Book contents
- Dynamic Pathways to Recovery from Alcohol Use Disorder
- Dynamic Pathways to Recovery from Alcohol Use Disorder
- Copyright page
- Dedication
- Contents
- Figures
- Tables
- Contributors
- Foreword
- Preface
- Acknowledgments
- Introduction
- Part I Micro Level
- Part II Meso Level
- 9 Natural Recovery from Alcohol Use Disorder
- 10 Individual Behavioral Interventions to Incentivize Sobriety and Enrich the Natural Environment with Appealing Alternatives to Drinking
- 11 Family and Social Processes in Recovery from Alcohol Use Disorder
- 12 Community-Based Harm Reduction Approaches for Alcohol Use Disorder
- 13 Use of Mobile Technology to Understand and Improve Recovery from Alcohol Use Disorder
- 14 Studying Recovery in the Social Context
- 15 Measuring Substance Use Contexts and Substance-Free Reinforcement
- Part III Macro Level
- Conclusions and Future Directions
- Index
- References
12 - Community-Based Harm Reduction Approaches for Alcohol Use Disorder
from Part II - Meso Level
Published online by Cambridge University Press: 23 December 2021
Book contents
- Dynamic Pathways to Recovery from Alcohol Use Disorder
- Dynamic Pathways to Recovery from Alcohol Use Disorder
- Copyright page
- Dedication
- Contents
- Figures
- Tables
- Contributors
- Foreword
- Preface
- Acknowledgments
- Introduction
- Part I Micro Level
- Part II Meso Level
- 9 Natural Recovery from Alcohol Use Disorder
- 10 Individual Behavioral Interventions to Incentivize Sobriety and Enrich the Natural Environment with Appealing Alternatives to Drinking
- 11 Family and Social Processes in Recovery from Alcohol Use Disorder
- 12 Community-Based Harm Reduction Approaches for Alcohol Use Disorder
- 13 Use of Mobile Technology to Understand and Improve Recovery from Alcohol Use Disorder
- 14 Studying Recovery in the Social Context
- 15 Measuring Substance Use Contexts and Substance-Free Reinforcement
- Part III Macro Level
- Conclusions and Future Directions
- Index
- References
Summary
Community-based harm reduction for alcohol use disorder (AUD) entails a compassionate stance and pragmatic strategies that minimize alcohol-related harm and enhance quality of life. Community-based harm reduction approaches aim to meet people where they are both in their communities and with respect to their motivation for change. Harm reduction approaches do not require or prioritize abstinence or alcohol use reduction as the sole or most desirable recovery pathway. To date, community-based harm reduction approaches have been applied and investigated primarily within marginalized populations, particularly people experiencing homelessness and AUD. Randomized controlled trials have established efficacy for the low-barrier, non-abstinence-based Housing First approach and for community-based harm-reduction treatment. Managed alcohol programs and meaningful activities programming have shown promising findings in nonrandomized trials and warrant further study. The chapter concludes with reflections on key themes undergirding work in community-based harm reduction and how it has positively affected individuals and communities.
