“I drink less and that's no small matter”: A qualitative study of a managed alcohol program evaluation in Barcelona.

Background: The concurrence of homelessness and severe alcohol dependence has multiple negative consequences in affected individuals. Managed alcohol programs (MAPs) have emerged as a potential solution to reduce alcohol-related harms in this population. This study aimed to explore the impact of the MAP implemented in the city of Barcelona on patterns of consumption of alcohol and other psychoactive substances, health, and quality of life, and included the gender perspective, on people who use drugs experiencing homelessness who had accessed a comprehensive residential center. 

Methods: A descriptive qualitative design was used, employing semi-structured interviews with eight participants who were enrolled in the MAP (three women, five men) and four program professionals. Thematic content analysis was used to analyze the resulting data. 

Results: Participants reported improved health due to reduced consumption of alcohol and other psychoactive substances, better anxiety management, and stable reconnection to the public health system. The participants also reported enhanced quality of life, including feeling safer and better rested, and better use of time, which had previously been spent on meeting their basic needs. Women reported that a key benefit of the program was living in a sexism-free environment. 

Conclusion: These results seem to demonstrate that harm reduction strategies prioritizing basic needs and adopting a gender-sensitive perspective can positively impact the health and quality of life of people experiencing homelessness with severe alcohol dependence.