Investigating the need for alcohol harm reduction and Managed Alcohol Programs for people experiencing homelessness and alcohol use disorders in Scotland

Abstract

Introduction and Aims: Managed alcohol programmes are a harm reduction approach for those experiencing alcohol use disorders and homelessness. These programmes were developed in Canada and have had positive results; very few exist in the UK and Ireland. The aim of this study was to scope the feasibility and acceptability of implementing managed alcohol programmes in Scotland. Design and methods: Using mixed-methods we conducted two linked phases of work. Quantitative data were collected from the case records of 33 people accessing eight third sector services in Scotland and analysed in SPSS using descriptive and inferential statistics. Qualitative data were collected in Scotland via semi-structured interviews with 29 individuals in a range of roles, including strategic informants (n=12), service staff (n=8) and potential beneficiaries (n=9). Data were analysed using Framework Analysis in NVivo. Results: The case record review revealed high levels of alcohol use, related health and social harms, illicit drug use, withdrawal symptoms, and mental and physical health problems. Most participants highlighted a lack of alcohol harm reduction services and the potential of managed alcohol programmes to address this gap for this group. Discussion: Our findings highlight the potential for managed alcohol programmes in Scotland to prevent harms for those experiencing homelessness and alcohol use disorders, due to high levels of need. Conclusions: Future research should examine the implementation of managed alcohol programmes in Scotland in a range of service contexts to understand their effectiveness in addressing harms and promoting wellbeing for those experiencing alcohol use disorders and homelessness.