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Clinical Trial Tests Harm Reduction Methods in Emergency Shelters

by Sam Leibowitz-Lord

A study published by Collins and associates (2021) found a direct correlation between harm-reduction based support services and a sharp decrease in alcohol-related deaths among individuals experiencing homelessness. The study provides even more empirical evidence for Harm Reduction Treatment for Alcohol (HaRT-A.) HaRT-A is a method that focuses on treating drug use as a complex but manageable behavior, allowing the patient to slowly reduce their consumption over a fixed period of time rather than counting total days abstinence. 

The study took place in three different low-barrier shelters and temporary housing facilities in the Seattle metro area, with participants aged 21-64 years old. Participants in the study all met the DSM-V criteria for Alcohol Use Disorder (AUD). HaRT-A was combined with supervised injections of either naltrexone or a placebo. Another group received traditional, group-based therapy with a focus on abstinence and total use prevention. Both the format of behavioral therapy and the injection (naloxone vs placebo) were randomized among the participants and across the three locations, providing controlled outcomes of overall alcohol consumption, mental and emotional harm, and physical side-effects based on the “HaRT-A + XR-NTX method.” 

Researchers found a significant improvement among the group that received HaRT-A behavioral support plus a weekly injection (whether placebo or naltrexone.), Alcohol quantity, alcohol frequency, and physical harm from alcohol decreased significantly among participants who received HaRT-A. Furthermore, the study showed no significant differences in outcomes between participants who received a XR-NTX injection and those who received a placebo injection. HaRT-A had a significant effect in reducing harmful outcomes for participants.

Combining behavioral harm-reduction treatment and extended-release naltrexone for people experiencing homelessness and alcohol use disorder in the USA: a randomised clinical trial 

Collins, Susan E et al. (2021) The Lancet Psychiatry, Volume 8, Issue 4, 287 – 300 

The study can be found here.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the Center of Alcohol & Substance Use Studies