Author | Title | Year | Country | Methodological approach | Setting/MAP intervention | Sample size (MAP only) |
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Primary data collection study designs | ||||||
Podymow, T.; Turnbull, J.; Coyle, D.; Yetisir, E.; Wells, G | Shelter-based managed alcohol administration to chronically homeless people addicted to alcohol | 2006 | Canada | Pre–post evaluation within subject of shelter-based MAP program | Ottawa, Canada. MAP provides shelter with bed and meals, medication administration, daily RN and weekly MD visits, ADL support, care coordination | 17 MAP program participants; 1 MAP program |
Francoeur, N., Vachon, F., & Scott, G | No place like home: housing and harm reduction | 2009 | Canada | Cross-sectional interview, and survey on housing needs among attendees at one-day "Housing people experiencing persistent homelessness" workshop (n = 27 of 47 completed survey) | Waterloo, Canada | N/A |
London Homeless Coalition | Managed alcohol: housing, health and hospital diversion—exploring a managed alcohol model for the city of London | 2011 | Canada | Cross-Sectional feasibility assessment for MAP based on interviews with persons with lived experience (n = 13), and consultations and semi-structured interviews with key informants (n = 43) | London, Ontario, Canada | N/A |
Evans, J | Supportive measures, enabling restraint: governing homeless “street drinkers” in Hamilton, Canada | 2012 | Canada | Longitudinal cohort study with In-depth interviews, observation of program operations, and document review | Hamilton, Canada MAP based in residential housing with on-site physician and nursing care, counseling, social services, 24/7 support with activities of daily living | 24 MAP participants; 2 MAP staff; 1 MAP program |
Stockwell, T; Pauly, B; Chow, C; Vallance, K; Perkin, K | Evaluation of a managed alcohol program in Vancouver, BC: Early findings and reflections on alcohol harm reduction | 2013 | Canada | Pre–post evaluation of a pilot study with pre–post comparison within subject | Station Street MAP in Vancouver Canada implemented in 2011. MAP located in Housing first permanent housing/residence building | 7 MAP participants; 1 MAP program |
Evans, J.; Semogas, D.; Smalley, J. G.; Lohfeld, L | “This place has given me a reason to care”: Understanding “managed alcohol programs” as enabling places in Canada | 2015 | Canada | Qualitative study with interviews and focus groups | MAP in Ontario Canada that had been in operation for 5 years. 16 bed capacity for men. Provides permanent housing, shared rooms, three meals daily. Daily access to RN, registered practical nurses, and social service providers. Weekly access to family practice physicians | 10 MAP participants; 1 program |
Ezard, N; Dolan, K; Baldry, E; Burns, L; Day, C; Hodge, S; Cubitt, T; Loesch, B; Mackay, T | Feasibility of a managed alcohol program (MAP) for Sydney’s homeless | 2015 | Australia | Qualitative study with one-to-one structured interviews | Non-MAP: Interviews within 20-bed Gorman House in Sydney (residential unit with withdrawal management) | N/A |
Hammond, K, Lynda G, Pauly, B | A cost–benefit analysis of a Canadian managed alcohol program | 2016 | Canada | Cost–benefit analysis with pre–post within-subject utilization comparison, and cost–benefit analysis with intervention (same as pre–post subjects) compared to control subjects | Kwae Kii Win Center in Thunder Bay, Ontario, Canada opened March 2012. 15-bed permanent supportive housing with communal living spaces. Residents have access to community worker (case manager), weekly NP visits, weekly Elder visits, community primary care, money mgmt, life skills training | 18 MAP participants; 20 Control; 1 program |
Pauly, B; Gray, E; Perkin, K; Chow, C; Vallance, K; Krysowaty, B; Stockwell, T | Finding safety: a pilot study of managed alcohol program participants’ perceptions of housing and quality of life | 2016 | Canada | Pre–post longitudinal evaluation with comparison within subject and comparison with treatment-as-usual controls. In-depth interviews with MAP participants and staff | Kwae Kii Win Center in Thunder Bay, Ontario, Canada opened March 2012. 15-bed permanent supportive housing with communal living spaces. Residents have access to community worker (case manager), weekly NP visits, weekly Elder visits, community primary care, money mgmt, life skills training | 18 MAP participants; 20 Control; 1 program |
Vallance, K.; Stockwell, T.; Pauly, B.; Chow, C.; Gray, E.; Krysowaty, B.; Perkin, K.; Zhao, J | Do managed alcohol programs change patterns of alcohol consumption and reduce related harm? A pilot study | 2016 | Canada | Pre–post longitudinal evaluation with comparison within subject and comparison with treatment-as-usual controls. In-depth interviews with MAP participants and staff | Kwae Kii Win Center in Thunder Bay, Ontario, Canada opened March 2012. 15-bed permanent supportive housing with communal living spaces. Residents have access to community worker (case manager), weekly NP visits, weekly Elder visits, community primary care, money mgmt, life skills training | 18 MAP participants; 20 Control; 1 program |
