Implementation of Harm Reduction Activities Among a Formerly Homeless Population with Chronic Alcoholism

Monday, 18 November 2013: 3:35 PM

Cindy Ringhofer Brown, DNP, MPH, MS, RN, RD
School of Nursing/ Post Baccalaureate Program, The College of St. Scholastica, Duluth, MN

Learning Objective 1: The learner will be able to identify the principles of the harm reduction model

Learning Objective 2: The learner will be able to describe the outcomes of this project in which harm reduction activities were implemented among a population with chronic alcoholism

Abstinence-based alcohol abuse treatment approaches result in high attrition and low success rates.  Additionally, homeless populations with chronic alcoholism have unique needs not traditionally addressed in current treatment approaches.  A harm reduction approach offers an alternative treatment for this population.  The purpose of this project was to provide tailored harm reduction activities for 30 formerly homeless individuals with chronic alcoholism in order to reduce risk or harmful consequences related to their alcohol abuse as measured by reductions in (a) emergency room (ER) visits, (b) law enforcement contacts, and (c) alcohol detoxification facility admissions.  An improvement in resident individual functioning was an additional outcome.  Residents living in a housing facility operating under harm reduction principles were provided with a variety of harm reduction activities over a three-month period.  Examples of activities and offerings included crafts, gardening, walking group, field trips, aromatherapy, guided imagery, and stress management.  Residents completed weekly Outcome Rating Scale (ORS) surveys and monthly sobriety calendars.  The number of activities, variety of activities, and resident participation in activities were increased as a result of the project.  While no significant reductions in law enforcement contacts and detoxification facility admissions were realized, there was a 52% reduction in ER visits.  Sixty percent of ORS participants (n=10) who had the potential to achieve both a reliable and clinically significant positive change in their individual function, achieved this change.  This project was successful in significantly improving overall well-being for six residents and in reducing ER visits for participating residents.