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Study looks at harm reduction for alcoholics

Study looks at harm reduction for alcoholicsBrewmaster Tyler Big Child, left, watches as program participants Kevin Sleziak, centre, and Rachel Eck transfer a batch of wine to a jar to ferment at the Portland Hotel Society alcohol-brewing co-op program in Vancouver, B.C., on Tuesday March 11, 2014. The program teaches alcoholics how to make their own beer and wine as part of a harm reduction program. Co-op members contribute their own money for ingredients and the brews are stored at the centre to ferment. It's aimed at a small population of alcoholics who might otherwise be drinking things such as mouthwash or hand sanitizer. THE CANADIAN PRESS/Darryl Dyck

VANCOUVER - Valerie was living on the streets of Vancouver, sleeping in the park with a plastic bag for a blanket.

She was a chronic, homeless alcoholic caught in the soul-crushing cycle of addiction on the city's notorious Downtown Eastside.

"I was living on the streets and I was drinking Listerine and rubbing alcohol," Valerie said in a video shot by staff at the Portland Hotel Society, one of five groups across Canada that has decided to extend to chronic alcohol addiction the controversial harm reduction approach better known for treating heroin addicts.

Valerie now lives at Station Street, an 80-unit supportive housing complex in Vancouver opened by the society two years ago, where a nurse or staff member provides her with an alcoholic beverage throughout the day.

She can't be intoxicated when her dose is due, and the drink isn't enough for her to get drunk. It is enough to stave off withdrawal and, say proponents, allows Valerie some stability in her life.

A new study by the Centre for Addictions Research of B.C. at the University of Victoria has found that the "managed alcohol program" approach reduced emergency hospital visits and arrests among participants at Shelter House, in Thunder Bay, Ont.

The centre's Dr. Tim Stockwell, who presented the study to Thunder Bay city council this week, said the results are encouraging.

"It's very controversial and that's why we wanted to take a good, hard look at the data," he said in an interview.

"We've had harm reduction programs for illicit drug users. Well, in fact, this population can be regarded also as illicit drug users because they're using a lot of non-beverage alcohol.

"Especially in winter time, there are strong compassionate grounds for not denying people shelter because they can't do without their alcohol, which has led to some tragic deaths in the past."

Every 90 minutes from 8 a.m. to 11 p.m. the Shelter House provides alcohol — typically six ounces of white wine — to residents who may otherwise consume hazardous "non-beverage" alcohol such as mouthwash, aftershave or even hand sanitizer. All residents were previously homeless.

The study looked at 18 people in the managed alcohol program, compared to 20 people who were not.

The number of police interactions and hospital admissions dropped between 40 and 80 per cent for the 18 participants, who also had stable housing, improved nutrition and renewed contact with families.

Both residents and shelter staff reported improvements in mental and physical health and life skills.

Program drinks are spaced out through the day, as opposed to consumed all at once — a much safer consumption pattern, the study said.

"It was also evident that the type of alcohol being consumed was intrinsically less hazardous; i.e. the wine provided on the program as opposed to a variety of forms of non-beverage and higher-strength alcohol," it said.

Despite the small number of study subjects, the study suggested the health and safety benefits translate to economic savings.

Research shows about 38 per cent of homeless men are alcoholics. There is little or no information on the rate among homeless women.

The first managed alcohol program was put in place by Toronto’s Seaton House after three men froze to death on the streets during the winter of 1995.

A larger study is pending on managed alcohol programs now in place in Thunder Bay, Vancouver, Toronto, Ottawa and Hamilton, Ont. The study said there are also at least two informal programs in towns in the B.C. Interior.

In Vancouver, where the city, health officials and the province are at odds with the federal government over safe injection sites for heroin, the non-profit Portland Hotel Society has forged ahead with harm reduction for the smaller but equally troubled population of severe alcoholics on the streets of the Downtown Eastside.

"For us it's kind of a pragmatic approach to people we deal with every day," said Mark Townsend, executive director. "We'd rather they didn't do this, but they're doing it so we're trying to make it a little bit safer for them."

In addition to the managed alcohol program, the society runs a "drinkers lounge" group for severe alcoholics that meets once a week. Among the programs offered to the group is a brew club, which allows them to join in brewing a batch of beer or wine for $10 a batch.

Two litres of each is donated to an alcohol exchange, where members can swap toxic, non-beverage alcohol for beer or wine.

"This is an extreme thing. If someone's drinking aftershave, it's pretty serious and they've done it for a very long time," Townsend said.

"All we're really trying to do is improve their behaviour in the community and make it possible to house them. For us, it's succeeded."

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