MAP Managed Alcohol Program Glasgow

The Scotsman

MAP Managed Alcohol Program Glasgow Simon Community Scotland introduced Scotland’s first Managed Alcohol Programme (MAP) in 2021. A ten bedroom trauma- informed service’s aim and objective is to support homeless men who are alcohol dependent, men who have experienced various attempts at other treatments and do not wish to stop drinking.  The evidence-based Harm Reduction approach has given the people that they support the opportunity to; live in a place that they call home control their alcohol intake through an agreed alcohol plan with support from the team engage with a range of primary care services that improves health and wellbeing eat on a regular basis participate  in a range of activities including music tuition and digital inclusion reconnect with family and friends. All in a place where they feel safe.  The service has been designed to a very high level that ensures the men live in a comfortable and stress -free environment.  The MAP service offers a creative and innovative way of helping the men that we support to drink less harmful and hazardous amounts of alcohol, whilst at the same time engaging with primary care services in looking after their health needs. Karyn McCluskey, the head of Community Justice Scotland, was behind piloting the Canadian model here.  She analysed the cost to emergency services of these men street-drinking before they entered the project and believes the cost of not having the MAP would run into “millions” of pounds.  “One of the men that I looked at had been taken to Glasgow Royal Infirmary by ambulance over 400 times in a period of two and a bit years,” she tells the BBC.  “That is extortionate. I mean serious amounts of money. Probably millions.”

Transcript

00:00 I'm Liri McGrath, I'm very privileged to be the Chief Exec of Simon Community Scotland

00:23 and today we're in our Managed Alcohol Programme accommodation.

00:27 So this is home to 10 men who have experienced long term addiction to alcohol and who have

00:34 tried in many different ways to tackle that addiction and not been able to find a route

00:39 to recovery.

00:40 It provides 24 hour support and high quality accommodation so that people can manage their

00:48 alcohol programme and we work with health services to determine a safe level of alcohol

00:53 consumption that allow people to manage their addiction without having chaos in their lives.

01:00 It's no great surprise that Scotland's relationship with alcohol is still long, long term, that

01:06 we are still seeing an increase in people dying.

01:10 2% doesn't sound like a lot but 31 lives is certainly more than any of us would want to

01:17 see.

01:18 It's still an upward trend, we want to see it a downward trend and there's lots of good

01:22 interventions being planned.

01:24 The minimum unit pricing of alcohol is obviously to prevent people getting into dependence

01:30 in the first place but we have too many people already heavily dependent on alcohol and that

01:35 is why we're still seeing that rise in deaths and that's the group of people we need to

01:40 think differently about and have a wider range of options for.

01:45 Which is why Simon Community have invested quite a lot of our own funds in making this

01:50 service available for men initially so that Scotland can have another strand to its bowl

01:57 in terms of how we respond to people who have alcohol dependence and for whom alcohol has

02:04 robbed their health, their wellbeing and their future.

02:10 I'd like to see us have more range of options for people.

02:13 We have a very strong recovery agenda for drugs related harms.

02:20 We've perhaps lost sight of the level of alcohol related harms we have in Scotland and we've

02:26 been focusing on that prevention agenda which is fantastic but like I said we know that

02:31 we've got far too many people already in the system who have that alcohol dependence so

02:36 we need to widen that range of options.

02:39 One of those options, our ambition is that we can have a managed alcohol programme embedded

02:47 in the system that can be delivered anywhere.

02:50 It doesn't need to be lots of buildings all over the country, it can just be a way of

02:54 working with people that gives them the opportunity to have the same level of stability, the same

03:00 level of comfort and safety that the men who come to live here are finding and tell us

03:06 that they have.

03:07 So the managed alcohol programme itself is based on 20 years of evidence from Canada

03:12 where there are upwards of 30 managed alcohol programmes of all different natures, buildings,

03:17 sizes and increasingly on a community basis as well.

03:23 So we've taken the learning from Canada and the evidence base from Canada and what we're

03:27 doing here is translating that into a Scottish context and hopefully taking it that step

03:33 further so that it can be a programme that is so well developed that the evidence base

03:38 is strong for and the system can accommodate so that people can actually access this from

03:44 their own home.

03:45 They don't have to come and live in a specialist unit like this, they can access it from their

03:49 own home.

03:50 That's the big ambition.

03:51 What sort of progress have you seen in the men who use this facility?

03:57 Astounding progress.

03:59 The men that have come to live here in the last year and a bit have just so clearly demonstrated

04:05 what people are capable of when they're given the opportunity, when they're given the safety,

04:10 the stability, the support and they have a nice home to live in, a high quality environment

04:17 that they can feel proud of.

04:20 They start looking after themselves, they start to see a different future for themselves.

04:25 We've got men who have reconnected with family members, family members who are telling us

04:30 for the first time it's actually helped their health because they're not worrying about

04:36 their loved one anymore in the same way as they were before.

04:39 They're happier, their wellbeing has improved.

04:43 The men that have come here within four weeks have all reduced their alcohol intake by a

04:48 minimum of 50%, some as much as 75% and they are engaging with health interventions, they

04:57 are looking after themselves, they're thinking about their health, they're engaging in community

05:03 activity.

