Goulet-Stock Sybil, Stockwell Tim, Brown Meaghan, Rautenberg Deidre, Pauly Bernie
Department of Psychology, University of Victoria, Victoria, BC, Canada.
Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.
Harm Reduct J. 2025 May 24;22(1):87. doi: 10.1186/s12954-025-01232-w.
Managed Alcohol Programs (MAPs) are a harm reduction strategy designed for individuals with severe AUD, unstable housing, and previous unsuccessful treatment attempts. MAPs provide access to individualized doses of beverage alcohol alongside other social supports and are effective for stabilizing alcohol consumption and reducing alcohol-related harms. In Canada, MAP models (scattered site outreach or fixed site) were developed in response to the COVID-19 pandemic to reduce harms associated with severe AUD, high-risk drinking, and unstable housing as means of supporting physical isolation and distancing. This study provides a description of novel program models and practices and an in-depth description of nine MAP participants in British Columbia in the context of the COVID-19 pandemic.
This research used a longitudinal mixed methods design. Participants included nine individuals enrolled in MAPs in British Columbia during the COVID-19 pandemic. Quantitative interviews assessing mental and physical health, safety, service usage, substance use, quality of life, well-being, physical distancing and risk behaviours, and alcohol-related harms were collected every 2 weeks for up to 3 months (n = 9). Qualitative interviews about experiences, goals, and expectations related to the MAP were conducted (n = 5). MAP records, including alcohol administration, liver function tests, and healthcare records were collected (n = 8).
Clinician-scattered site outreach or fixed-site MAP models were the most common during the COVID-19 pandemic. The individual findings suggest that MAPs may enhance housing stability, improve health, safety, and well-being, reduce alcohol-related harms, and help participants improve their ability to follow COVID-19 guidelines.
The COVID-19 pandemic accelerated the development of novel MAP models and approaches to alcohol distribution. The findings of this pilot evaluation illustrate the potential role for outreach models in the development of future MAPs.
管理式酒精项目（MAPs）是一种减少伤害的策略，专为患有严重酒精使用障碍（AUD）、住房不稳定且之前治疗尝试未成功的个体设计。MAPs提供个性化剂量的酒精饮料，同时提供其他社会支持，对于稳定酒精消费和减少与酒精相关的伤害有效。在加拿大，为应对新冠疫情，开发了MAP模型（分散站点外展或固定站点），以减少与严重AUD、高风险饮酒和住房不稳定相关的伤害，作为支持身体隔离和保持社交距离的手段。本研究描述了新的项目模型和实践，并深入描述了新冠疫情背景下不列颠哥伦比亚省9名MAP参与者的情况。
本研究采用纵向混合方法设计。参与者包括新冠疫情期间在不列颠哥伦比亚省参加MAPs的9个人。每2周进行一次定量访谈，评估心理健康、身体健康、安全、服务使用、物质使用、生活质量、幸福感、身体距离和风险行为以及与酒精相关的伤害，为期最长3个月（n = 9）。进行了关于与MAP相关的经历、目标和期望的定性访谈（n = 5）。收集了MAP记录，包括酒精管理、肝功能测试和医疗记录（n = 8）。
在新冠疫情期间，临床医生分散站点外展或固定站点MAP模型最为常见。个体研究结果表明，MAPs可能会增强住房稳定性，改善健康状况、安全性和幸福感，减少与酒精相关的伤害，并帮助参与者提高遵守新冠指南的能力。
新冠疫情加速了新型MAP模型和酒精分发方法的发展。本次试点评估的结果说明了外展模型在未来MAPs发展中的潜在作用。
