Community managed alcohol programs in Canada: Overview of key dimensions and implementation

Area of Science:

• Public Health
• Addiction Medicine
• Social Work

Background:

• Severe alcohol dependence and homelessness create significant vulnerability to multiple harms.
• Managed Alcohol Programs (MAPs) offer an alternative harm reduction strategy for this population.
• Existing evidence suggests MAPs can reduce acute and social harms associated with alcohol dependence.

Purpose of the Study:

• To describe the key dimensions and implementation issues of Managed Alcohol Programs (MAPs) in Canada.
• To identify common goals and variations in program structures.
• To inform future development and research of MAPs.

Main Methods:

• Identification of 13 Canadian MAPs through the Canadian Managed Alcohol Program Study.
• Conducting nine key informant interviews.
• Analysis of program documents and reports using inductive content analysis and cross-case comparisons.

Main Results:

• MAPs share a common goal of preserving dignity and reducing alcohol-related harms while improving access to services.
• Six key dimensions of MAPs were identified: program goals/eligibility, food/accommodation, alcohol management, funding, primary care, and social/cultural connections.
• Programs operate as residential or day services, with variations across these dimensions.

Conclusions:

• MAPs integrate alcohol intervention with housing, primary care, and social/cultural support.
• Permanent housing and social/cultural reconnection are crucial for recovery.
• Further research is needed on Indigenous and gendered approaches, chronic harms, and alcohol management outcomes.