Publication Highlights

A managed alcohol program where long term homeless individuals with severe alcohol dependence are given small amounts of alcohol under supervision could save $1.25 million a year in hospital and crisis accommodation for a 15-person residential MAP in Sydney, say the authors from St Vincent’s Hospital and the National Drug and Alcohol Research Centre.

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.

In 2014, the authors conducted a survey among eligible homeless alcohol‐dependent residents of an inner‐Sydney short‐stay alcohol withdrawal service to assess acceptability. Administrative data were analysed to ascertain estimates of cost‐savings for a MAP based in Sydney.

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.

The 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.