Drinking under control programmes: perception of alcohol-related harm reduction measures in Poland. Results of qualitative study among outpatient alcohol treatment providers

Abstract

Introduction: Harm reduction programmes for drug addicts are well documented and accepted by practitioners, whereas harm reduction programmes for alcohol addicts are under researched and encounter resistance. The article presents the results of a qualitative study focused on the perception of two case studies of drinking under control programmes (DUCPs) by outpatient treatment providers working in abstinence-focused Polish alcohol treatment system. StreszczenieWprowadzenie: Programy redukcji szkód skierowane do osób uzależnionych od narkotyków są dobrze udokumentowane i akceptowane przez środowisko terapeutyczne. Jednocześnie programy tego typu skierowane do osób uzależnionych od alkoholu są rzadko tematem opracowań naukowych, a ich realizacja napotyka opór środowiska. Artykuł prezentuje wyniki badania jakościowego poświęconego percepcji dwóch przykładowych programów redukcji szkód dla osób uzależnionych od alkoholu, zrealizowanego z terapeutami uzależnienia od alkoholu. 162Justyna I. Klingemann, Harald Klingemann

Scoping review of managed alcohol programs

“…There were 38 established MAPs found in this scoping review, including programs located in housing or shelters, non-residential day programs, mobile services to scattered sites, and inpatient services, of which 9 were featured in the research literature (Table 1 ). The majority of MAPs in operation are located within Canada; additional research works out of Australia, Poland, the USA, and the UK evaluate potential feasibility and fit of a MAP [ 40 – 44 ]. One study featured an additional three temporary MAP sites emerged during the COVID-19 pandemic response, including in short-term Isolation and Quarantine sites (intended for those with or exposed directly to COVID-19 to aid recovery and decrease community transmission) and within residential homeless programs such as medical respite/recuperative care [ 27 ].…”

“…We included 14 studies that evaluated feasibility and acceptability of MAP at the health systems level [ 10 , 27 , 30 , 36 , 40 – 44 , 47 , 53 , 56 – 58 ]. For communities with an established MAP, qualitative analyses discussed the importance of establishing shared goals and measures of success within and between the MAP and community-based organizations, including holistic measures of health, culture, socioeconomic, social, and priorities defined by participants.…”

“…However, researchers of one qualitative study of addiction counselors from Poland found low acceptability and belief that a MAP would not be feasible at that time [ 44 ]. Researchers found that acceptance of harm reduction principles around alcohol use was lacking and noted that cultural and interpersonal stigmas of addiction needed to be addressed before MAP establishment.…”

Comparative study of three alcohol-related harm reduction programs: an ideal-type analysis

“…It is also important for this intervention to be co-constructed by users and professionals so that it makes sense for both. needs, depending on the severity of their addiction and the level of their craving, (Klingemann & Klingemann, 2017) as well as to the expectations expressed and the user's pro le. Mobilization of the notion of proportionate universalism, as de ned in 2010, (29) could be a relevant perspective for AHR interventions This principle states that "actions should be universal, but with an intensity and a scale that is proportional to the level of disadvantage".…”