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Alcohol dependence – harm reduction in homeless populations



Simple guidance on determining baseline alcohol intake and brief guidance on safe reduction

This information is sourced from the Homeless Drug and Alcohol Service (HDAS) and Dr Dana Beale:

As part of the Pan-London response to homeless patients being placed in emergency hotel accommodation, Homeless Drug and Alcohol Service (HDAS) was formed and provides simple guidance on common substance misuse issues seen in homeless populations

Their resources found here provide excellent practical guidance to print and hand out to patients or guide your practice as a GP

Alcohol withdrawal can be fatal; the goal should be to cut down and gain some control of drinking by moving to treating alcohol as a medicine – i.e. spacing out drinks to manage withdrawal symptoms

As GPs we often refer to addictions services; if the wait to be ‘picked up’ by services is long, practical advice such as that provided by HDAS can be life-saving

Outline:

  1. Drink diary: note down which drinks/how many; use a unit calculator -Alternatively: % alcohol on the side of the bottle or can represents the amount of units in a litre
  2. Encourage to try to space out their drinks
    Once stabilised daily intake for one week, start to cut down slowly
  3. Cut down by no more than 10% of total units per day
  4. Ideally, cut down by 10% every four days, particularly those drinking more than 25 units per day
  5. If they start to experience withdrawal symptoms, means they are cutting down too rapidly. Stabilise for one week and then cut down by 5-10% each week