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Prescription Alcohol Can Help Problem Drinkers
In managed alcohol programs, booze is doled out in doses, saving lives in the process

On the morning of October 1, 1998, Vernon Crow’s body, surrounded by empty bottles of cheap cooking alcohol, was found frozen to death on a street in Toronto, Ontario. While it’s not uncommon for people to freeze on the streets today, throughout the 1990s, so many folks succumbed to the cold that a street nurse described it at the time as being “like a slaughter.”
Two years earlier, three men were denied access to Seaton House, the largest homeless shelter in Toronto, because of their alcohol use. Like most shelters, using booze was strictly forbidden. The men did not survive the night, which opened a coroner’s inquest declaring the deaths entirely preventable and suggested some shelters should allow alcohol consumption on site.
Seaton House did exactly that, under the premise that allowing supervised alcohol use would reduce the risk of death or injury and discourage people from drinking nonconsumable alcohol like mouthwash. Seaton House and other community shelters in Canada soon took the concept a step further by providing prescribed doses of alcohol, typically wine, for their participants throughout the day.
Today, 23 managed alcohol programs (MAPs), as they are known, exist across Canada. A few other countries, such as Australia, Norway, and the U.K., have explored similar programs, but so far they haven’t multiplied at the same rate. In the United States, only one shelter program exists that allows alcohol, but the alcohol is not prescribed. Experts who study MAPs say they provide an effective avenue for reducing the harms of alcohol misuse — so why hasn’t this idea caught on elsewhere, the way it did in Canada?
Every hour, from 7:30 in the morning to 9:30 at night, residents are given a “pour” of prescription alcohol.
How MAPs work
MAPs are typically coupled with housing and cater only to people with extreme chronic alcohol use problems, usually folks who have been through abstinence-based treatment multiple times without success.