Breaking the cycle of survival drinking: insights from a non-residential, peer-initiated and peer-run managed alcohol program

Abstract

Managed alcohol programs (MAPs) have been implemented in Canada to reduce harms of severe alcohol use disorder and homelessness. Programs traditionally provide participants with regulated doses of alcohol as part of residential housing or shelter services. This study describes the experience of members of a non-residential, peer-initiated and peer-run MAP in Vancouver, BC, Canada. Semi-structured qualitative interviews were conducted with 14 members of the Community Managed Alcohol Program (CMAP) using questionnaires from the larger Canadian Managed Alcohol Program Study. Participants were recruited through word of mouth; interviews were audio-taped and transcribed. Data were coded inductively and analyzed using the constant comparative method. The CMAP was a community response to ongoing harms and increasing deaths related to the consumption of non-beverage alcohol (NBA). Participants reported that daily doses of self-managed alcohol and other supports provided by the program enabled them to change harmful drinking patterns, reduce NBA consumption, engage in program activities and feel a greater sense of well-being. Implementation of a non-residential, peer-initiated and peer-run MAP had an overall positive impact on participants’ lives. Reported benefits included shifting away from NBA use, self-managing levels of alcohol consumption and developing stronger community engagement. Further investigation of this model of MAP is warranted.

Keywords:

• Managed alcohol programs
• homelessness
• peer-run programs
• illicit alcohol
• non-beverage alcohol
• qualitative methods
• Canada

Acknowledgements

The authors thank our research partners at DURC and particularly Michelle Wishart, the CMAP coordinator at PHS Community Services Society, for their contributions to this project. We also want to thank all of the participants of the Vancouver CMAP for their time and willingness to share their stories with us. We are also grateful to Dr. Rita McCracken and Sarah Dobson for their guidance throughout this endeavor.

Disclosure statement

The authors declare that they have no competing interests with the exception of Tim Stockwell, who received research funds and travel expenses from both the Swedish (Systembolaget) and Finnish (ALKO) government retail alcohol monopolies for the conduct of research into the impacts of their policies on alcohol consumption and related harm.

Additional information

Funding

This work was supported by the University of British Columbia (UBC) Family Practice Residency Program and the Canadian Managed Alcohol Programs Study, funded by the Canadian Institutes of Health Research (CIHR) under Funding Reference Number PHE - 129903.