Keywords
- Type
- Chapter
- Information
- Dynamic Pathways to Recovery from Alcohol Use DisorderMeaning and Methods, pp. 218 - 238Publisher: Cambridge University PressPrint publication year: 2022
References
Anderson, K. (2010). How to change your drinking: A harm reduction guide to alcohol. HAMS Harm Reduction Network.Google Scholar
Becker, H. C. (1998). Kindling in alcohol withdrawal. Alcohol Health & Research World, 22, 25–33.Google ScholarPubMed
Bronfenbrenner, U. (1979). The ecology of human development. Harvard University Press.Google Scholar
Brown, M. M., Jason, L. A., Malone, D. K., Srebnik, D., & Sylla, L. (2016). Housing first as an effective model for community stabilization among vulnerable individuals with chronic and nonchronic homelessness histories. Journal of Community Psychology, 44, 384–390. https://doi.org/10.1002/jcop.21763Google Scholar
Clatworthy, J., Hinds, J., & Camic, P. M. (2013). Gardening as a mental health intervention: A review. Mental Health Review Journal, 18, 214–225. https://doi.org/10.1108/MHRJ-02-2013-0007Google Scholar
Clifasefi, S. L., Collins, S. E., & The LEAP Advisory Board. (2020). The life enhancing alcohol-management program (LEAP): Results from a 6-month nonrandomized controlled pilot study assessing a community-based participatory research program in Housing First. Journal of Community Psychology, 48, 763–776. https://doi.org/10.1002/jcop.22291Google Scholar
Clifasefi, S. L., Collins, S. E., Torres, N. I., Grazioli, V. S., & Mackelprang, J. L. (2016). Housing First, but what comes second? A qualitative study of resident, staff, and management perspectives on single-site Housing First program enhancement. Journal of Community Psychology, 44, 845–855. https://doi.org/10.1002/jcop.21812Google Scholar
Clifasefi, S. L., Malone, D., & Collins, S. E. (2013). Associations between criminal history, Housing First exposure, and jail outcomes among chronically homeless individuals with alcohol problems. International Journal of Drug Policy, 24, 291–296. https://doi.org/10.1016/j.drugpo.2012.10.002CrossRefGoogle Scholar
Collins, S. E. (2016). Associations between socioeconomic factors and alcohol outcomes. Alcohol Research: Current Reviews, 38, 83–94.Google Scholar
Collins, S. E., Clifasefi, S. L., Andrasik, M. P., Dana, E. A., Stahl, N. E., Kirouac, M., Welbaum, C., King, M., & Malone, D. K. (2012). Exploring transitions within a project-based Housing First setting: Qualitative evaluation and practice implications. Journal of Health Care for the Poor and Underserved, 23, 1678–1697. https://doi.org/10.1353/hpu.2012.0187Google Scholar
Collins, S. E., Clifasefi, S. L., Dana, E. A., Andrasik, M. P., Stahl, N. E., Kirouac, M., Welbaum, C., King, M., & Malone, D. K. (2012). Where harm reduction meets Housing First: Exploring alcohol’s role in a project-based Housing First setting. International Journal of Drug Policy, 23, 111–119. https://doi.org/10.1016/j.drugpo.2011.07.010Google Scholar
Collins, S. E., Clifasefi, S. L., Logan, D. E., Samples, L., Somers, J., & Marlatt, G. A. (2011). Chapter 1–Harm reduction: Current status, historical highlights, and basic principles. In Marlatt, G. A., Witkiewitz, K., & Larimer, M. E. (Eds.), Harm reduction: Pragmatic strategies for managing high-risk behaviors. (2nd ed.) (pp. 3-35). Guilford.Google Scholar
Collins, S. E., Clifasefi, S. L., Nelson, L. A., Stanton, J., Goldstein, S. C., Taylor, E. M., Hoffmann, G., King, V. L., Hatsukami, A. S., Cunningham, Z. L., Taylor, E., Mayberry, N., Malone, D. K., & Jackson, T. R. (2019). Randomized controlled trial of harm reduction treatment for alcohol (HaRT-A) for people experiencing homelessness and alcohol use disorder. International Journal of Drug Policy, 67, 24–33. https://doi.org/10.1016/j.drugpo.2019.01.002Google Scholar
