A program in Ottawa has been helping people experiencing homelessness who struggle with severe alcohol addiction for over 20 years. Instead of just telling people to stop drinking, the program gives them a safe place to live, controlled amounts of alcohol, meals, medical care, and support from counselors and community workers. This approach, called a Managed Alcohol Program, focuses on keeping people healthy and stable rather than forcing them to quit immediately. The program shows that when you combine housing, healthcare, and social support all in one place, people with severe addiction can live safer, more dignified lives.
The Quick Take
- What they studied: How a Managed Alcohol Program in Ottawa helps people experiencing homelessness who have severe alcohol addiction by providing housing, controlled alcohol, medical care, and social support all together.
- Who participated: The program serves people experiencing homelessness with severe alcohol use disorder in Ottawa. This is a description of how the program works rather than a traditional research study with a specific number of participants.
- Key finding: The program has successfully operated since 2001 by combining housing, healthcare, and social supports in one place, helping reduce emergency room visits and improving people’s health and dignity.
- What it means for you: If you or someone you know struggles with severe alcohol addiction and homelessness, this type of program may offer a practical path to stability and better health. However, this approach works best as part of a larger system of support and may not be available everywhere.
The Research Details
This is a detailed description of how one successful program in Ottawa operates, rather than a traditional research study comparing groups. The authors explain the practical strategies and daily operations of the Ottawa Inner City Health Managed Alcohol Program, which has been running since 2001. They describe what the program does, how it’s organized, and what makes it work well for the people it serves.
The program combines several key elements: people get a safe place to live, receive measured amounts of alcohol at scheduled times, get regular meals, receive medical and mental health care, and work with counselors and peer supporters. The program also includes an Indigenous healer and staff trained in trauma-informed care, meaning they understand that many participants have experienced serious harm and treat them with respect and patience.
This type of description helps other cities and organizations understand how to create similar programs. Rather than testing whether something works through a controlled experiment, the authors share real-world lessons from 20+ years of experience.
Understanding how successful programs actually work in real life is just as important as traditional research studies. This detailed description helps other communities learn what strategies are effective, what challenges they might face, and how to organize services to help people with the most severe addiction problems. The program shows that a ‘harm reduction’ approach—focusing on reducing harm rather than demanding immediate abstinence—can work for people experiencing homelessness.
This is an expert commentary based on 20+ years of real-world program experience, not a controlled research study. The information comes from people who actually run the program and see the results daily. While this type of description is valuable for practical insights, it doesn’t have the same level of scientific proof as studies that compare groups of people. The program’s long history of operation and recognition internationally suggests it’s effective, but more formal research studies would provide additional confirmation.
What the Results Show
The Ottawa Inner City Health Managed Alcohol Program has successfully served people experiencing homelessness with severe alcohol addiction since 2001. The program works by providing stable housing combined with controlled alcohol distribution, medical care, meals, and social support all in one integrated system.
Key operational strategies that make the program successful include: giving each person a structured alcohol schedule tailored to their individual needs rather than a one-size-fits-all approach; providing regular nutritious meals; offering comprehensive medical and mental health services; including peer workers and an Indigenous healer on the team; and using trauma-informed care practices that treat people with dignity and respect.
The program has reduced reliance on emergency room visits and hospital care by addressing people’s health needs proactively. By providing stable housing and regular care, the program helps prevent health crises before they happen. Staff pay special attention to nutrition, hygiene, and screening for serious health problems, catching issues early when they’re easier to treat.
The program operates through strong partnerships with community organizations, pharmacies, and medical specialists, creating a coordinated system of care. This collaborative approach means people don’t have to navigate multiple separate services—everything is connected and working together toward the same goals.
Beyond the main health benefits, the program creates important social outcomes. Participants report increased feelings of dignity, stability, and community belonging. The program reduces the stigma and judgment that people with severe addiction often experience, replacing it with respect and support. Life skills training helps people develop practical abilities for daily living. The inclusion of peer workers—people with lived experience of addiction and homelessness—creates trust and understanding that professional staff alone cannot provide. The program also demonstrates that Indigenous healing practices can be valuable alongside Western medicine.
Managed Alcohol Programs have evolved from experimental ideas into recognized harm reduction strategies used in multiple countries. This Ottawa program is one of the longest-running examples, providing evidence that this approach is sustainable and effective over decades. The program builds on earlier harm reduction research showing that meeting people where they are—rather than demanding immediate abstinence—leads to better health outcomes for people with severe addiction. The integration of housing, healthcare, and social support reflects a growing understanding that addiction cannot be treated in isolation from homelessness and poverty.
This description is based on one program’s experience rather than a formal comparison study, so we cannot definitively say this approach works better than other methods without additional research. The program operates in a specific Canadian city with particular resources and community partnerships, so results may differ in other locations. The article does not provide specific numbers on how many people the program serves or detailed statistics on health improvements. The authors note that challenges remain in expanding these programs to other cities, refining how to identify who would benefit most, and developing clear policies to support these programs. More formal research studies would help confirm which specific elements are most important for success.
The Bottom Line
For people experiencing homelessness with severe alcohol addiction: Managed Alcohol Programs appear to be a promising option that may improve health, stability, and quality of life. This approach is supported by over 20 years of real-world experience in Ottawa and is recognized internationally. (Confidence level: Moderate—based on program experience rather than controlled research studies.) For communities and policymakers: Consider developing or supporting Managed Alcohol Programs as part of a comprehensive approach to homelessness and addiction, particularly for people with the most severe cases who haven’t benefited from other treatments. (Confidence level: Moderate to High—based on long-term program success and international recognition.)
This approach is designed for people experiencing homelessness who have severe alcohol addiction and have not been helped by traditional treatment programs. It may be less relevant for people with mild to moderate alcohol problems or those with stable housing. Healthcare providers, social workers, and community organizations serving homeless populations should understand this model. City planners and policymakers deciding how to address homelessness and addiction should consider these programs. People who have experienced homelessness and addiction themselves can offer valuable insights into whether this approach would help their communities.
The Ottawa program has been operating successfully for over 20 years, suggesting this is a sustainable long-term approach rather than a quick fix. People typically see improvements in health and stability within weeks to months of joining the program, though deeper changes in quality of life and social connection may develop over longer periods. The program is designed for ongoing support rather than a time-limited treatment, recognizing that severe addiction requires sustained care.
Want to Apply This Research?
- If using an app to support someone in a Managed Alcohol Program: Track daily check-ins with healthcare providers, medication adherence, meal consumption, and attendance at social support activities. Monitor changes in emergency room visits or hospital admissions as a key health indicator.
- Users could use an app to: Set daily goals for attending meals and health appointments, track mood and stress levels throughout the day, log participation in life skills training or social activities, and communicate with peer supporters or counselors. The app could provide reminders for medication times and scheduled alcohol distribution.
- Long-term tracking should focus on: Frequency of healthcare visits and emergency room use, physical health markers (nutrition, hygiene, sleep), mental health and mood patterns, social engagement and community participation, and overall sense of stability and dignity. Regular check-ins with the care team help adjust the program to meet changing needs.
This article describes a specific program’s approach to managing severe alcohol addiction in people experiencing homelessness. It is not a substitute for professional medical advice, diagnosis, or treatment. If you or someone you know struggles with alcohol addiction, please consult with a healthcare provider, addiction specialist, or contact a local substance abuse helpline. The effectiveness of Managed Alcohol Programs may vary depending on local resources, community support, and individual circumstances. This information is intended for educational purposes and to inform discussions about addiction treatment approaches, not to provide medical guidance for individual cases.