Collins said that traditional alcohol treatment programs that demand abstinence fail to help many people experiencing homelessness and alcohol use disorder. By some estimates, people who experience chronic homelessness and alcohol use disorder have, on average, undergone alcohol treatment 16 times in their lives.
"Oftentimes, these folks are labeled 'treatment failures,' but we started to realize after many years of doing this work, maybe it's us, the treatment system that's failing them, more than the other way around," said Collins. "What we do with harm reduction treatment is try to meet people where they are at. Instead of falling into this paternalistic, advice-giving approach that turns people off, we try to support them in reaching their own goals."
Many of the study participants had multiple goals, only some of which involved reducing drinking. As might be expected, the most common goal was finding more stable housing, but other goals included re-connecting with family, finding work and engaging in hobbies they once enjoyed.
While this study included people experiencing homelessness, the findings also hold potential for other people with alcohol use disorder, Collins said.
"This approach has the potential to help anybody who would like to change their
alcohol use but might not be ready or able to stop entirely," said Collins. "We can do treatment in an incremental way that might be more sustainable and less demoralizing than going through these cycles, where people feel if they aren't able to stop
drinking, they can't start recovery or they aren't good enough for our treatment system. Instead, it is our definition of recovery and our treatment system that needs to change."
