'There is a Place': impacts of managed alcohol programs for people experiencing severe alcohol dependence and homelessness
| Autor: | Bonnie Krysowaty, Erin Gray, Tim Stockwell, Joshua Evans, Meaghan Brown, Kate Vallance, Rebecca Schiff, Andrew Ivsins, Bernie Pauly |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Psychological intervention 030508 substance abuse Medicine (miscellaneous) 0302 clinical medicine 030212 general & internal medicine media_common Social policy Harm reduction Risk environment Social work lcsh:Public aspects of medicine Managed Care Programs 1. No poverty Homelessness Middle Aged Enabling environments Alcoholism Psychiatry and Mental health Health psychology Ill-Housed Persons Female 0305 other medical science Psychology Attitude to Health Adult Safer drinking interventions Canada medicine.medical_specialty media_common.quotation_subject Illicit alcohol 03 medical and health sciences Sobriety Managed alcohol programs medicine Humans Psychiatry Poverty Aged Stereotyping Research Public Health Environmental and Occupational Health Social Support lcsh:RA1-1270 Abstinence 13. Climate action Homebound Persons Situational analysis |
| Zdroj: | Harm Reduction Journal, Vol 16, Iss 1, Pp 1-14 (2019) Harm Reduction Journal |
| ISSN: | 1477-7517 |
| Popis: | Background The twin problems of severe alcohol dependence and homelessness are associated with precarious living and multiple acute, social and chronic harms. While much attention has been focused on harm reduction services for illicit drug use, there has been less attention to harm reduction for this group. Managed alcohol programs (MAPs) are harm reduction interventions that aim to reduce the harms of severe alcohol use, poverty and homelessness. MAPs typically provide accommodation, health and social supports alongside regularly administered sources of beverage alcohol to stabilize drinking patterns and replace use of non-beverage alcohol (NBA). Methods We examined impacts of MAPs in reducing harms and risks associated with substance use and homelessness. Using case study methodology, data were collected from five MAPs in five Canadian cities with each program constituting a case. In total, 53 program participants, 4 past participants and 50 program staff were interviewed. We used situational analysis to produce a series of “messy”, “ordered” and “social arenas” maps that provide insight into the social worlds of participants and the impact of MAPs. Results Prior to entering a MAP, participants were often in a revolving world of cycling through multiple arenas (health, justice, housing and shelters) where abstinence from alcohol is often required in order to receive assistance. Residents described living in a street-based survival world characterized by criminalization, unmet health needs, stigma and unsafe spaces for drinking and a world punctuated by multiple losses and disconnections. MAPs disrupt these patterns by providing a harm reduction world in which obtaining accommodation and supports are not contingent on sobriety. MAPs represent a new arena that focuses on reducing harms through provision of safer spaces and supply of alcohol, with opportunities for reconnection with family and friends and for Indigenous participants, Indigenous traditions and cultures. Thus, MAPs are safer spaces but also potentially spaces for healing. Conclusions In a landscape of limited alcohol harm reduction options, MAPs create a new arena for people experiencing severe alcohol dependence and homelessness. While MAPs reduce precarity for participants, programs themselves remain precarious due to ongoing challenges related to lack of understanding of alcohol harm reduction and insecure program funding. |
| Databáze: | OpenAIRE |
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