On the outside looking in: Finding a place for managed alcohol programs in the harm reduction movement



Ivsins A, Pauly B, Brown M, Evans J, Gray E, Schiff R, Krysowaty B, Vallance K & Stockwell T (2019) On the outside looking in: Finding a place for managed alcohol programs in the harm reduction movement. International Journal of Drug Policy, 67, pp. 58-62.

Alcohol policy in North America is dominated by moderation and abstinence-based modalities that focus on controlling population-level alcohol consumption and modifying individual consumption patterns to prevent and reduce alcohol-related harms. However, conventional alcohol policies and interventions do not adequately address harms associated with high-risk drinking among individuals experiencing severe alcohol use disorder (AUD) and structural vulnerability such as poverty and homelessness. In this commentary we address this gap in alcohol harm reduction, and highlight the lack of, and distinct need for, alcohol-specific harm reduction for people experiencing structural vulnerability and severe AUD. These individuals, doubly impacted by structural oppression and severe AUD, engage in various high-risk drinking practices that contribute to a unique set of harms that conventional abstinence-based treatments and interventions fail to adequately attend to. Managed alcohol programs (MAPs) have been established to address these multiple intersecting harms, and though gaining momentum across Canada, have had a hard time finding their place within the harm reduction movement. We illustrate how MAPs play a crucial role in the harm reduction movement in their ability to not only address high-risk drinking practices among structurally marginalized individuals, but to respond to harms associated with broader structural inequities such as poverty and homelessness.

Health Policy; Medicine (miscellaneous)

International Journal of Drug Policy: Volume 67

FundersCanadian Institutes of Health ResearchCanadian Institutes of Health Research, Michael Smith Foundation for Health Research, Shelter House and Vancouver Coastal Health
Publication date31/05/2019
Publication date online06/04/2019
Date accepted by journal06/04/2019
PublisherElsevier BV

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Professor Bernadette Pauly

Professor Bernadette Pauly

Honorary Professor, Faculty of Social Sciences