Citation

Ivsins A, Pauly B, Brown M, Evans J, Gray E, Schiff R, Krysowaty B, Vallance K, Stockwell T. Int. J. Drug Policy 2019; 67: 58-62.

Affiliation

Canadian Institute for Substance Use Research, University of Victoria, Technology Enterprise Facility Room 273, 2300 McKenzie Ave, Victoria, BC, V8P 5C2, Canada.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.drugpo.2019.02.004

PMID

30959410

Abstract

Alcohol policy in North America is dominated by moderation and abstinence-based modalities that focus on controlling population-level alcohol consumption and modifying individual consumption patterns to prevent and reduce alcohol-related harms. However, conventional alcohol policies and interventions do not adequately address harms associated with high-risk drinking among individuals experiencing severe alcohol use disorder (AUD) and structural vulnerability such as poverty and homelessness. In this commentary we address this gap in alcohol harm reduction, and highlight the lack of, and distinct need for, alcohol-specific harm reduction for people experiencing structural vulnerability and severe AUD. These individuals, doubly impacted by structural oppression and severe AUD, engage in various high-risk drinking practices that contribute to a unique set of harms that conventional abstinence-based treatments and interventions fail to adequately attend to. Managed alcohol programs (MAPs) have been established to address these multiple intersecting harms, and though gaining momentum across Canada, have had a hard time finding their place within the harm reduction movement. We illustrate how MAPs play a crucial role in the harm reduction movement in their ability to not only address high-risk drinking practices among structurally marginalized individuals, but to respond to harms associated with broader structural inequities such as poverty and homelessness.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

Keywords

Alcohol; Alcohol harm reduction; Alcohol use disorder; Enabling places; Harm reduction; Homelessness; Managed alcohol program