Collins, S. E., Clifasefi, S. L., Stanton, J., The LEAP Advisory Board, Straits, K. J. E., Gil-Kashiwabara, E., Nicasio, A. V., Hawes, S. M., Nelson, L. A., Duran, B. M., & Wallerstein, N. (2018). Community-based participatory research (CBPR): Towards equitable involvement of community in psychology research. American Psychologist, 73, 884–898. https://doi.org/10.1037/amp0000167Google Scholar
Collins, S. E., Duncan, M. H., Saxon, A. J., Taylor, E. M., Mayberry, N., Merrill, J. O., Hoffmann, G. E., Clifasefi, S. L., & Ries, R. K. (2021). Combining extended-release naltrexone and behavioral harm-reduction treatment for people experiencing homelessness and alcohol use disorder in the USA: A randomized clinical trial. The Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(20)30489-2Google Scholar
Collins, S. E., Goldstein, S. C., King, V. L., Orfaly, V. E., Gu, J., Clark, A., Vess, A., Lee, G., Taylor, E. M., Fentress, T., Braid, A. K., & Clifasefi, S. L. (2020). Characterizing components of and attendance at resident-driven Housing First programming in the context of community-based participatory research. Journal of Community Psychology, 1–17. https://doi.org/10.1002/jcop.22491Google Scholar
Collins, S. E., Grazioli, V., Torres, N., Taylor, E., Jones, C., Hoffman, G., Haelsig, L., Zhu, A., Hatsukami, A. S., Koker, M. J., Herndon, P., Greenleaf, S. M., & Dean, P. (2015). Qualitatively and quantitatively evaluating harm-reduction goals among chronically homeless individuals with alcohol dependence. Addictive Behaviors, 45, 184–190. https://doi.org/10.1016/j.addbeh.2015.02.001Google Scholar
Collins, S. E., Jones, C. B., Hoffmann, G., Nelson, L. A., Hawes, S. M., Grazioli, V. S., Mackelprang, J. L., Holttum, J., Kaese, G., Lenert, J., Herndon, P., & Clifasefi, S. L. (2016). In their own words: Content analysis of pathways to recovery among individuals with the lived experience of homelessness and alcohol use disorders. International Journal of Drug Policy, 27, 89–96. https://doi.org/10.1016/j.drugpo.2015.08.003CrossRefGoogle ScholarPubMed
Collins, S. E., Malone, D. K., & Clifasefi, S. L. (2013). Housing retention in single-site Housing First for chronically homeless individuals with severe alcohol problems. American Journal of Public Health, 103, S269–S274. https://doi.org/10.2105/AJPH.2013.301312Google Scholar
Collins, S. E., Malone, D. K., Clifasefi, S. L., Ginzler, J. A., Garner, M. D., Burlingham, B., Lonczak, H. S., Dana, E. A., Kirouac, M., Tanzer, K., Hobson, W., Marlatt, A., & Larimer, M. E. (2012). Project-based Housing First for chronically homeless individuals with alcohol problems: Within-subjects analyses of two-year alcohol-use trajectories. American Journal of Public Health, 102, 511–519. https://doi.org/10.2105/AJPH.2011.300403Google Scholar
Collins, S. E., Malone, D. K., & Larimer, M. E. (2012). Motivation to change and treatment attendance as predictors of alcohol-use outcomes among project-based housing first residents. Addictive Behaviors, 37, 931–939. https://doi.org/10.1016/j.addbeh.2012.03.029Google Scholar
Crabtree, A., Latham, N., Morgan, R., Pauly, B., Bungay, V., & Buxton, J. A. (2018). Perceived harms and harm reduction strategies among people who drink non-beverage alcohol: Community-based qualitative research in Vancouver, Canada. International Journal of Drug Policy, 59, 85–93. https://doi.org/10.1016/j.drugpo.2018.06.020Google Scholar
Denning, P., & Little, J. (2012). Practicing harm reduction psychotherapy: An alternative approach to addictions (2nd ed.). Guilford.Google Scholar
