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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
Author(s) -
Erickson Rebekah A.,
Stockwell Tim,
Pauly Bernadette Bernie,
Chow Clifton,
Roemer Audra,
Zhao Jinhui,
Vallance Kate,
Wettlaufer Ashley
Publication year - 2018
Publication title -
drug and alcohol review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.018
H-Index - 74
eISSN - 1465-3362
pISSN - 0959-5236
DOI - 10.1111/dar.12649
Subject(s) - alcohol , coping (psychology) , logistic regression , ethnic group , alcohol dependence , odds , demography , medicine , odds ratio , psychology , psychiatry , gerontology , sociology , biochemistry , chemistry , anthropology
and Aims We investigated coping strategies used by alcohol‐dependent and unstably housed people when they could not afford alcohol, and how managed alcohol program (MAP) participation influenced these. The aim of this study was to investigate potential negative unintended consequences of alcohol being unaffordable. Design and Methods A total of 175 MAP residents in five Canadian cities and 189 control participants from nearby shelters were interviewed about the frequency they used 10 coping strategies when unable to afford alcohol. Length of stay in a MAP was examined as a predictor of negative coping while controlling for age, sex, ethnicity, housing stability, spending money and drinks per day. Multivariate binary logistic and linear regression models were used. Results Most commonly reported strategies were re‐budgeting (53%), waiting for money (49%) or going without alcohol (48%). A significant proportion used illicit drugs (41%) and/or drank non‐beverage alcohol (41%). Stealing alcohol or property was less common. Long‐term MAP participants (>2 months) exhibited lower negative coping scores than controls (8.76 vs. 10.63, P < 0.001) and were less likely to use illicit drugs [odds ratio (OR) 0.50, P = 0.02], steal from liquor stores (OR 0.50, P = 0.04), re‐budget (OR 0.36, P < 0.001) or steal property (OR 0.40, P = 0.07). Long‐term MAP participants were also more likely to seek treatment (OR 1.91, P = 0.03) and less likely to go without alcohol (OR 0.47, P = 0.01). Discussion and Conclusions People experiencing alcohol dependence and housing instability more often reduced their alcohol consumption than used harmful coping when alcohol was unaffordable. MAP participation was associated with fewer potentially harmful coping strategies.