Winnipeg needs program to provide managed doses of alcohol for addicts, feasibility study says
'All we are doing is creating … an environment where people can do the things they want to do' safely: author
Winnipeg needs a managed alcohol program for chronic alcoholics experiencing homelessness, a new feasibility study finds.
While many shelters enforce abstinence from alcohol, a report from the non-profit Sunshine House is recommending a treatment program where alcoholics living on the street won't be turned away if they won't — or can't — stop drinking.
No managed alcohol programs are currently in place in Manitoba — which, if established, would effectively act as a supervised consumption site for alcoholics by providing a daily dosage of alcohol to participants.
A managed alcohol program may be a residential program — where alcohol is dispensed in doses at an on-site residence, which might offer shelter services — or may be a drop-in model, where alcohol is dispensed throughout the day with drop-in programming.
The report, released publicly on Friday, suggests Winnipeg requires a "pilot day program with strong housing supports." It estimates the yearly cost at $600,000 to $1 million, operated by health-care aides or facility staff.
"I really believe in a harm-reduction model. I really believe that people who are impacted are the ones who have all the lessons to teach us," said Margaret Bryans, the registered nurse who authored the study.
After 12 weeks of research, she says her findings were influenced by people living on the street and their supporters. Through them, Bryans determined a community-centred and stigma-free treatment program would work locally.
Participants in the study expressed support for both a residential model and a drop-in model that included housing supports, her report says.
Her report focuses more on the people such a program would aim to help, and those who would work with them, than statistics.
"Nurses and doctors are really super excited to tell you that we researched it all and we did a lot of evidence-searching, but the truth is the people who are doing this work on the ground are people who are most impacted and the very front-line workers," she said.
Bryans said people in need are getting alcohol somehow, with or without a managed alcohol facility.
I really believe that people who are impacted are the ones who have all the lessons to teach us.- Report author Margaret Bryans
"All we are doing is creating a context and an environment where people can do the things they want to do" safely, she said.
This form of harm prevention already exists in Toronto, Ottawa and Vancouver, and will soon in Montreal.
Sunshine House, a Winnipeg drop-in centre focused on harm reduction, began considering the idea in 2016 to support its participants who drink chronically and may not have a safe place to go to avoid withdrawals.
Bryans shared the story of a person who compared being spurned by a dry shelter to a cancer patient finding out that their chemotherapy is failing them.
"You wouldn't give up on them," Bryans said.
Skeptic is convinced
Damon Johnston, chair of the Addictions Foundation of Manitoba, was skeptical when he first heard of managed alcohol programs, but was convinced when he saw one in action in Thunder Bay, Ont.
"When I came away from it, I was quite pleased with what I saw and actually convinced that for some people, it's a much better way to approach their issues," he said in an interview.
Johnston said the hurdle in Manitoba is government funding. The province has thus far dismissed calls for a supervised injection site for people struggling with drug addiction, citing a lack of evidence.
As far as the need for a harm-reduction site for alcoholics, Manitoba Premier Brian Pallister said Friday he wants to learn more about the proposal.
"We're all focused on cannabis right now, but alcohol is the major problem," he said.
Bryans wants the province to put up money to help people dependent on alcohol.
"I think we need to try something. The best approach in a pilot is to actually run the tests," she said.
"If folks down there [at the Manitoba Legislature] care nothing about anything but numbers, then we need to run a pilot to see if things are cost-effective or not."
A Canadian research study found participants in a managed alcohol program had fewer hospital visits, detox episodes and police contacts leading to custody than those who went without.
With files from Sean Kavanagh and The Canadian Press