Department of Psychiatry, University of British Columbia (UBC), David Strangway Building, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada.
Department of Psychiatry, Tanta University, Tanta, Egypt.
Harm Reduct J. 2021 Oct 17;18(1):108. doi: 10.1186/s12954-021-00555-8.
Among individuals experiencing homelessness, the prevalence of alcohol use disorder is extremely high. Alcohol-related harms are compounded by the use of non-beverage alcohol (NBA; e.g. rubbing alcohol, cooking wine). The dangers of NBA consumption pose significant risks to the individual and to others when consumed in large quantities and when mixed with other substances. The objectives of this paper are to describe the alcohol consumption patterns of individuals experiencing homelessness, identify substance use patterns, psychological stressors, and related harms associated with NBA consumption, and compare NBA consumers to non-NBA consumers in relation to their use of services and perceived barriers to care.
Using a cross-sectional survey, 150 individuals experiencing homelessness were recruited from Edmonton's inner city and adjoining areas. Frequency, quantity, and volume of alcohol consumption were used to assess patterns of alcohol use in the last 6 months. Descriptive statistics and bivariate analyses were used to compare participants reporting NBA consumption and non-NBA consumption (p ≤ 0.05).
The majority of participants were male (71.3%) and self-identified as Indigenous (74.0%). Overall, 24% (n = 36) reported NBA consumption within the last six months. NBA consumers were older than non-NBA consumers (p = 0.005), reported different perceived living stability (p = 0.022), and had higher psychological distress (p = 0.038). The majority of NBA consumers reported not receiving harm reduction services while also not needing such services (n = 18, 51.4%), which differed from non-NBA consumers (p = 0.003). Structural barriers (e.g. availability, location, cost) were most frequently reported as reasons for unmet harm reduction (60.9%) and hospital care (58.3%) needs, while barriers to skills training (58.5%) and counselling services (53.6%) were mostly motivational (e.g. personal beliefs).
Within such an already marginalized population experiencing homelessness, individuals who consume NBA represent a vulnerable subpopulation who require adapted and distinct health and social services to stabilize and recover. Current harm reduction services are not prepared to effectively assist this group of individuals, and specific treatment programs are rare. Managed alcohol programs are a feasible approach but must be tailored to the specific needs of those who consume NBA, which is especially important for Indigenous people. More comprehensive assessments of NBA consumption are needed for program development and policy recommendations.
在无家可归者中，酒精使用障碍的患病率极高。与非饮料酒精（NBA；例如酒精、料酒）相关的酒精危害因使用 NBA 而变得更加复杂。大量饮用 NBA 并与其他物质混合时，个人和他人都会面临巨大的风险。本文的目的是描述无家可归者的酒精消费模式，确定与 NBA 消费相关的物质使用模式、心理压力源和相关危害，并将 NBA 消费者与非 NBA 消费者进行比较，比较他们对服务的使用和对护理的认知障碍。
使用横断面调查，从埃德蒙顿市中心和毗邻地区招募了 150 名无家可归者。在过去 6 个月中，使用频率、数量和体积来评估酒精使用模式。使用描述性统计和双变量分析比较报告 NBA 消费和非 NBA 消费的参与者（p≤0.05）。
大多数参与者为男性（71.3%），自我认同为土著人（74.0%）。总体而言，24%（n=36）报告在过去 6 个月内 NBA 消费。NBA 消费者比非 NBA 消费者年龄更大（p=0.005），报告的生活稳定性不同（p=0.022），心理困扰更大（p=0.038）。大多数 NBA 消费者表示没有接受减少伤害服务，同时也不需要此类服务（n=18，51.4%），与非 NBA 消费者不同（p=0.003）。结构障碍（例如可用性、位置、成本）是减少伤害和医院护理未得到满足的最常见原因（分别为 60.9%和 58.3%），而技能培训（58.5%）和咨询服务（53.6%）的障碍主要是动机性的（例如个人信仰）。
在这样一个已经边缘化的无家可归者群体中，消费 NBA 的个体代表了一个脆弱的亚群体，他们需要适应和独特的健康和社会服务来稳定和恢复。目前的减少伤害服务还没有准备好有效地帮助这一群体，特定的治疗计划也很少。管理酒精计划是一种可行的方法，但必须针对消费 NBA 的人的特定需求进行调整，这对土著人尤为重要。需要对 NBA 消费进行更全面的评估，以制定方案和政策建议。
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