Grazioli, V., Collins, S., Paroz, S., Graap, C., Daeppen, J | Six-month outcomes among socially marginalized alcohol and drug users attending a drop-in center allowing alcohol consumption | 2017 | Switzerland | Cross-sectional design, no comparison group | Drop-in center in French-speaking area of Switzerland open 12-7 pm created related to lack of daytime shelters and public intoxication by socially marginalized adults; no housing or shelter provided. Capacity 25 clients. Staffing with social workers, nurses, and psychologist. Access to hygiene facilities (shower, laundry, toilets), clothing, nonalcohol beverages, snacks (free) and lunch (small fee). Counseling also provided during alcohol dosing. Attendance by participants is recorded to an administrative database | 1 Day-Only MAP |
Klingemann, J. & Klingemann, H | Drinking under control programs: perception of alcohol-related harm reduction measures in Poland. Results of a qualitative study among outpatient alcohol treatment providers | 2017 | Poland | Qualitative study with focus groups | N/A | N/A |
Ramsperger, E. & Ramage, K | A selective literature review on managed alcohol programs and indigenous healing methodologies | 2017 | Canada | Evaluate feasibility and acceptability of MAP for Indigenous populations. Consultations/interviews. Conduct literature review of MAPs in Canada | Indigenous elders from Calgary and neighboring First Nation communities in Canada | N/A |
Wettlaufer, A., Pauly, B., Brown, M., Chow, C., Vallance, K., Kauppi, C., Larocque, C., Stockwell, T., & Zhao, J | Toward alcohol harm reduction: results from an evaluation of a Canadian managed alcohol program | 2017 | Canada | Evaluation including monthly participant surveys x 6mos, and secondary data analysis, and in-depth interviews with select participants | Sudbury (Canada) Harm Reduction—Managed Alcohol Program. Day program only; no residential component | 8 MAP participants; 16 Controls; 8 MAP staff; 1 MAP program |
Beausoleil RM, Hunt-Jinnouchi F, Onespot-Whitney J, Brown M, Owens T | Indigenous pathways to health and well-being: managed alcohol program (MAP) feasibility study | 2018 | Canada | Survey assessing feasibility and acceptability of a MAP. No comparison group | N/A | N/A |
Chow, C.; Wettlaufer, A.; Zhao, J.; Stockwell, T.; Pauly, B. B.; Vallance, K | Counting the cold ones: a comparison of methods measuring total alcohol consumption of managed alcohol program participants | 2018 | Canada | Comparison sample cross-sectional design | 6 MAP programs: 2 in Ottawa, 1 each in Toronto, Hamilton, Thunder Bay and Vancouver. All have connection to housing with residential, transitional, or shelter-based models. Toronto: a 55-capacity shelter-based program for men upstairs from shelter for 543 homeless men. Ottawa: Features two programs for men and women: The Downtown MAP (12 beds) accepts new clients and assesses clients for a possible long-term stay at The Oaks facility (45 beds). Hamilton: A residential program for up to 22 men and women. Thunder Bay: A 15-bed residential facility for men and women. Vancouver: A 8-bed residential program for men and women | 65 MAP participants; 6 MAP programs N/A |
Ezard, N.; Cecilio, M. E.; Clifford, B.; Baldry, E.; Burns, L.; Day, C. A.; Shanahan, M.; Dolan, K | A managed alcohol program in Sydney, Australia: Acceptability, cost-savings and non-beverage alcohol use | 2018 | Australia | Qualitative study with one-to-one structured interviews | N/A | |
Stockwell, T.; Pauly, B. B.; Chow, C.; Erickson, R. A.; Krysowaty, B.; Roemer, A.; Vallance, K.; Wettlaufer, A.; Zhao, J | Does managing the consumption of people with severe alcohol dependence reduce harm? A comparison of participants in six Canadian managed alcohol programs with locally recruited controls | 2018 | Canada | Comparison sample, cross-sectional survey design using survey data from participants | 6 MAP programs: 2 in Ottawa, 1 each in Toronto, Hamilton, Thunder Bay and Vancouver. All have connection to housing with residential, transitional, or shelter-based models. Toronto: a 55-capacity shelter-based program for men upstairs from shelter for 543 homeless men. Ottawa: Features two programs for men and women: The Downtown MAP (12 beds) accepts new clients and assesses clients for a possible long-term stay at The Oaks facility (45 beds). Hamilton: A residential program for up to 22 men and women. Thunder Bay: A 15-bed residential facility for men and women. Vancouver: A 8-bed residential program for men and women | 175 MAP participants; 189 Control; 6 MAP programs 5 MAP programs |
