PDF(Pubmed)
Abstract：
BACKGROUND: Alcohol is a leading cause of morbidity and mortality in the United States and people who are unstably housed are disproportionately impacted by adverse alcohol-related health outcomes. Addressing the needs of unstably housed people with high-intensity alcohol use (i.e., heavy episodic use or binge drinking), including those whose goal is not abstinence, is critical to reducing harms among this population. This study explores the alcohol-related treatment and support needs among unstably housed people who use alcohol.
METHODS: Data collection included participant observation and semi-structured interviews (n = 25) with unstably housed people with high-intensity alcohol use. Data were analysed thematically, with attention to structural vulnerability and social-structural forces at shaping perceptions of and experiences with alcohol treatment.
RESULTS: Participants underscored how housing instability was critical in precipitating and maintaining heavy alcohol use, with alcohol often used to manage the stress and anxiety related to housing instability. While participants regularly engaged with alcohol treatment programs, program design and barriers to access undermined the effectiveness of these services for participants. Participants described the need for a range of program and service options across a continuum of care to be implemented to support participants in meeting their diverse needs and identified goals regarding alcohol use.
CONCLUSIONS: Alcohol treatment and supports need to be modified so that they include a range of harm reduction and abstinence-based models to better meet people\'s diverse needs. Furthermore, treatment must be paired with permanent and affordable housing to address underlying drivers of alcohol-related harm for unstably housed people.
METHODS: Data collection included participant observation and semi-structured interviews (n = 25) with unstably housed people with high-intensity alcohol use. Data were analysed thematically, with attention to structural vulnerability and social-structural forces at shaping perceptions of and experiences with alcohol treatment.
RESULTS: Participants underscored how housing instability was critical in precipitating and maintaining heavy alcohol use, with alcohol often used to manage the stress and anxiety related to housing instability. While participants regularly engaged with alcohol treatment programs, program design and barriers to access undermined the effectiveness of these services for participants. Participants described the need for a range of program and service options across a continuum of care to be implemented to support participants in meeting their diverse needs and identified goals regarding alcohol use.
CONCLUSIONS: Alcohol treatment and supports need to be modified so that they include a range of harm reduction and abstinence-based models to better meet people\'s diverse needs. Furthermore, treatment must be paired with permanent and affordable housing to address underlying drivers of alcohol-related harm for unstably housed people.
摘要：
背景：酒精是美国发病率和死亡率的主要原因，居住不稳定的人不成比例地受到酒精相关的不良健康结果的影响。解决高强度酒精使用不稳定住房的人的需求(即，重度间歇性使用或暴饮暴食)，包括那些目标不是禁欲的人，对减少这些人群的危害至关重要。这项研究探讨了酒精相关的治疗和支持需求不稳定的人谁使用酒精。
方法：数据收集包括参与者观察和半结构化访谈（n=25），这些访谈对象居住不稳定且使用高强度酒精的人。数据进行了主题分析，关注结构性脆弱性和社会结构性力量，以塑造人们对酒精治疗的看法和经验。
结果：参与者强调了住房不稳定对促使和维持大量饮酒的关键，经常使用酒精来管理与住房不稳定有关的压力和焦虑。虽然参与者经常参与酒精治疗计划，方案设计和访问障碍削弱了这些服务对参与者的有效性。参与者描述了需要在连续的护理中实施一系列计划和服务选项，以支持参与者满足他们的多样化需求和确定的酒精使用目标。
结论：需要修改酒精治疗和支持，以便它们包括一系列减少伤害和禁欲的模式，以更好地满足人们的多样化需求。此外，治疗必须与永久性和负担得起的住房配对，以解决不稳定住房的人与酒精相关伤害的潜在驱动因素。
方法：数据收集包括参与者观察和半结构化访谈（n=25），这些访谈对象居住不稳定且使用高强度酒精的人。数据进行了主题分析，关注结构性脆弱性和社会结构性力量，以塑造人们对酒精治疗的看法和经验。
结果：参与者强调了住房不稳定对促使和维持大量饮酒的关键，经常使用酒精来管理与住房不稳定有关的压力和焦虑。虽然参与者经常参与酒精治疗计划，方案设计和访问障碍削弱了这些服务对参与者的有效性。参与者描述了需要在连续的护理中实施一系列计划和服务选项，以支持参与者满足他们的多样化需求和确定的酒精使用目标。
结论：需要修改酒精治疗和支持，以便它们包括一系列减少伤害和禁欲的模式，以更好地满足人们的多样化需求。此外，治疗必须与永久性和负担得起的住房配对，以解决不稳定住房的人与酒精相关伤害的潜在驱动因素。
