A pilot evaluation of managed alcohol programs operating in the context of the COVID-19 pandemic.

Background: 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.

Methods: 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).

Results: 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.

Conclusions: 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.