Hall, S | Clients perspectives of managed alcohol programs in the first 6 months and their relational shifts | 2019 | Canada | Secondary data analysis of qualitative interviews utilizing interpretive description informed by constructivism | Five MAPs with connection to housing with residential, transitional, or shelter-based models. Toronto, Seaton House: men's-only shelter-based program with up to 114 men enrolled in MAP out of 543 shelter-capacity. Ottawa: Features two programs for men and women: The Wet Program MAP (12 beds) accepts new clients and assesses clients for a possible long-term stay at The Oaks facility (45 beds). Hamilton: A residential program for up to 20–24 men and women. Thunder Bay, Kwae Kii Win: A 15-bed residential facility for men and women | |
Hedland, K. (Thesis) | Community programming in mental healthcare planning: a case study at the drinkers lounge in Vancouver, BC (Thesis) | 2019 | Canada | Qualitative interviews with narrative research methodology informed by methods of research of Indigenous populations | The Drinker’s Lounge is a small drop-in center in the Downtown Eastside (DTES) of Vancouver, run under the non-profit harm reduction organization, PHS Community Services Society (PHS). Focus on community building. Open M-F, 10a-2p. Tuesdays host weekly ‘meeting of the drinkers’. To become member, person must attend three Tuesday meetings | 16 MAP participants; 2 MAP staff; 1 MAP program |
Mattison CA, Belesiotis P, Wilson MG | Rapid synthesis determining the features of managed alcohol programs | 2019 | Canada | Literature review | Rapid synthesis of MAPs in Canada, including jurisdictional scan with findings detailing MAP staffing, operations, and funding | Basic details on 23 MAPs in Canada |
Pauly, B; Brown, M.; Evans, J.; Gray, E.; Schiff, R.; Ivsins, A.; Krysowaty, B.; Vallance, K.; Stockwell, T | “There is a Place”: impacts of managed alcohol programs for people experiencing severe alcohol dependence and homelessness | 2019 | Canada | Multiple case study design utilizing situational analysis for 45–90-min semi-structured, in-depth interviews | 6 MAP programs: 2 in Ottawa, 1 each in Toronto, Hamilton, Thunder Bay and Vancouver. All have connection to housing with residential, transitional, or shelter-based models. Toronto: a 55-capacity shelter-based program for men upstairs from shelter for 543 homeless men. Ottawa: Features two programs for men and women: The Downtown MAP (12 beds) accepts new clients and assesses clients for a possible long-term stay at The Oaks facility (45 beds). Hamilton: A residential program for up to 22 men and women. Thunder Bay: A 15-bed residential facility for men and women. Vancouver: A 8-bed residential program for men and women | 57 current and former MAP participants; 50 MAP staff; 5 MAP programs N/A |
Parkes, T.; Carver, H.; Matheson C.; Pauly, B.; Browne, T | Scoping the feasibility and acceptability of managed alcohol programs for people who are homeless with severe alcohol problems in community-based, third sector services in Scotland. Research briefing | 2020 | UK (Scotland) | Quantitative: case record reviews of those accessing third sector (civil society/not for profit) homelessness services who would meet the criteria for MAPs. Qualitative: semi-structured interviews (purposive sampling) | N/A | |
Pauly, B; King, V.; Smith, A.; Tranquilli-Doherty, S.; Wishart, M.; Vallance, K.; Stockwell, T.; Sutherland, C | Breaking the cycle of survival drinking: insights from a non-residential, peer-initiated and peer-run managed alcohol program | 2020 | Canada | Semi-structured in-depth interviews with SEMAP participants recruited through purposive sampling | Vancouver-based Street Entrenched Managed Alcohol Program was operating as a non-residential community MAP and was entirely peer-developed and peer-led. The harm reduction goals for the MAP as identified by the peers were to help prevent withdrawal symptoms, improve daily functioning, and consume sufficient levels of alcohol to preclude the need for NBA. Specific goals included reduction in NBA use, and reduction in alcohol-related deaths | 14 MAP participants; 1 MAP program |
Carver, H., Parkes, T., Browne, T., Matheson, C., & Pauly, B | Investigating the need for alcohol harm reduction and managed alcohol programs for people experiencing homelessness and alcohol use disorders in Scotland | 2021 | UK (Scotland) | Quantitative: case record reviews of those accessing third sector (civil society/not for profit) homelessness services who would meet the criteria for MAPs. Qualitative: semi-structured interviews (purposive sampling) | N/A | N/A |