Denning, P., & Little, J. (eds.). (2017). Over the influence: The harm reduction guide for managing drugs and alcohol. Guilford.Google Scholar
Des Jarlais, D. C., Feelemyer, J. P., Modi, S. N., Abdul-Quader, A., & Hagan, H. (2013). High coverage needle/syringe programs for people who inject drugs in low and middle income countries: A systematic review. BMC Public Health, 13, 53. https://doi.org/10.1186/1471-2458-13-53Google Scholar
Dingle, G. A., Gleadhill, L., & Baker, F. A. (2008). Can music therapy engage patients in group cognitive behavior therapy for substance abuse treatment? Drug and Alcohol Review, 27, 190–196. https://doi.org/10.1080/09595230701829371Google Scholar
Gaetz, S., Scott, F., & Gulliver, T. (2013). Housing First in Canada: Supporting communities to end homelessness. Canadian Homelessness Research Network Press.Google Scholar
Gilmer, T. P., Stefancic, A., Sklar, M., & Tsemberis, S. (2013). Development and validation of a Housing First fidelity survey. Psychiatric Services, 64, 911–914. https://doi.org/10.1176/appi.ps.201200500Google Scholar
Grazioli, V. S., Collins, S. E., Paroz, S., Graap, C., & Daeppen, J. B. (2017). Six-month outcomes among socially marginalized alcohol and drug users attending a drop-in center allowing alcohol consumption. International Journal of Drug Policy, 41, 65–73. https://doi.org/10.1016/j.drugpo.2016.12.015Google Scholar
Harm Reduction Coalition (2020). Principles of Harm Reduction. Retrieved from https://harmreduction.org/about-us/principles-of-harm-reduction/Google Scholar
Heather, N. (2006). Controlled drinking, harm reduction and their roles in the response to alcohol-related problems. Addiction Research and Theory, 14, 7–18. https://doi.org/10.1080/16066350500489170Google Scholar
Kertesz, S. G., Crouch, K., Milby, J. B., Cusimano, R. E., & Schumacher, J. E. (2009). Housing First for homeless persons with active addiction: Are we overreaching?Milbank Quarterly, 87, 495–534. https://doi.org/10.1111/j.1468-0009.2009.00565.xGoogle Scholar
Kirst, M., Zerger, S., Misir, V., Hwang, S., & Stergiopoulos, V. (2015). The impact of a Housing First randomized controlled trial on substance use problems among homeless individuals with mental illness. Drug and Alcohol Dependence, 146, 24–29. https://doi.org/10.1016/j.drugalcdep.2014.10.019Google Scholar
Larimer, M., Malone, D., Garner, M., Atkins, D., Burlingham, B., Lonczak, H., Tanzer, K., Ginzler, J., Clifasefi, S. L., Hobson, W. G., & Marlatt, G. A. (2009). Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems. JAMA, 301, 1349–1357. https://doi.org/10.1001/jama.2009.414CrossRefGoogle ScholarPubMed
Lee, H. S., & Petersen, S. R. (2009). Demarginalizing the marginalized in substance abuse treatment: Stories of homeless, active substance users in an urban harm reduction based drop-in center. Addiction Research & Theory, 17, 622–636. https://doi.org/10.3109/16066350802168613Google Scholar
Mackelprang, J. L., Collins, S. E., & Clifasefi, S. L. (2014). Housing First is associated with reduced use of emergency medical services. Prehospital Emergency Care, 18, 478–482. https://doi.org/10.3109/10903127.2014.916020Google Scholar
Malone, D. K. (2009). Assessing criminal history as a predictor of future housing success for homeless adults with behavioral health disorders. Psychiatric Services, 60, 224–230. https://doi.org/10.1176/appi.ps.60.2.224Google Scholar
Malone, D. K., Collins, S. E., & Clifasefi, S. L. (2015). Single-site Housing First for chronically homeless people. Housing, Care and Support, 18, 62–66. https://doi.org/10.1108/HCS-05-2015-0007CrossRefGoogle Scholar
