Counting the cold ones: A comparison of methods measuring total alcohol consumption of managed alcohol program participants

• Published in: Drug and alcohol review Vol. 37; no. S1; pp. S167 - S173
• Main Authors: Chow, Clifton, Wettlaufer, Ashley, Zhao, Jinhui, Stockwell, Tim, Pauly, Bernadette (Bernie), Vallance, Kate
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.04.2018; Wiley Subscription Services, Inc
• Subjects: Alcohol; alcohol consumption; Alcohol related disorders; Alcohol use; Alcoholism; Counting; Dosage; Drinks; Ethanol; Harm reduction; Housing; Illnesses; managed alcohol programs; Meals; Polls & surveys; Self report; self‐report measures; Substance use disorder; managed alcohol programs; alcohol consumption; self-report measures; harm reduction
• ISSN: 0959-5236; 1465-3362
• DOI: 10.1111/dar.12648

Introduction and Aims Managed alcohol programs (MAP) aim to reduce harms experienced by unstably housed individuals with alcohol use disorders by providing regulated access to beverage alcohol, usually alongside housing, meals and other supports. This study compares two methods of estimating participants’ outside alcohol consumption in order to inform program policies and practices around alcohol dosing and reducing risks of alcohol‐related illnesses. Methods The total alcohol consumption of 65 people participating in Canadian MAPs was assessed comparing daily MAP records (1903 client days) with researcher‐administered surveys over the same time period. A sub‐sample of more complete daily MAP records for 39 people (696 client days) was also compared with the equivalent survey data on drinking. Results Significantly more standard drinks per day (SDs, one SD = 17.05 mL ethanol) were reported in research interviews than recorded by program staff, whether for program administered drinks alone (means 16.04 vs. 8.32 SDs, t = 5.79, P < 0.001) or including outside‐program drinks as reported to staff (16.04 vs. 8.89 SDs, t = 5.37, P < 0.001). Consistent results were found in the sub‐sample. The number of outside drinks estimated by comparing program records with the research interviews, varied between 2.71 and 9.94 mean drinks per day per site. Discussion and Conclusions At two sites, MAP participants reported consuming more than twice the amount of alcohol administered on the program. At most sites, there was significant under‐reporting of outside drinking. Addressing the problem of outside drinking and total daily consumption is critical for achieving program goals of both short and long‐term harm reduction.