Towards Alcohol Harm Reduction: Preliminary Results from an Evaluation of a Canadian Managed Alcohol Program

This report presents an evaluation of a Managed Alcohol Program (MAP) currently being provided for homeless men and women in the Thunder Bay, Ontario region who have severe problems relating to alcohol use and homelessness. The aims of the research were to establish whether the MAP was contributing to (i) improvements in health and well-being of participants (ii) reductions in their use of emergency, hospital and police services, and (iii) less hazardous patterns of alcohol including reduced use of non-beverage alcohol. We also aimed to inform the development of future program and policy recommendations.

This was a pilot study for a national research program funded by the Canadian Institutes for Health Research for the evaluation of five MAPs in Ontario and British Columbia. Harms from alcohol can be broadly classified as acute, chronic, and social (Rehm et al., 2009; Stockwell et al., 2010). Prolonged, heavy alcohol use increases the risk of numerous physical diseases while episodes of intoxication increase risk of self-inflicted and accidental injuries. In this population such problems are especially prevalent and, as well, may be compounded by the use of non-beverage sources alcohol such as rubbing alcohol, mouthwash, hair spray or alcohol-based hand sanitizers. Previous research has demonstrated health and social benefits for this population and also reduced alcohol consumption when continued use of alcohol is tolerated in a housing program (e.g. Marlatt and Witkeiwitz, 2010).

In Canada, to our knowledge 6 MAPs have taken this a step further by providing beverage alcohol of known quality to program participants at regular intervals over the day Shelter House opened a MAP (the Kwae Kii Win Centre) in Thunder Bay, Ontario, in March 2012. It provides 15 beds for men and women with severe alcohol dependence who have been living outside or in emergency shelters and have a high rate of police contact. It provides communal living where residents receive meals, assistance with money management, health care services, counseling and referrals to health, housing and cultural supports appropriate to their needs. 

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Ontario & British Columbia, Canada