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A Hospital-based Managed Alcohol Program in a Canadian Setting.

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Summary

A hospital-based managed alcohol program (MAP) safely reduced alcohol consumption and improved liver enzymes in patients with severe alcohol use disorder. This harm reduction strategy shows promise for inpatient settings.

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Area of Science:

  • Addiction Medicine
  • Public Health
  • Internal Medicine

Background:

  • Managed alcohol programs (MAPs) are harm reduction strategies for severe alcohol use disorder.
  • Community MAPs demonstrate positive outcomes, but hospital applicability is not well-understood.

Purpose of the Study:

  • To describe a novel hospital-based MAP.
  • To characterize participants in a hospital-based MAP.
  • To evaluate the outcomes of a hospital-based MAP.

Main Methods:

  • Retrospective chart review of MAP participants at an academic hospital (July 2016 - October 2017).
  • Data collected included demographics, alcohol/substance use, alcohol withdrawal risk, and MAP indication.
  • Outcomes assessed included changes in daily alcohol consumption and liver enzymes.

Main Results:

  • Seventeen patients with severe alcohol use disorder participated across 26 admissions.
  • Participants consumed a mean of 14 standard drinks daily prehospitalization.
  • Hospital-based MAP reduced daily alcohol consumption by a mean of 5 drinks (P=0.002) and improved liver enzymes with few adverse events.

Conclusions:

  • Hospital-based MAP is a potentially effective and safe approach to reduce harm for individuals with severe alcohol use disorder.
  • Further research is needed to identify optimal candidates and long-term outcomes.