T. Stockwell, T., Zhao, J., Pauly, B., Chow, C., Vallance, K., Wettlaufer, C., Saunders, J.B., & Chick, J | Trajectories of alcohol use and related harms for managed alcohol program participants over 12 months compared with local controls: a quasi-experimental study | 2021 | Canada | Quasi-experimental study within systematic longitudinal study with in-depth interviews of MAP participants (at 0–2, 6 and 12 months from admission) and of locally recruited controls | The six MAP programs included one site each in Toronto, Ottawa, Hamilton, Thunder Bay, Sudbury, and Vancouver. More detailed descriptions are provided in Pauly et al. (2018) | 59 MAP participants;116 Controls; 6 MAP programs |
Secondary data studies | ||||||
Kidd, S. A.; Kirkpatrick, H.; George, L | Getting to know Mark, a homeless alcohol dependent artist, as he finds his way out of the river | 2011 | Canada | Longitudinal single participant examination with interviews and chart review | 20 bed MAP in Canadian urban center. Provides shelter, meals, treatment of medical and psychiatric conditions | 1 MAP program participant |
Pauly, B; Vallance, K; Wettlaufer, A; Chow, C; Brown, R; Evans, J; Gray, E; Krysowaty, B; Ivsins, A; Schiff, R; Stockwell, T | Community managed alcohol programs in Canada: overview of key dimensions and implementation | 2018 | Canada | Case study methodology with interviews, inductive content analysis | Study involves 13 community-based MAPs in 7 cities throughout Canada. The sites are not specifically named in the study. Programs included if: 1. An aim of program was to reduce harms; 2. There was daily alcohol dispensing for clients; and, 3. Alcohol was provided as part of the program. Excluded if: located in long-term care or hospital; tolerated alcohol use without any management of consumption, such as wet shelter | 13 MAP programs |
Erickson, R. A.; Stockwell, T.; Pauly, B. B.; Chow, C.; Roemer, A.; Zhao, J.; Vallance, K.; Wettlaufer, A | How do people with homelessness and alcohol dependence cope when alcohol is unaffordable? A comparison of residents of Canadian managed alcohol programs and locally recruited controls | 2018 | Canada | Cross-sectional comparisons of data on self-reported coping strategies collected from interviews | 6 MAP programs: 2 in Ottawa, 1 each in Toronto, Hamilton, Thunder Bay and Vancouver. All have connection to housing with residential, transitional, or shelter-based models. Toronto: a 55-capacity shelter-based program for men upstairs from shelter for 543 homeless men. Ottawa: Features two programs for men and women: The Downtown MAP (12 beds) accepts new clients and assesses clients for a possible long-term stay at The Oaks facility (45 beds). Hamilton: A residential program for up to 22 men and women. Thunder Bay: A 15-bed residential facility for men and women. Vancouver: A 8-bed residential program for men and women | 175 MAP participants; 189 Control; 6 MAP programs |
Ristau, J.,Mehtani, N., Gomez, S., Nance, M., Keller, D., Surlyn, C., Eveland, J. & Smith-Bernardin, S | Successful implementation of managed alcohol programs in the San Francisco Bay Area during the COVID-19 crisis | 2021 | USA | Descriptive | San Francisco and Alameda Counties, California. I&Q: total 3 sites initially, to 7 total. Bed capacity 60–120 per site. Short-term up to ~ 16 days. Respite: 1 site. 75beds. I&Q staffing by disaster services workers: medical providers (MDs, NPs, PharmDs), public health nurses, behavioral health clinicians, and nonclinical support staff (including healthcare workers, clerical support workers, and shelter staff). At SF Respite SIP setting, staffing remained the same prior to COVID-19 and the implementation of the MAP pilot | 21 MAP participants; 3 MAP sites |
Editorial/commentary | ||||||
Muckle, J.; Muckle, W.; Turnbull, J | COMMENTARY: Operating principles from Ottawa’s managed alcohol program | 2018 | Canada | Descriptive | Downtown MAP & The Oaks (Ottawa Canada) operating since 2001. The 28 bed Downtown MAP transitional program operates as a starter site, focusing on stabilizing alcohol consumption, behavioral management, addressing care needs, and providing service linkages. The Oaks 55-bed program offers permanent housing, emphasizing life skill development, social connections, and is viewed as a graduate program of Downtown MAP for stabilized residents. Staffing includes client care workers, peer workers, nurses, physicians, and peer leaders (specifically at The Oaks) | 1 MAP program |
Stockwell, T. & Pauly, B | Managed alcohol programs: Is it time for a more radical approach to reduce harms for people experiencing homelessness and alcohol use disorders? | 2018 | Canada | Editorial | Editorial introduction to collection of studies of managed alcohol programs. Authors provide both benefits and risks of MAP related to alcohol harms, and insight to common concerns raised by reviewers and commentators responding to MAP research | N/A |