'We treat it like it is medicine': Prescribed alcohol program shows promising results

A harm reduction approach that prescribes alcohol to people who have struggled with homelessness in Halifax is showing encouraging results, according to those who run the program.

The Managed Alcohol Program out of the North End Community Health Centre administers pre-set daily doses of liquor to 25 clients taking part in the project.

"Overall people are drinking less, and this is the goal. We don't want them to go into withdrawal and we don't want them to be over-intoxicated, so it's about a smoothing out of drinking patterns," said Helen Rivers-Bowerman, the program's team manager and nurse.

The first pandemic lockdown led to the creation of the service as an emergency measure to try to stop the spread of COVID-19.

"Through that time, we were providing alcohol to socially complex individuals who were needing to isolate in hotels due to COVID exposures, or to reduce survival strategies such as panhandling and theft to prevent exposure to themselves and the community," Rivers-Bowerman said.

Doctor with special permit prescribes doses 

After the United Way provided the initial funding, the provincial government is now financing the program, which is the only one of its kind in Atlantic Canada.

People who have been homeless in the past six months or over a span of three years can apply.

Those who meet the criteria have also generally not been successful in other treatment programs, especially abstinence-based ones.

A doctor with a specific permit to prescribe alcohol determines the appropriate dose based on individual needs.

"Everybody has a different dose. We treat it like it is medicine. And it is given at predetermined times and you're not supposed to take it outside of that," Rivers-Bowerman said.

The treatment is one of a range of services offered to those in the program, as well as connection to health services and housing support.

The overall goal is to help move people onto a path to stability and away from the cycle of homelessness. 

"We really work with people to get them housing so that we can see them at a fixed address each day, and of course that's important for a whole host of social reasons, safety being one of them," said Agi Cabel, a harm reduction social worker with the program.

"We see people who haven't accessed primary health care, nurses or doctors, access that for the first time in a very low-barrier way."

An outreach team delivers the prescribed alcohol directly to where people live every day. The service is offered seven days a week.

Prior to alcohol being provided, Cabel knew of some people drinking hand sanitizer or rubbing alcohol.

They're not focusing on where their next drink is coming from.- Helen Rivers-Bowerman

Just over a year into the program, there appear to be fewer visits to hospital for over-intoxication, in addition to less interaction with police for those receiving the support.

"If someone is out engaging in panhandling, which is illegal, or engaging in petty theft, they're going to be going through the revolving door of the criminal justice system," Cabel said.

Removing the need to pay for alcohol is also resulting in some of the program's clients returning to relationships that had broken down.  

"We have some folks who have reconnected with family, including children. We have seen folks focusing on other aspects of their life, because they're not focusing on where their next drink is coming from because that creates a huge sense of anxiety," said Rivers-Bowerman.

Reporting statistics are being gathered now about the impact of the program's first year and are expected to be released in the next couple of months.