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Managed alcohol: one community's innovative response to risk management during COVID-19.
Brocious, Heidi; Trawver, Kathi; Demientieff, LaVerne Xilegg.
  • Brocious H; University of Alaska Anchorage, Professional Studies Building, Suite 234, 3211 Providence Drive, Anchorage, AK, 99508, USA. hlbrocious@alaska.edu.
  • Trawver K; University of Alaska Anchorage, Professional Studies Building, Suite 234, 3211 Providence Drive, Anchorage, AK, 99508, USA.
  • Demientieff LX; University of Alaska Fairbanks, P.O. Box 756280, Fairbanks, AK, 99775, USA.
Harm Reduct J ; 18(1): 125, 2021 12 06.
Article in English | MEDLINE | ID: covidwho-1555202
ABSTRACT

BACKGROUND:

Harm reduction programs often lack community-based support and can be controversial, despite data demonstrating effectiveness. This article describes one small Alaskan community's development of a harm reduction managed alcohol program (MAP) in the context of a city-run quarantine site for individuals experiencing homelessness. The MAP was developed to support quarantining by COVID-19-exposed or COVID-positive individuals who also experienced chronic homelessness, a severe alcohol use disorder, and heightened health risks related to potentially unsupported alcohol withdrawal.

METHOD:

Five interviews with key informants involved in planning or implementation of the MAP were conducted using rapid qualitative analysis and narrative analysis techniques.

OUTCOME:

This study documents the planning and implementation of an innovative application of a managed alcohol harm reduction intervention in the context of the COVID-19 pandemic. In this instance, a MAP was used specifically to limit hospital admissions for alcohol withdrawal during a surge of cases in the community, as well as to mitigate spread of the virus. Key informants report no residents enrolled in the MAP program as a part of quarantine required hospitalization for withdrawal or for COVID symptoms, and no shelter resident left the quarantine site while still contagious with COVID-19. Additionally, the level of community support for the program was much higher than originally expected by organizers.

CONCLUSIONS:

This program highlighted an example of how a community recognized the complexity and potential risk to individuals experiencing structural vulnerability related to homelessness and a severe AUD, and the community at large, and was able to create an alternative path to minimize those risks using a harm reduction strategy.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Substance Withdrawal Syndrome / Ill-Housed Persons / Alcoholism / COVID-19 Type of study: Observational study / Prognostic study / Qualitative research Limits: Humans Language: English Journal: Harm Reduct J Year: 2021 Document Type: Article Affiliation country: S12954-021-00574-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Substance Withdrawal Syndrome / Ill-Housed Persons / Alcoholism / COVID-19 Type of study: Observational study / Prognostic study / Qualitative research Limits: Humans Language: English Journal: Harm Reduct J Year: 2021 Document Type: Article Affiliation country: S12954-021-00574-5