Marlatt, A., & Witkiewitz, K. (2002). Harm reduction approaches to alcohol use: Health promotion, prevention, and treatment. Addictive Behaviors, 27, 867–886. https://doi.org/10.1016/S0306-4603(02)00294-0Google Scholar
Marlatt, G. A., Baer, J. S., Kivlahan, D. R., Dimeff, L. A., Larimer, M., Quigley, L., Somers, J. M., & Williams, E. (1998). Screening and brief intervention for high-risk college student drinkers: Results from a 2-year follow-up assessment. Journal of Consulting and Clinical Psychology, 66, 604–615. https://doi.org/10.1037//0022-006X.66.4.604Google Scholar
Marlatt, G. A., & Witkiewitz, K. (2010). Update on harm-reduction policy and intervention research. Annual Review of Clinical Psychology, 6, 591–606. https://doi.org/10.1146/annurev.clinpsy.121208.131438Google Scholar
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change (3rd ed.). Guilford.Google Scholar
Muckle, W., Muckle, J., Welch, V., & Tugwell, P. (2012). Managed alcohol as a harm reduction intervention for alcohol addiction in populations at high risk for substance abuse. Cochrane Database of Systematic Reviews, 12, CD006747. https://doi.org/10.1002/14651858.CD006747.pub2Google Scholar
National Alliance to End Homelessness. (2012). Solutions: Housing First. www.endhomelessness.org/pages/solutionsGoogle Scholar
NIAAA. (2005). Helping patients who drink too much: A clinician’s guide. https://pubs.niaaa.nih.gov/publications/practitioner/cliniciansguide2005/guide.pdfGoogle Scholar
Nielsen, S., Larance, B., Degenhardt, L., Gowing, L., Kehler, C., & Lintzeris, N. (2016). Opioid agonist treatment for pharmaceutical opioid dependent people. Cochrane Database of Systematic Reviews, 5. https://doi.org/10.1002/14651858.CD011117.pub2Google Scholar
Orwin, R. G., Garrison-Mogren, R., Jacobs, M. L., & Sonnefeld, L. J. (1999). Retention of homeless clients in substance abuse treatment: Findings from the National Institute on Alcohol Abuse and Alcoholism Cooperative Agreement Program. Journal of Substance Abuse Treatment, 17, 45–66. https://doi.org/10.1016/s0740-5472(98)00046-4Google Scholar
Pauly, B., Vallance, K., Wettlaufer, A., Chow, C., Brown, R., Evans, J., Gray, E., Krysowaty, B., Ivsins, A., Schiff, R., & Stockwell, T. (2018). Community managed alcohol programs in Canada: Overview of key dimensions and implementation. Drug and Alcohol Review, 37, S132–S139. https://doi.org/10.1111/dar.12681Google Scholar
Pauly, B. M., Stockwell, T., Chow, C., Gray, E., Krysowaty, B., & Vallance, K. (2013). Towards alcohol harm reduction: Preliminary results from an evaluation of a Canadian managed alcohol program. Centre for Additions Research of British Columbia.Google Scholar
Pearson, M. R. (2013). Use of alcohol protective behavioral strategies among college students: A critical review. Clinical Psychology Review, 33. https://doi.org/10.1016/j.cpr.2013.08.006Google Scholar
Podymow, T., Turnbull, J., Coyle, D., Yetisir, E., & Wells, G. (2006). Shelter-based managed alcohol administration to chronically homeless people addicted to alcohol. Canadian Medical Association Journal, 174, 45–49. https://doi.org/10.1503/cmaj.1041350Google Scholar
Substance Abuse and Mental Health Services Administration (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (NSDUH). www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdfGoogle Scholar
Slayton, S. C., D’Archer, J., & Kaplan, F. (2010). Outcome studies on the efficacy of art therapy: A review of findings. Art Therapy, 27, 108–118. https://doi.org/10.1080/07421656.2010.10129660Google Scholar
