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ID: 453

Type of submission: Oral

Conference track: Research

Topics: Homelessness, Housing and Harm Reduction; Innovative Harm Reduction Programmes

Presenting author: Bernie Pauly

Presenting author biography:

Bernie Pauly is an Associate Professor (Nursing), Scientist (Centre for Addictions Research of BC), a University of Victoria Provost's Community Engaged Scholar and Island Health Scholar in Residence. Her research focuses on a public health approach to reducing the harms of homelessness and substance use.

Managed Alcohol Programs: Current Evidence, Effectiveness and Implementation of Innovative Alcohol harm Reduction Programs

Bernie Pauly, Tim Stockwell, Ashley Wettlauffer, Clifton Chow, Kate Vallance, Erin Gray, Josh Evans, Rebecca Schiff, Andrew Ivsins, Alexis Crabtree, Bonnie Krysowaty, Meaghan Brown, Vicky Stergiopoulos

Managed alcohol programs (MAPs) are a harm reduction response to the health and safety problems associated with heavy drinking episodes, non-beverage alcohol use and homelessness without requiring abstinence or reductions in use. These programs are rapidly developing throughout Canada. Canadian MAPs incorporate an alcohol intervention alongside housing and other programming with a primary goal of preventing the harms of substance use.

Methodology: The Canadian National study of MAPs is a mixed method evaluation initiated in 2013 by the Centre for Addictions Research of British Columbia. The goal is to rigorously evaluate the outcomes, impacts and implementation of MAPs in Canada.
We are conducting longitudinal analysis of survey responses from cohorts of 364 MAP participants and controls regarding alcohol consumption, alcohol related harms, non beverage use, health, housing satisfaction and quality of life across 6 MAP sites. Qualitative interviews were conducted with more than 80 MAP participants and staff and analyzed using situational analysis. As well, an environmental scan and economic costing study were completed.

Results: Preliminary analyses indicate significant changes in patterns of alcohol use, reductions in harms, and decreases in use of non-beverage alcohol for MAP participants compared with controls. MAP participants were more likely to retain their housing and to report feelings of safety and well-being. Economic benefits were evident in a pilot analysis through reduced use of police and health services. In this workshop, we will provide an overview of Canadian MAPs and national study research methodology, outcomes related to alcohol use and related harms, participant perceptions of the program and the extent to which medications that reduce alcohol cravings are incorporated into programming.

Conclusions: Overall, MAPs were found to be effective in reducing the harms of alcohol and provide an alternative to abstinence-based treatment for a specific group of people experiencing severe alcohol dependence and homelessness.