Coronavirus: why managed alcohol programmes are essential for problem drinkers who are homeless

People who are homeless are being particularly affected by the coronavirus pandemic. Common health problems such as respiratory disease put people who are homeless at more risk and self-isolation is impossible if you are living on the streets or in temporary accommodation. Those dependent on alcohol are at even greater risk as they need to continue using to prevent withdrawal, which can lead to serious health problems and sometimes death. But lockdown and self-isolation are challenging if you need to get a hold of alcohol.https://theconversation.com/coronavirus-why-managed-alcohol-programmes-are-essential-for-problem-drinkers-who-are-homeless-13665

Autism and Addiction

The Neurodiversity Reader collection brings together work from pioneering figures within and beyond the neurodiversity movement to critically explore its associated concepts and how they might be translated into practice. The concept of neurodiversity can be traced to the late 1990s and the work of the autistic Australian sociologist Judy Singer (1998), with its origins within the autistic rights movement that had begun in earnest some years prior to that. In the 20 years since the inception of the concept, a strong international movement championing the civil rights of those deemed ‘neurodivergent’ from idealised norms has grown, rallying behind the slogan ‘Nothing about us without us’. Alongside this political movement has been an increasing academic interest in the concept of neurodiversity and how such ideas can relate to practice and service provision. This collection will explore the history of the movement, the concepts that have shaped it, and where the future might lead to. Through a variety of accounts, the relevance and criticisms of these concepts in understanding ourselves and one another will be examined, as well as implications for practice

Feasibility and acceptability of Managed Alcohol Programmes for people who are homeless with severe alcohol problems

In Scotland, rates of alcohol use and alcohol-related harm are high, with more than 1100 deaths attributable to alcohol in 2018. People who are experiencing homelessness are at a particularly high risk of alcohol use and associated harms, including experience of extreme social inequalities. Managed Alcohol Programmes (MAPs) are a harm reduction approach specifically for people experiencing homelessness, providing alcohol in measured, regular doses throughout the day, as well as a range of other supports including health and housing. This briefing paper summarise a study which aimed to scope the feasibility and acceptability of MAPs in Scotland

A Strategy to Address the Stigmatisation of People and Communities Affected by Drug Use

The aim of this strategy is to lead a more informed and compassionate approach across society toward people with a drug problem, lived experience of drug use and their families. We acknowledge that people across society use drugs. This strategy is focussed on those for whom drug use is, or drug use has been, problematic

A Strategy to Address the Stigmatisation of People and Communities Affected by Drug Use

The aim of this strategy is to lead a more informed and compassionate approach across society toward people with a drug problem, lived experience of drug use and their families. We acknowledge that people across society use drugs. This strategy is focussed on those for whom drug use is, or drug use has been, problematic

Long-acting depot buprenorphine in people who are homeless: Views and experiences

IntroductionPeople experiencing homelessness often experience intersecting mental and physical health problems, alongside problem substance use and a range of overlapping challenges, including access to appropriate treatment. New long-acting opioid replacement therapies (ORT) offer potential benefits for this group. This study explored the views of people who are homeless and dependent on prescribed or illicit opiates/opioids on the range of ORT delivery options, including long-acting buprenorphine (LAB) depot injection, methadone liquid, and sublingual/wafer buprenorphine.MethodsThe research team conducted three focus groups (n = 9 participants) and individual interviews (n = 20) with people living in Scotland and Wales. We sought to explore participants' experiences and views on a range of ORT options, and to explore experiences and perceptions of the acceptability and utility of LAB for this group.ResultsTwenty-nine people participated (8 women, 21 men) and described experiences of poor mental health and interaction with the criminal justice system, including prison. All had experience of ORT and some had a preference for the “comfort” of methadone while others liked the clear headedness of buprenorphine. Participants saw LAB as a valuable addition to the treatment options. Potential benefits included freedom from the challenges associated with daily dispensing and the freedom to be able to attend to their priorities and regain control over their day-to-day lives. LAB naïve participants required reassurance regarding the duration of effect and wanted information and evidence from both their health care providers and their peers.ConclusionParticipants generally recognized the potential of LAB. The research team identified crucial themes for those experiencing homelessness: emotions, trust, and time. A move to LAB represents a shift in the locus of control to the individual, which, for some is exciting, but for others is daunting. Providers should address this shift in control, and it must to be central to joint decision-making on whether someone is ready for LAB, the information they require to help them decide, and the support they will require during treatment

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

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

Managed alcohol programmes: Scoping the potential of a novel intervention to help prevent infection (COVID-19) for people experiencing alcohol dependency and homelessness - Clients

Homelessness affects a significant number of people in Scotland, and access to healthcare can be challenging for this group. During COVID-19, people who are homeless are more vulnerable due to their increased risk of respiratory disease and difficulty in self-isolating. Lockdown restrictions can be challenging for those dependent on alcohol

COVID-19 MAPs Study Briefing - Clients

Homelessness affects a significant number of people in Scotland, and access to healthcare can be challenging for this group. During COVID-19, people who are homeless are more vulnerable due to their increased risk of respiratory disease and difficulty in self-isolating. Lockdown restrictions can be challenging for those dependent on alcohol