Help for illicit alcohol users
Radical harm-reduction programs may reduce violence, save lives
Providing managed doses of liquor can help stabilize the lives of severe alcoholics who use illicit forms of alcohol, such as mouthwash and rubbing alcohol, according to four articles by researchers at the Canadian Institute for Substance Use Research at the University of Victoria.
The studies of “radical harm-reduction” zeroed in on highly structured managed alcohol programs (MAPs) across the country in which patients were treated in a residential facility and provided measured doses of alcohol either hourly or every 90 minutes.
“(MAPs) can achieve significant harm-reduction objectives for this very vulnerable population,” said institute director Tim Stockwell, a psychologist at the University of Victoria. “These people are experiencing a lot of harm and creating a lot of cost.”
People who consume inexpensive household products for their alcohol content are usually homeless and are often unable to access shelters due to extreme intoxication.
The authors note that MAPs may be successful in reducing acute alcohol-related harms such as violence, alcohol poisoning and death due to exposure.
“This solution is for a small population of people who are without housing, who can’t keep housing due to explosive drinking patterns,” he said. “The program must include strategies to manage outside drinking to maximize harm reduction.”
Participants usually have to be present in the facility for 60 minutes before receiving a dose, to discourage them from supplementing with outside sources of alcohol.
Participants are generally supportive of structured access because it reduces extreme drunkenness in the facility, which makes their living environment less prone to violence.
A special issue of Drug and Alcohol Review features four papers by researchers at the institute, which examine data from about 380 MAP participants — the largest study ever conducted.
Stockwell estimates Vancouver’s non-beverage alcohol abusers number in the “low hundreds.”
Canada is home to at least 23 MAP programs, but there are likely many more informal programs “flying under the radar.”
In Vancouver, a handful of residents of Station Street supportive housing participate in a highly structured MAP, but blocks away the Vancouver Area Network of Drug Users hosts a less formal program that provides a lounge and access to inexpensive bottles of sherry, for people at risk of using illicit alcohol.
Eastside Illicit Drinkers Group for Education is an advocacy and education group with about 70 members, according to program co-ordinator Brittany Graham. About 20 people participate in the sherry program.
“People can come in and get one bottle of sherry a day if they have the funds for it,” she said.
EIDGE was founded six years ago to provide front line evidence that replacing illicit alcohol provides significant benefit, enough that health authorities might consider funding larger programs.
“In the meantime, people are going to continue to drink, so the suggestion from within our group was to start selling sherry in the neighbourhood,” she said.
Liquor sources in the Downtown Eastside charge about $14 a bottle for sherry — normally a cheap source of beverage alcohol — almost double the price at a government liquor store. There is no government liquor store in the immediate neighbourhood.
“I go to the B.C. liquor store and buy a box at $8 a bottle and bring it back so people have access for that price,” she said.
Loretta Brown — a client and steering committee member of EIDGE — joined to find solutions for herself and for the friends she made in the neighbourhood when she arrived about five years ago.
“I really want to help people get off the illicit stuff and for myself to stay away from it and the hard drugs,” she said. “I’m not drinking as much as I used to and I got off the illicit stuff real quickly.”