05:05 Many are seeking counselling to help deal with many of the aspects that alcohol has

05:12 brought to their lives, the negative aspects, things that they may look back on and feel

05:17 bad about, trauma that's happened to them, grief and loss that they've never processed

05:22 because they've been lost in alcohol dependence during that period as well.

05:28 So many different aspects.

05:30 Guys leaving the city for the first time on day trips, going on holiday, drawing for the

05:37 first time in their lives, playing music, recording their songs.

05:42 The list of things that the guys have been able to do is just phenomenal and for me they

05:49 demonstrate just what people are capable of and these are guys that were probably written

05:54 off over and over and over again and the system seen them as a problem rather than as a human

06:03 being with potential but here we are sitting chatting to them today and it's so obvious

06:10 just how amazing these guys are and can be.

06:13 I am drunk and a lesbian.

06:14 I tend to drink heavily and so as to avoid any personal issues that I don't want to address

06:22 because I'm scared of the heartache that it's going to cause me and being hurt like that

06:28 by your own means can drive you into a more darker place.

06:35 I was approached in town, I was sleeping rough in town but before that I had been going through

06:44 hostel after hostel after hostel.

06:48 I had separated from my long term partner and my children.

06:55 I found it difficult coming back home and trying to come back into the way of life in

06:59 Glasgow and it wasn't getting moved out for me being a negative person or anything like

07:05 that or it was just my time at that place had come to an end so it was now time to move

07:11 on to another placement but again that had come from being, I had been just a sleeping

07:16 bag in my possession to sleeping in shop doorways in the city centre and coming back and trying

07:26 to spend as much time at friends houses and people's but I don't want to be a burden on

07:31 them so I would leave making out that everything was fine and go and get where I had hidden

07:38 my sleeping bag and go and set up for the evening and just try and get to sleep you

07:44 know and the hustle and bustle of the nightlife in town and that you know.

07:48 I got involved with the project itself, the community itself, Simon community and my worker

07:58 had actually sought a, she didn't even explain really about the place she just says I've

08:06 got a good placement for you and she had made all the arrangements for me to come here and

08:13 I was quite, I found the experience quite not to be true as if at any moment it's going

08:21 to get taken away from us and it's just a wee temporary placement for maybe a week or

08:26 so and I found out very soon after the week that I was to be accepted here on a full time

08:36 basis and I've not looked back. I've got my alcohol misuse down to just a normal strength

08:44 of a lagger each day for about one every two or three hours and you can actually get that

08:52 lowered if it's not working for you, it's to stop you going out and causing chaos in

09:00 the streets by drinking in the street you know, not only are you like not keeping yourself

09:06 safe but you're not safe to others either in a manner of speaking because when you get

09:12 so belligerently drunk you don't actually realise the harm that you're doing, one to

09:16 yourself, your body, your personality, just your way of life in general and what you can

09:24 be doing to other people, you just take that as an everyday just like, "Ah well that

09:30 happens but it shouldn't happen and I didn't want it to continue." It's your choice to

09:36 engage with things like we've got art class and all that you know, help out in the kitchen

09:42 and all that if you choose to, if you want to, do anything that you feel but I think

09:48 this place actually invokes and wakens in someone as my own way of life, the encouragement

09:56 to actually do better, do better for yourself and just do better in general because if you're

10:03 better for yourself then you're better for society and you're better for the actual area

10:09 that you live in, the place where you come from.

10:12 They're loved and they have potential to love back as well but that's been robbed of them

10:16 by alcohol and that's one of the biggest things that we can give back. We would love to roll

10:22 it out for women as well. The reason that we started with men is that that's where the

10:28 majority of the need is, particularly in Glasgow and it wasn't a great idea in terms of what

10:36 we were talking to people about having a mixed gender environment to begin with but we definitely

10:42 know plenty of women who have come through our services or other services within the

10:47 8,000 people that we work with every year that would benefit from it. Unfortunately

10:53 we don't have the resources to do that on our own. I'm really hopeful that resources

10:59 will come into the system to allow that to happen.

11:02 The biggest challenge is the building. Family Community Scotland bought this building and

11:07 refurbished it with our own funds. If that hadn't been possible there wouldn't be a map,

11:15 there just wouldn't be. We're also underwriting the funding on an annual basis alongside some

11:20 money from Scottish Government and some grants and trusts but again if we weren't doing that

11:25 there wouldn't be a map.

11:28 I really hope that the Scottish Government, once we have the formal evaluation that's

11:33 been funded, once we have that in place that will give them the ability to make good decisions

11:39 about the future of a managed alcohol programme approach in Scotland and provide funds and

11:46 to see the cost benefit in terms of taking away people who were, some of the guys here

11:52 in the previous six months before they came here they might have been in A&E 15 times

11:57 or more in a six month period. That's not happening here. They may have been in and

12:02 out of custody several times in that period. That's not happening here. So even if you

12:08 are not counting the human value, if you count the public purse impact, there's a good economic

12:16 sense and basis for developing the managed alcohol programme but that is yet to be properly

12:22 formally evidenced and obviously Scottish Government will need that formal evidence

12:26 to base those decisions on going forward. But there are obviously other big grants and

12:31 trusts out there who are also in a position to help us. Some of them are linked to the

12:35 alcohol industry. It would be interesting to hear that they would be willing to support

12:43 us as well.

12:44 [End of Audio] Duration: 5 minutes and 40 seconds

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