Breaking the cycle of survival drinking: insights from a non-residential, peer-initiated and peer-run managed alcohol program

Managed alcohol programs (MAPs) have been implemented in Canada to reduce harms of severe alcohol use disorder and homelessness. Programs traditionally provide participants with regulated doses of alcohol as part of residential housing or shelter services. This study describes the experience of members of a non-residential, peer-initiated and peer-run MAP in Vancouver, BC, Canada. Semi-structured qualitative interviews were conducted with 14 members of the Community Managed Alcohol Program (CMAP) using questionnaires from the larger Canadian Managed Alcohol Program Study. Participants were recruited through word of mouth; interviews were audio-taped and transcribed. Data were coded inductively and analyzed using the constant comparative method. The CMAP was a community response to ongoing harms and increasing deaths related to the consumption of non-beverage alcohol (NBA). Participants reported that daily doses of self-managed alcohol and other supports provided by the program enabled them to change harmful drinking patterns, reduce NBA consumption, engage in program activities and feel a greater sense of well-being. Implementation of a non-residential, peer-initiated and peer-run MAP had an overall positive impact on participants' lives. Reported benefits included shifting away from NBA use, self-managing levels of alcohol consumption and developing stronger community engagement. Further investigation of this model of MAP is warranted.