year in 2025, as well as dry conditions in spring and summer, and severe storms. Globally, extreme weather events such as floods, fires, storms, and heatwaves are becoming more frequent and severe, while longer-term changes like rising temperatures and shifting rainfall patterns create ongoing pressure on communities and systems. Climate change is already affecting many parts of everyday life, including people’s health, mental wellbeing, housing, income, and access to support services. People experiencing disadvantage, including many of those who access alcohol and other drug (AoD) services, are likely to experience more acute impacts. This has been found in many countries, including the UK, and it is an especially apparent extreme risk in regions that are vulnerable to disasters such as floods and fires.
AoD services support people who are often already experiencing crisis, distress, and multiple forms of disadvantage. At the same time, the AoD sector itself is constrained by limited funding. This makes it hard for services to plan for the complex and evolving challenges climate change brings. Despite this, we have argued that alcohol and other drug (AoD) services have a critical role in supporting service users to adapt to life in a changing climate. Here, we summarise this argument.
How climate change affects people who use alcohol and other drugs
People with intensive or dependent patterns of substance use may also have to contend with poor physical or mental health, low income, insecure housing or homelessness, limited social support, and reliance on under-resourced services. These disadvantages interact to make people more vulnerable to climate risks.
Many people who use AoD experience stigma. During disasters that occur more frequently as the climate warms, this can become more harmful. Some people avoid shelters or health services because they fear being turned away or treated badly. Others have reported being denied access to emergency shelters or delayed care because they were seen as ’difficult’. This leaves them exposed to danger during extreme weather events.
In a review of past studies, we found that people who use AoD are impacted by climate change in specific ways. Exposure to events such as fires and other extreme weather events leads to increased substance use for some people. Researchers identified a 185% increase in alcohol consumption after Hurricane Katrina in the United States. Conversely, substance use can decline after disasters. After Hurricane Katrina, people who were relocated to Houston and were dependent on illegal drugs were forced into sudden withdrawal when access was disrupted.
People who use alcohol, opioids, and stimulants are also more physically vulnerable to heat-related illness or death. In a UK sample, people with a primary diagnosis of substance use disorder, along with younger patients, were most likely to die in a heatwave. Mental health issues such as climate grief, anxiety, depression, and trauma may worsen as climate-related stress increases, making it harder for people to manage substance use. A study conducted in Vietnam found that people who used psychoactive substances were at higher risk of mental health disorder hospitalisation after heatwaves.
Climate change is already impacting drug markets. Beyond disrupted supply during emergencies, climate change threatens the production of AoD. For example, alcohol and cannabis crops are sensitive to heat, drought, and smoke from fires, potentially making them harder to get in the future. As traditional agriculture becomes harder, farmers may shift toward illicit drug production, while AoD users may turn towards less climate-sensitive synthetic drugs. These combined changes could significantly alter drug availability and related harms.
How climate change affects AoD services and staff
Climate change affects AoD services directly. Extreme weather can damage buildings, cut power, disrupt transport, and interrupt supply chains. This can prevent services from operating just when demand is increasing. Access to opioid treatments may be disrupted. At the same time, more people may need help due to stress, trauma, or changes in substance use. In Australia, pharmacies closed or reduced opening hours after a flood and those that remained open were unable to cope with demand.
Staff working in AoD services are not immune to these impacts. They may experience damage to their own homes, health problems from smoke or heat, and increased anxiety about the future. During disasters, staff need to support highly distressed clients while dealing with their own losses. Demand for health and welfare services rises while staff availability drops, placing enormous pressure on those who remain.
What can be done?
Climate change adaptation means taking action to reduce risks and adjust to actual and expected climate and its impacts. This requires planning at multiple levels, as outlined in more detail in a recent editorial.
Governments play a crucial role by developing climate adaptation plans for health and welfare services, updating disaster response systems, coordinating across agencies, and protecting worker wellbeing. Services themselves can assess risks to buildings, supply chains, and operations, improve coordination with other agencies, and train staff to understand how climate change affects service users.
Many community-based initiatives that are not AoD-specific are needed, such as affordable heat-safe housing, access to green spaces, food security programs, and open public shelters. Helping people develop social networks and peer support makes them more resilient to impacts of climate change.
Specific AoD-focused responses are also needed. Emergency plans should ensure continuity of care, including access to medications during disasters. Dedicated shelters that welcome people who use drugs, rather than excluding them, can reduce harm. Outreach during heatwaves, transport assistance, flexible treatment arrangements, and mental health support can all make a difference.
A call-to-action
Climate change is already worsening health and social inequalities, including for people who use AoD. Escalating future disruption is predicted, involving increased impact on weather and rising sea levels, leading to ecological damage, diseases, disrupted livelihoods, food scarcity, pandemics, and displacement, that will affect AoD users and services in complex ways. Services need proper funding, support, and leadership to plan proactively. At the same time, we must all advocate for action to reduce emissions and support a fair transition to a low-carbon future.
Written by Professor Sarah MacLean, Social Work and Social Policy and the Centre for Alcohol Policy Research (CAPR), Dr Megan Cook, CAPR, and Dr Lisa de Kleyn and Professor Lauren Rickards, Climate Change Adaptation Lab, La Trobe University.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.