January 05, 2006

MOUTHWASH?



Study toasts free drinks for homeless alcoholics

Free drinks may improve the health and lives of homeless alcoholics and reduce their run-ins with police, according to a study published in the Canadian Medical Association Journal.

Seventeen chronic alcoholics who drank upwards of 46 glasses a day over the past 35 years, including cheap substitutes such as mouthwash that often led to unconsciousness, were offered a glass of wine or sherry each hour, from 7:00 am to 10:00 pm at an Ottawa shelter over five to 24 months.

Most of the fifteen men and two women, with an average age of 51 years, had tried detox programs and abstention, but were unable to maintain sobriety.

"These are people you and I would pass on the street totally inebriated, who had drunk huge amounts," said Jeff Turnbull, one of the authors of the study.

Three quit, three died of alcohol-related disease before the end of the study, but 11 others reported "a markedly decreased consumption of beverage and non-beverage alcohol, and most reported improved sleep, hygiene, nutrition and health," according to the authors of the study.

More than half of the capital city's 1,000 homeless people abuse alcohol. They typically suffer increased health problems, require emergency services and have frequent contact with police.

The likelihood of their rehabilitation is low because of psychiatric illness, poor social support, lack of stable housing, years of addiction or they simply refuse treatment.

Participants in this study, however, reported fewer hospital visits, down from an average 13.5 to eight per month, while encounters with police fell from 18.1 to 8.8. The related savings per person for these services was 445 Canadian dollars (387 US) per month.

The average cost to administer the program per person was 771 Canadian dollars (670 US) per month.

"Once the craziness of their alcoholism is under control, their wasted lives on the street turned around, they're interesting people and all that destructive behavior is behind them," Turnbull said.

"They'll never be fully integrated into society, but they'll be less of a drain and even contributors."

Critics said the study lacked a comparison group, such as an abstinence program. Others lamented that offering a drunk a drink is contrary to common sense.

"We've been accused of facilitating alcohol abuse, but we feel this is a very useful tool in combating a serious societal problem. Just because someone has failed an abstinence-based program doesn't mean they should have to die in the street," Turnbull said.

"We agree that abstinence is the best approach to alcohol addiction; however, when abstinence programs have failed, we still have to care for the individuals," he said.

"By giving them alcohol in modest and controlled amounts, we've been able to minimize the harm they do to themselves and work on their bad behavior."

The program will soon be expanded to 24 beds and healthcare providers in other Canadian provinces and the United States
have expressed interest in setting up their own.

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