Do managed alcohol programs change patterns of alcohol consumption and reduce related harm? A pilot study

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dc.contributor.author Vallance, Kate
dc.contributor.author Stockwell, Tim
dc.contributor.author Pauly, Bernie
dc.contributor.author Chow, Clifton
dc.contributor.author Gray, Erin
dc.contributor.author Krysowaty, Bonnie
dc.contributor.author Perkin, Kathleen
dc.contributor.author Zhao, Jinhui
dc.date.accessioned 2017-08-29T16:45:53Z
dc.date.available 2017-08-29T16:45:53Z
dc.date.copyright 2016 en_US
dc.date.issued 2016
dc.identifier.citation Vallance, K., Stockwell, T., Pauly, B., Chow, C., Gray, E., Krysowaty, B., … Zhao, J. (2016). Do managed alcohol programs change patterns of alcohol consumption and reduce related harm? A pilot study. Harm Reduction Journal, 13(13), 1-11. en_US
dc.identifier.uri http://dx.doi.org/10.1186/s12954-016-0103-4
dc.identifier.uri http://hdl.handle.net/1828/8487
dc.description.abstract Background: Managed alcohol programs (MAPs) are a harm reduction strategy for people with severe alcohol dependence and unstable housing. MAPs provide controlled access to alcohol usually alongside accommodation, meals, and other supports. Patterns of alcohol consumption and related harms among MAP participants and controls from a homeless shelter in Thunder Bay, Ontario, were investigated in 2013. Methods: Structured interviews were conducted with 18 MAP and 20 control participants assessed as alcohol dependent with most using non-beverage alcohol (NBA). Qualitative interviews were conducted with seven participants and four MAP staff concerning perceptions and experiences of the program. Program alcohol consumption records were obtained for MAP participants, and records of police contacts and use of health services were obtained for participants and controls. Some participants’ liver function test (LFT) results were available for before and after MAP entry. Results: Compared with periods off the MAP, MAP participants had 41 % fewer police contacts, 33 % fewer police contacts leading to custody time (x2 = 43.84, P < 0.001), 87 % fewer detox admissions (t = −1.68, P = 0.06), and 32 % fewer hospital admissions (t = −2.08, P = 0.03). MAP and control participants shared similar characteristics, indicating the groups were broadly comparable. There were reductions in nearly all available LFT scores after MAP entry. Compared with controls, MAP participants had 43 % fewer police contacts, significantly fewer police contacts (−38 %) that resulted in custody time (x2 = 66.10, P < 0.001), 70 % fewer detox admissions (t = −2.19, P = 0.02), and 47 % fewer emergency room presentations. NBA use was significantly less frequent for MAP participants versus controls (t = −2.34, P < 0.05). Marked but non-significant reductions were observed in the number of participants self-reporting alcohol-related harms in the domains of home life, legal issues, and withdrawal seizures. Qualitative interviews with staff and MAP participants provided additional insight into reductions of non-beverage alcohol use and reductions of police and health-care contacts. It was unclear if overall volume of alcohol consumption was reduced as a result of MAP participation. Conclusions: The quantitative and qualitative findings of this pilot study suggest that MAP participation was associated with a number of positive outcomes including fewer hospital admissions, detox episodes, and police contacts leading to custody, reduced NBA consumption, and decreases in some alcohol-related harms. These encouraging trends are being investigated in a larger national study. en_US
dc.description.sponsorship This study was funded by Shelter House Thunder Bay, the Canadian Institutes for Health Research, and the Michael Smith Foundation for Health Research. en_US
dc.language.iso en en_US
dc.publisher Harm Reduction Journal en_US
dc.rights Attribution 2.5 Canada *
dc.rights.uri http://creativecommons.org/licenses/by/2.5/ca/ *
dc.subject Alcohol harm reduction en_US
dc.subject Managed alcohol programs en_US
dc.subject Hospital admissions en_US
dc.subject Police contacts en_US
dc.subject Non-beverage alcohol en_US
dc.subject Non-potable alcohol en_US
dc.subject Housing First en_US
dc.subject Homelessness en_US
dc.subject Alcohol use disorders en_US
dc.title Do managed alcohol programs change patterns of alcohol consumption and reduce related harm? A pilot study en_US
dc.type Article en_US
dc.description.scholarlevel Faculty en_US
dc.description.reviewstatus Reviewed en_US

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