Innovative alcohol abuse treatment programs in Amsterdam and Vancouver are abandoning the idea of abstinence, instead letting chronic alcoholics have a few drinks to help them control and regulate their habit.

A project spearheaded by the city of Amsterdam and a local NGO called the Rainbow Group offers beer in exchange for cleaning up litter in a city park that is a frequent gathering spot for alcoholics.

In addition to the five beers given to each so-called “paper picker” over the course of a shift, the program — which currently employs about 20 alcoholics — also provides them with a meal and 10 euros for their work. 

Organizer Janet van der Noord said the project has two goals: to clean up the park and to improve the lives of the alcoholics who would otherwise gather there to drink.

“They have structure ... they have a healthy meal, which is good ... they're happy that they have something to do, they’re not bored the whole day ... and we see also a change in their lives,” van der Noord said in a documentary that aired on CBC Radio’s The Current.

B.C.'s managed alcohol programs

Bernie Pauly, a professor at the University of Victoria and a scientist with the Centre for Addictions Research of British Columbia, said these kinds of programs help reduce harm for people with severe alcohol addiction.

Pauly studies the impact of Vancouver’s “managed alcohol programs,” or MAPs, where chronic alcoholics are given wine, beer or spirits as part of treatment. She said at least six of these programs currently exist in Canada.

'What’s interesting with this program is it’s not about in some ways giving them alcohol. It’s actually about giving them community, purpose and meaning.' - Dr. Mark Weiss, medical director of Bellwood Health Services 

In an interview with The Current host Ana Maria Tremonti, Pauly said managed alcohol programs are helpful for people with a long history of chronic alcoholism – they may have undergone treatment several times, but were unsuccessful.

“In many cases, abstinence treatment has really not been effective for this group of people,” Pauly said. “It’s really an option to assist people to live a better quality of life and to reduce those harms that go with drinking.”

Dr. Mark Weiss, the medical director of Bellwood Health Services in Toronto, said that these kinds of managed alcohol programs can complement traditional abstinence programs.

“I think one of the things that we sometimes err on when we think about addiction is that we think about addiction as you either have it or you don't,” Weiss said. “And addiction is a continuum, in reality.”

Weiss said that for some alcoholics, a managed alcohol program could be the first step toward complete sobriety.

In the meantime, Weiss said projects like the one in Amsterdam can improve the lives of alcoholics, especially those who have ended up homeless.

“What’s interesting with this program is it’s not about in some ways giving them alcohol,” he said. “It’s actually about giving them community, purpose and meaning.”