Drug and alcohol review · 2018
A managed alcohol program in Sydney, Australia: Acceptability, cost-savings and non-beverage alcohol use.
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Ezard Nadine, Cecilio Michael E, Clifford Brendan, Baldry Eileen, Burns Lucinda, Day Carolyn A, Shanahan Marian, Dolan Kate
Аннотация
INTRODUCTION AND AIMS: Managed alcohol programs (MAPs) are a novel harm reduction intervention for people who experience long-term homelessness and severe long-term alcohol dependence. MAPs provide regulated amounts of alcohol onsite under supervision. Preliminary international evidence suggests that MAPs are associated with improvements such as reduced non-beverage alcohol consumption and decreases in some alcohol-related harms. There are currently no MAPs in Australia. We aimed to assess the feasibility of a MAP in inner-Sydney.
DESIGN AND METHODS: A survey among eligible homeless alcohol-dependent residents of an inner-Sydney short-stay alcohol withdrawal service occurred in 2014 to assess acceptability. Administrative data were analysed to ascertain estimates of cost-savings for a MAP based in Sydney.
RESULTS: Fifty-one eligible participants were surveyed. More than one-quarter (28%) reported consumption of non-beverage alcohol. A residential model received greatest support (76%); the majority (75%) of participants indicated a willingness to pay at least 25% of their income to utilise a MAP. Hospital and crisis accommodation cost-savings were conservatively estimated at AUD$926 483.40 and AUD$347 574.00, respectively per year for a 15-person residential MAP.
DISCUSSION AND CONCLUSIONS: Our findings demonstrate the acceptability of a MAP in Sydney among a target population sample, with the implementation of a residential MAP likely to produce significant cost-savings. A trial of a Sydney MAP evaluating the impact on health and social outcomes, including a comprehensive economic evaluation, is strongly recommended.
DESIGN AND METHODS: A survey among eligible homeless alcohol-dependent residents of an inner-Sydney short-stay alcohol withdrawal service occurred in 2014 to assess acceptability. Administrative data were analysed to ascertain estimates of cost-savings for a MAP based in Sydney.
RESULTS: Fifty-one eligible participants were surveyed. More than one-quarter (28%) reported consumption of non-beverage alcohol. A residential model received greatest support (76%); the majority (75%) of participants indicated a willingness to pay at least 25% of their income to utilise a MAP. Hospital and crisis accommodation cost-savings were conservatively estimated at AUD$926 483.40 and AUD$347 574.00, respectively per year for a 15-person residential MAP.
DISCUSSION AND CONCLUSIONS: Our findings demonstrate the acceptability of a MAP in Sydney among a target population sample, with the implementation of a residential MAP likely to produce significant cost-savings. A trial of a Sydney MAP evaluating the impact on health and social outcomes, including a comprehensive economic evaluation, is strongly recommended.