Sobell, L. C., Ellingstad, T. P., & Sobell, M. B. (2000). Natural recovery from alcohol and drug problems: Methodological review of the research with suggestions for future directions. Addiction, 95, 749–764. https://doi.org/10.1046/j.1360-0443.2000.95574911.xGoogle Scholar
Somers, J. M., Moniruzzaman, A., Patterson, M., Currie, L., Rezansoff, S. N., Palepu, A., & Fryer, K. (2017). A randomized trial examining Housing First in congregate and scattered site formats. PLoS ONE, 12, e0168745. https://doi.org/10.1371/journal.pone.0168745Google Scholar
Stergiopoulos, V., Gozdzik, A., Misir, V., Skosireva, A., Connelly, J., Sarang, A., Whisler, A., Hwang, S. W., O’Campo, P., & McKenzie, K. (2015). Effectiveness of Housing First with intensive case management in an ethnically diverse sample of homeless adults with mental illness: A randomized controlled trial. PLoS ONE, 10, e0130281. https://doi.org/10.1371/journal.pone.0130281Google Scholar
Stockwell, T., Pauly, B., Chow, C., Erickson, R. A., Krysowaty, B., Roemer, A., Vallance, K., Wettlaufer, A., & Zhao, J. (2018). 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. Drug and Alcohol Review, 37, S159-S166. https://doi.org/10.1111/dar.12618Google Scholar
Tartarsky, A. (2002). Harm reduction psychotherapy: A new treatment for drug and alcohol problems. Rowman &Littlefield.Google Scholar
Thornquist, L., Biros, M., Olander, R., & Sterner, S. (2002). Health care utilization of chronic inebriates. Academic Emergency Medicine, 9, 300–308. https://doi.org/10.1111/j.1553-2712.2002.tb01323.xCrossRefGoogle ScholarPubMed
Tsemberis, S. (2010). Housing First: The pathways model to end homelessness for people with mental illness and addiction. Hazelden Publishing.Google Scholar
Tsemberis, S., & Eisenberg, R. F. (2000). Pathways to Housing: Supported housing for street-dwelling homeless individuals with psychiatric disabilities. Psychiatric Services, 51, 487–493. https://doi.org/10.1176/appi.ps.51.4.487Google Scholar
Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health, 94, 651–656. https://doi.org/10.2105/AJPH.94.4.651Google Scholar
Tsemberis, S., Kent, D., & Respress, C. (2012). Housing stability and recovery among chronically homeless people with co-occurring disorders in Washington DC. American Journal of Public Health, 102, 13–16. https://doi.org/10.2105/AJPH.2011.300320Google Scholar
Vaeth, P. A., Wang‐Schweig, M., & Caetano, R. (2017). Drinking, alcohol use disorder, and treatment access and utilization among US racial/ethnic groups. Alcoholism: Clinical and Experimental Research, 41, 6–19. https://doi.org/10.1111/acer.13285Google Scholar
Vallance, K., Stockwell, T., Pauly, B., Chow, C., Gray, E., Krysowaty, B., Perkin, K., & Zhao, J. (2016). Do managed alcohol programs change patterns of alcohol consumption and reduce related harm? A pilot study. Harm Reduction Journal, 13, 13. https://doi.org/10.1186/s12954-016-0103-4Google Scholar
Watson, D. P., Orwat, J., Wagner, D. E., Shuman, V., & Tolliver, R. (2013). The Housing First model (HFM) fidelity index: Designing and testing a tool for measuring integrity of housing programs that serve active substance users. Substance Abuse Treatment, Prevention and Policy, 8, 1–16. https://doi.org/10.1186/1747-597X-8-16CrossRefGoogle ScholarPubMed
Willenbring, M. L. (2014). Treatment of heavy drinking and alcohol use disorder. In Ries, R. K., Fiellin, D. A., Miller, S. C., & Saitz, R. (Eds.), The ASAM principles of addiction medicine (5th ed.) (pp. 375–388). Wolters Kluwer.Google Scholar
Witkiewitz, K., Montes, K. S., Schwebel, F. J., & Tucker, J. A. (2020). What is recovery?Alcohol Research: Current Reviews, 40, 01–01. https://doi.org/10.35946/arcr.v40.3.01Google Scholar