The recommended treatment for
chronic alcoholism is abstinence. But in Ottawa, Canada, a new approach called the Managed Alcohol Program (MAP) aims to change the drinking behaviour of inveterate addicts.
Started in 2001 by a group of health professionals around 15 years ago, it aims to help those who have tried to stop drinking and failed. If their lives could be stabilized, (the day that begins with the search for
alcohol and all the complications that occur with that), then better help could be given with their mental health, addiction to alcohol and physical illnesses.
MAP is run by a partnership of two NGOs - the Shepherds of Good Hope,
and Ottawa Inner City Health. It began in the Shepherds' homeless
hostel downtown, and the Oaks (a hotel converted into a permanent home for those who once lived on the streets) which opened in 2010. But the approach is
controversial.
The
Oaks has a waiting list. Before being accepted, potential residents
must prove they can live within the rules of the Managed Alcohol
Program. The Shepherds' hostel downtown is a 12-bed unit, but the
atmosphere is far less benign than at the Oaks.
The residents of the Oaks, a converted hotel, are mostly middle-aged or older, their health fragile due to a lifetime of drinking. Here nearly 50 residents are given a measure of Californian white wine (13% alcohol, made
on the premises) at hourly intervals. The first 'pour' of the day at 7.30am is a kickstarter of 7oz (nearly 200ml, a larger-than-average sized glass of wine in Europe). For
the rest of the day until 9.30pm, they are given 5oz - just over 140ml. If anyone shows signs of intoxication, they will not be served.
Residents contribute to the cost of their keep - and the wine -
through pensions and state benefits. In the common area and the courtyard outside they chat with
their friends, play cards and just sit. There is a TV room, a computer, outings and shopping
trips, a gentle keep-fit class. This calm,
stable environment has enabled some to
re-establish contact with families; others are hoping to
volunteer or even go back to work. Inuit residents have formed a
task force to compile information for homeless people like them.
Lifelong alcoholics are an enormous drain on public resources. Dr Jeff Turnbull, one of those early innovators, and the chief of staff at Ottawa Hospital said "One
of our clients was in the emergency department 191 times in the six
months preceding coming onto the MAP, and that was
just in our hospital. He could've been in other healthcare facilities
during that time as well." No one study about the MAP has crunched the numbers fully, but it is
not unrealistic to assume that the city of Ottawa has saved millions of
dollars. "There's a profound reduction in 911 calls, hospital emergency visits, paramedic and police encounters" says Dr Turnbull.
Source: Treating alcohoics - with wine: by Linda Pressly, BBC News, Ottawa (7 July 2016)
