TREATING ALCOHOLICS WITH ALCOHOL

Strict bans on drinking keep street people from seeking help -- so an
Ottawa shelter is trying to teach moderation. Jennifer Kennedy reports.

Brights 74 sherry, to be exact.

Every day, from 7:30 a.m. until 10 p.m., staff serve mugs of the sherry to
the group gathered in a tiny room in the Shepherd's shelter. The eight men
and two women, their ages ranging from 31 to 71, get a maximum of one drink
per hour, or sometimes less, depending on the behaviour and drunkenness of
the clients.

The program has just received $140,000 from the federal government to
remain open for two more years.

"The people targeted for this program are on a cycle of 'get drunk till I
pass out and I either end up in jail or I'm brought to a shelter, wake up,
head out to the street and start looking to get a bottle again, or find the
bottle that I hid last night,' " says Mary Cleary, director of the program.

For years, staff had been trying to break the pattern, but being a dry
shelter forced these hard-to-reach street alcoholics outside and away from
beneficial services.

Hope Recovery Stage Two, as it's called, began last March as a way of
getting street alcoholics into the shelter, where basic services like a hot
shower, a warm meal, clean clothes and a doctor are available.

This moderate drinking program fits into the category of "harm-reduction"
methods, like methadone clinics and needle exchanges, but it's nowhere near
as popular.

While more than 100 needle exchanges exist across the country, there are
only two drinking programs. The model for Ottawa's program came from
Toronto's Seaton House men's shelter, the only other one in the
country. Because of limited funds, only 10 people are in the program right
now. Five more are on the waiting list.

Since alcoholics in the program know they will get a drink at the shelter,
they have an incentive to stay off the street, Ms. Cleary says. The program
works because it doesn't demand what can be an impossible requirement --
sobriety.

"To say to the person who's 31, who's been drinking since he was seven,
'Stop drinking' -- he doesn't even have a sense of that. He doesn't know
what not drinking is," Ms. Cleary says. "He really doesn't understand what
life without alcohol is."

But not everyone sees it that way. Some groups see prevention and the
elimination of alcohol, not reduction, as the only way to effectively
address alcoholism -- notably the Nebraska-based Drug Watch International,
which promotes a drug-free society ideal. In Canada, however, there are
many supporters of such projects.

"We're very much in favour of harm-reduction policies," said Richard
Garlick, spokesman for the Canadian Centre for Substance Abuse in Ottawa.
"Abstinence is part of the continuum. It just doesn't begin with
abstinence," he says.

Indeed, giving alcohol to street alcoholics actually causes them to drink
less, Ms. Cleary says. "They might drink 40 ounces of alcohol during the
day here, which is a lot for you and I, but on the street, they would drink
six 40-ounce bottles.

"Not to mention the amount of mouthwash they would drink on top of that."

One of the goals of the program is also to get the clients off mouthwash,
which is a poison when large amounts are ingested.

Those in the program are getting proper medical care, forming bonds with
people and becoming part of a community. For the first time in a long time,
some have a mailing address and a sense of responsibility, Ms. Cleary says.

"What we were hoping to accomplish in six months happened in the first
month," she said. "People wanted showers, saw doctors, saw dentists, got
haircuts, took care of themselves."

Also, the program saves money by reducing emergency room visits, 911 calls
and court cases.

"Innovation is where we need to go to solve some of these (social and
housing) problems," says Peter Hume, councillor for Alta Vista on city
council, about the program. "The one-size-fits-all model doesn't work."

Ottawa's chapter of Alcoholics Anonymous, although unaware of Hope Recovery
Stage Two, says part of its belief system is the virtue of accepting things
as they are and not judging other programs that help severely dependent users.

Everyone in the Shepherds program pays $100 a month, a fair chunk of the
$112 most receive as a basic-needs allowance each month from the Ontario
government, Ms. Cleary says.

"Basically, the wine belongs to them," she said. "We just control giving it
out."

The program costs $149,000 a year. About half of that comes from the
federal government through the Initiative to End Homelessness. The rest
comes from public donations and charity.

In 1996, the Seaton House men's shelter in Toronto began a harm-reduction
program after a coroner's inquest into the freezing deaths of three chronic
alcoholic street people recommended a program of this type.

Within months, the shelter had a harm-reduction program serving 20
people. Now, about four years later, 140 men are in the program. The
quality of life for people in the program has gone up "tenfold," program
supervisor Arthur Manuel says. "It's wonderful."