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

Browne, Tania

Carver, Hannah

Parkes, Tessa

English

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

Stirling Online Research Repository (RIOXX)

AuthorsTessa ParkesResearch Director, University of StirlingAcademic rigour, journalistic flairPeople who are homeless are being particularly affected by the coronaviruspandemic. Common health problems such as respiratory disease put peoplewho are homeless at more risk and self-isolation is impossible if you are livingon the streets or in temporary accommodation. Those dependent on alcoholare at even greater risk as they need to continue using to prevent withdrawal,which can lead to serious health problems and sometimes death. But lockdownand self-isolation are challenging if you need to get a hold of alcohol.The coronavirus recovery needs to be evidence-led – helpus bring you the facts.DonateShutterstockCoronavirus: why managed alcohol programmes areessential for problem drinkers who are homelessMay 6, 2020 3.37pm BSTHannah CarverLecturer in Substance Use, University ofStirlingTania BrowneResearch Assistant, University of StirlingA Managed Alcohol Programme is a harm-reduction initiative that offersregularly dispensed alcohol alongside medical care, financial, housing andsocial support to people who have been drinking for many years, and whomove between homeless hostels, hospitals and the criminal justice system. Key dimensions of MAPs also include primary care services and clinicalmonitoring.MAPs were created in Canada in the late 1990s to deal with a crisis situationwhen three men froze to death in Toronto. Since then, a further 23 MAPsacross 13 Canadian cities have been established providing vital support tovulnerable people.Bernie Pauly and colleagues at the University of Victoria in British Columbia have been looking intothe effectiveness of MAPs in Canada. Their findings show that MAPs improve the safety, stability,mental and physical health, housing, relationships, life skills and self-esteem of programmeparticipants. They can reduce alcohol-related harms and, in some cases, consumption. Importantly,MAPs are also beneficial to the state in terms of significantly reduced ambulance call outs, hospitaladmissions and time in police custody.We recently conducted a study to explore whether MAPs could be implemented in Scotland. Webelieve that similar services are urgently required in Scotland, and in the UK more widely, particularlyduring the current coronavirus pandemic.Coronavirus and MAPs in ScotlandManaged Alcohol Program shows promiseIn Canada, MAPs operate in a variety of guises – drop-in programmes, shelters, hostels andpermanent accommodation. Alcohol provision also varies in relation to timing and quantity of dosing,from an hourly standard drink to a daily ration. Programme rules are similarly diverse with emphasison staff management of clients’ alcohol consumption. MAPs run community activities and may servemeals, given the importance and challenges of good nutrition, and provide healthcare professionalson or off site to monitor participants.Our own study involved in-depth interviews with three groups: those working in government and theNHS, charity services and those who would potentially benefit from MAPs. We also examined the casenotes of 33 people in eight charity homelessness services to gain a better understanding of people whomight be eligible for MAPs in Scotland.Our findings highlight key components that services would need to take into account if MAPs were tobe implemented in the current pandemic, and more generally. In terms of settings, as with Canadianservices, MAPs could be provided in either residential or drop-in places, depending on the needs of aspecific group, and what was available. While coronavirus has meant many homelessness servicesclosing, many others have changed the ways that they operate to continue providing essential services.MAPs could be provided alongside important social distancing practices, via volunteer deliveries forexample. It is important to stress that MAPs can be staffed by those already working in the field, andin services already being provided. Compassion and a non-judgemental approach are essential here,as the main purpose is to try to reduce harm, not change people.MAPs are intended to reduce harm not change people. ShutterstockCoronavirus Homelessness LockdownAs a starting point, participants for a MAP should be confirmed as alcohol dependent. Then adrinking plan can be developed collaboratively between an individual, service staff and clinicians.This would usually state the person’s preferred alcohol type, daily dose, frequency, and how widerhealth and social care needs are to be addressed. Specialist medical advice could either be provided onsite or, in the current situation, virtually.There are additional key components which would need to be implemented if MAPs were to work inthe longer term, rather than as a response to the current pandemic, such as helping people to developnew life skills, social and community connections, and the capacity to exit MAPs, should they wish tomove on. Any new MAPs put in place as an urgent response to COVID-19 must also involve carefulplanning for after lockdown, to ensure that people are not put at greater risk when they leave theservice.The message from our research is clear. MAPs are necessary in Scotland and should be included aspart of a system of care to reduce alcohol-related harm among one of our most vulnerable groups. Inthe current pandemic, the introduction of MAPs has the potential to reduce risks of virus infectionand transmission by providing more stability and helping people with the safer management andsupply of alcohol. This way no one is forced to break lockdowns to manage dangerous withdrawal.This will be something we will be examining in our new research project on managed alcoholprogrammes in the context of COVID-19 in Scotland.Before you go...The coronavirus outbreak is causing confusion and panic, andmisinformation is rife. For crystal clear explanations on everything you needto know about the pandemic, come to The Conversation, a global networkproviding evidence-based advice on everything from face masks to handwashing. If you want to support our brand of independent, not-for-profitjournalism, please donate today.Clint WitchallsHealth + Medicine EditorYou might also likeDonate nowMedicating alcohol problems shouldn’t mask moralising about ‘good’ and‘bad’ drinkingHard Evidence: has Scotland had enough to drink?Britain’s drinking habits revealed – new figuresMinimum pricing for alcohol helps poorer, heavy drinkers

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

Stirling Online Research Repository

http://dspace.stir.ac.uk/bitstream/1893/31174/1/Parkes-Conversation-2020.pdf

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

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