A safe place for homeless alcoholics to do their drinking?

The head of an Austin organization working on homelessness included this caveat when she sent me her group’s thought-provoking new study on homelessness and alcoholism:

“These concepts, unfortunately, could easily end up as fodder for those interested in ‘shock-jock’ type of reporting,” Helen Varty, executive director of Front Steps, said in her e-mail. “That is the last thing that citizens of Austin need.”

The report is titled “Solutions for Homeless Chronic Alcoholics in Austin.” It was produced by ECHO (Ending Community Homelessness Coalition) with financial support from Front Steps, which manages the Austin Resource Center for the Homeless.

The report doesn’t tell you anything you didn’t know about the state of the problem. Austin has too many homeless people, somehow estimated at 3,451 in a 2008 report. And, as you suspected, alcohol plays a big role in those numbers.

The report estimates that more than 1,200 of the homeless “suffer from some form of alcohol disorder.” Other numbers in the report detail the high cost of the often-unsuccessful approaches we take toward these folks.

“This money is being thrown towards a pattern that likely ends only with an individual’s death,” the report notes.

And that’s where it launches into concepts that are both shock-jock fodder and challenging notion. One of the concepts is “harm reduction,” the theory behind using methadone clinics and needle exchanges to reduce the risks associated with heroin addiction.

“Harm reduction acknowledges that some progress is better than none, and that is preferable to reduce drinking and improve overall wellness than to try but fail to demand sobriety,” the report says.

The report points to Seattle’s Downtown Emergency Service Center, which combines harm reduction and “housing first” in an effort to work with “chronically homeless, late-stage alcoholics.” Seventy-five rooms were offered to “individuals placing the greatest financial strain on city resources.” So far, the program has saved Seattle $1.8 million in emergency room visits alone.

The Seattle success is based, in part, (and here comes the shock-jock part) on the notion of providing a place for alcoholics to imbibe.

“While residents are allowed to drink in their rooms, alcohol use dropped from an average of 15.7 drinks daily to 10.6 after one year,” the report notes. “Again, these rates continued to decrease as clients remained in the program. In addition, researchers also found a statistically significant reduction in the number of days the residents reported intoxication.”

Challenging notion, isn’t it? And even more challenging if the program is in your neighborhood.

Ottawa, Canada, established a similar program in 2001. But unlike Seattle’s, Ottawa goes a step further by actually providing alcohol to the alcoholics in “small medical dosages.” Ottawa’s success has been more modest than Seattle’s, according to the report, but did manage to reduce city costs associated with homeless alcoholics.

The Canadian Medical Association Journal determined the average daily consumption of alcoholic drinks by participants in the program dropped from 46 (!) to eight.

So what do you think? Are you ready to stray from the cold-turkey notion of how to deal with homeless alcoholics? You willing to try programs that allow them to drink?

“I think we should try it,” Varty told me.

She didn’t always think so.

“I didn’t understand how we could put people who were still active (drinkers) into apartments and how that could work,” she said. “I had the notion that people had to stop drinking first.”

But that notion was challenged by numbers from elsewhere indicating that harm reduction can work.

“When we demand sobriety, what happens to people is they die on the streets,” Varty said, noting that 150 alcoholics died on Austin streets last year.

Varty hopes to compile stats showing how harm reduction can reduce the local cost of dealing with homeless alcoholics.

“If we can prove how much less expensive it is to get people into housing, then folks who can’t get it from a humanitarian point of view can sure get it from a cost-effective point of view,” she said.

Want to hear more? ECHO, Front Steps, the city of Austin and Travis County — among others — are holding a forum Oct. 16 at City Hall (8 a.m. to noon) to talk about chronically homeless people with substance abuse problems or mental illness.

Bill Hobson, a key player in the Seattle program, is the keynote speaker.

If you care about homelessness (and you should) the forum could be enlightening.

But please don’t tell the shock jocks about it.

source: Austin American-Statesman