Editing Harm reduction (section)

=====Alcohol=====
{{See also|Fomepizole|Denatured alcohol#Toxicity}}
Traditionally, [[homeless shelter]]s ban [[alcoholic beverage|alcohol]]. In 1997, as the result of an [[inquest]] into the deaths of two people experiencing homelessness who recreationally used alcohol two years earlier, [[Toronto]]'s [[Seaton House]] became the first homeless shelter in Canada to operate a "wet shelter" on a "managed alcohol" principle in which clients are served a glass of wine once an hour unless staff determine that they are too inebriated to continue. Previously, people experiencing homelessness who consumed excessive amounts of alcohol opted to stay on the streets often seeking alcohol from unsafe sources such as mouthwash, rubbing alcohol or industrial products which, in turn, resulted in frequent use of [[Emergency department|emergency medical facilities]]. The programme has been duplicated in other Canadian cities, and a study of [[Ottawa]]'s "wet shelter" found that emergency room visit and police encounters by clients were cut by half.<ref>{{Cite news |last=McKeen, Scott |date=7 March 2007 |title='Wet' shelter needs political will: Toronto project could serve as model for Edmonton |work=Edmonton Journal}}</ref> The study, published in the ''[[Canadian Medical Association Journal]]'' in 2006, found that serving people experiencing long-term homelessness and who consume excessive amounts of alcohol controlled doses of alcohol also reduced their overall alcohol consumption. Researchers found that programme participants cut their alcohol use from an average of 46 drinks a day when they entered the programme to an average of 8 drinks and that their visits to emergency rooms dropped from 13.5 to an average of 8 per month, while encounters with the police fall from 18.1 to an average of 8.8.<ref name="pmid16389236">{{Cite journal |vauthors=Podymow T, Turnbull J, Coyle D, Yetisir E, Wells G |year=2006 |title=Shelter-based managed alcohol administration to chronically homeless people addicted to alcohol. |journal=CMAJ |volume=174 |issue=1 |pages=45–49 |doi=10.1503/cmaj.1041350 |pmc=1319345 |pmid=16389236}}</ref><ref>{{Cite news |last=Patrick, Kelly |date=7 January 2006 |title=The drinks are on us at the homeless shelter: Served every 90 minutes: Managed alcohol program reduces drinking |work=National Post}}</ref>

Downtown Emergency Service Center (DESC),<ref>{{Cite web |date=3 March 2016 |title=DESC |url=http://www.desc.org/supportive_housing.html |url-status=live |archive-url=https://web.archive.org/web/20160303175712/http://www.desc.org/supportive_housing.html |archive-date=3 March 2016 |access-date=2 February 2021}}</ref> in [[Seattle]], Washington, operates several [[Housing First]] programmes which utilize the harm reduction model. [[University of Washington]] researchers, partnering with DESC, found that providing housing and support services for homeless alcoholics costs taxpayers less than leaving them on the street, where taxpayer money goes towards police and emergency health care. Results of the study funded by the Substance Abuse Policy Research Program (SAPRP) of the [[Robert Wood Johnson Foundation]]<ref name="SAPRPpressRelease">{{Cite web |date=April 2009 |title=SAPRP Project: Housing First: Evaluation of Harm Reduction Housing for Chronic Public Inebriates |url=http://www.saprp.org/m_pr_archives_detail.cfm?AppID=3836 |url-status=dead |archive-url=https://web.archive.org/web/20100729084741/http://www.saprp.org/m_pr_archives_detail.cfm?AppID=3836 |archive-date=29 July 2010 |website=SAPRP}}</ref> appeared in the ''[[Journal of the American Medical Association]]'' in April 2009.<ref>{{Cite journal |vauthors=Larimer ME, Malone DK, Garner MD, etal |date=April 2009 |title=Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems |journal=JAMA |volume=301 |issue=13 |pages=1349–1357 |doi=10.1001/jama.2009.414 |pmid=19336710 |doi-access=free}}</ref> This first controlled assessment in the U.S. of the effectiveness of Housing First, specifically targeting chronically homeless alcoholics, showed that the programme saved taxpayers more than $4 million over the first year of operation. During the first six months, the study reported an average cost-savings of 53 percent (even after considering the cost of administering the housing's 95 residents)—nearly $2,500 per month per person in health and social services, compared to the per month costs of a wait-list control group of 39 homeless people. Further, despite the fact residents are not required to be abstinent or in treatment for alcohol use, stable housing also results in reduced drinking among people experiencing homelessness who recreationally use alcohol.

======Alcohol-related programmes======
A high amount of media coverage exists informing people of the dangers of [[drunk driving|driving drunk]]. Most people who recreationally consume alcohol are now aware of these dangers and safe ride techniques like '[[designated driver]]s' and free taxicab programmes are reducing the number of drunk-driving crashes. Many cities have free-ride-home programmes during holidays involving high amounts of alcohol use, and some bars and clubs will provide a visibly drunk patron with a free cab ride.

In [[New South Wales]] groups of licensees have formed local liquor accords and collectively developed, implemented and promoted a range of harm minimisation programmes including the aforementioned 'designated driver' and 'late night patron transport' schemes. Many of the transport schemes are free of charge to patrons, to encourage them to avoid drink-driving and at the same time reduce the impact of noisy patrons loitering around late night venues.

[[Moderation Management]] is a programme which helps drinkers to cut back on their consumption of alcohol by encouraging safe drinking behaviour.

Harm reduction in alcohol dependency could be instituted by use of [[naltrexone]].<ref name="Volpicelli1992">{{Cite journal |last1=Volpicelli |first1=Joseph R. |last2=Alterman |first2=Arthur I. |last3=Hayashida |first3=Motoi |last4=O'Brien |first4=Charles P. |date=1 November 1992 |title=Naltrexone in the Treatment of Alcohol Dependence |journal=Archives of General Psychiatry |volume=49 |issue=11 |pages=876–880 |doi=10.1001/archpsyc.1992.01820110040006 |pmid=1345133}}</ref>