The city of San Francisco is providing free shots of beer and vodka to homeless alcoholics at taxpayer expense under a little-known pilot program.
The “Managed Alcohol Program” operated by the San Francisco Department of Public Health serves regulated doses of alcohol to volunteer participants with alcohol addiction in an effort to keep homeless people off the streets and relieve emergency services from the city. Experts say the program can save or prolong lives, but critics question whether the government would be better off funding treatment and sobriety programs.
“Established in countries such as Canada and Australia, an alcohol management program is typically administered by a nurse and trained support staff in a facility such as a homeless shelter or transitional or permanent home, and is a method of minimizing harm to those who use alcohol. use disorder,” explains the California Health Care Foundation in a 2020 article describing the pilot program.
“By prescribing limited amounts of alcohol, the model aims to prevent the potentially life-threatening effects of alcohol withdrawal, such as seizures and injuries.”
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A man pours liquor from a small bottle into a glass at night. San Francisco has funded a managed alcohol pilot program to provide free shots of beer and vodka to homeless people with severe alcoholism. (Soeren Stache/Picture Alliance via Getty Images)
San Francisco's Managed Alcohol Program, or MAP, was established during the COVID-19 pandemic to prevent vulnerable homeless people who were placed in isolation in hotel rooms from suffering from alcohol withdrawal. But the program, which began with 10 beds, has since expanded to a 20-bed program operating out of a former hotel in the Tenderloin with an annual budget of $5 million, the San Francisco Chronicle reported.
Alice Moughamian, nurse manager of the San Francisco Managed Alcohol Program and Sobriety Center, explained in a presentation in October that nurses provide clients with a motel room, three meals a day and enough alcohol “to meet their alcohol needs.” addiction, but keeping someone at a safe level of intoxication.”
Initial success in stabilizing alcoholic patients prompted health officials to expand the pilot program into a long-term program with 10 beds intended for “the Latino and indigenous population,” while the city's traditional sober-living center It has 12 additional beds, Moughamian said.
Bryce Bridge, a social worker involved in the program, said during the presentation that once a client is identified as having alcohol abuse problems and admitted, they are evaluated to determine their individual needs. Clients are connected to a primary care physician, provided resources to obtain a government ID if they lack a social security card or other documents, and assisted with psychiatric care, on-site wellness activities, and other health-based treatments. in evidence.
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A homeless encampment is seen in the Tenderloin district of San Francisco, California, the United States, on June 6, 2023. (Tayfun Coskun/Anadolu Agency via Getty Images)
“We actually connect them with different community organizations that help us run art groups and poetry groups and just help them explore ways that they can express themselves,” Bridge said.
Bridge also said marijuana use is “quite common at our sites” and said there is no policy prohibiting marijuana use, although health providers monitor such activity to prevent harmful health effects or interpersonal conflicts.
Although relatively unknown until now, the program is under new scrutiny after Adam Nathan, CEO of an artificial intelligence company and president of the San Francisco Salvation Army, made several social media posts criticizing what he witnessed at the site. .
“Inside the lobby they had barrels. [sic] installed at taps where they basically gave free beer to homeless people who have been identified with AUD (alcohol use disorder),” Nathan wrote in X after visiting the hotel in the Tenderloin where homeless alcoholics are served.
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San Francisco's alcohol management program is run out of a former hotel on Eddy Street in the Tenderloin. (Google Maps)
“It's set up so people in the program just come in and have a beer, and then another. All day long,” he said.
“This is all very strange to me and it just doesn't seem right to me. Providing free drugs to drug addicts doesn't solve their problems. It just prolongs them. Where is the recovery in all of this?” she asked.
The Salvation Army promotes abstinence for alcoholics and offers free rehabilitation programs for adults.
Public health officials called some of Nathan's claims misleading. In a statement to the San Francisco Chronicle, the health department said alcohol is dispensed by a nurse and that homeless people who do not participate cannot simply walk into the facility and receive a free beer. The program operates out of a former Tenderloin resort hotel that has a bar, but the facility's faucets are “inoperable and unused,” the release said.
Still, the program also received criticism from none other than San Francisco Mayor London Breed, who said in February that harm reduction was “not reducing the harm” but “making things a lot worse.”
San Francisco Mayor London Breed has criticized harm prevention programs that provide addictive substances to substance users. (KTVU)
“Are we going to manage people's addictions with our taxpayers' money in perpetuity forever? It seems like that's basically what we're saying,” Tom Wolf, who is recovering from heroin addiction, said in a statement to the Chronicle. “I think we should spend that money on detox and recovery.”
But recovery is not the point, according to Moughamian.
“Our goal at MAP is not to decrease the amount of alcohol consumed, nor to gradually taper someone toward abstinence, although both have happened with clients in our program,” he said in the October presentation. “The goal is to mitigate the numerous health, legal and interpersonal harms associated with unsafe alcohol consumption.”
San Francisco health officials say the program has saved $1.7 million in six months by reducing hospital visits and police calls made by participants who previously relied heavily on emergency services. Officials said that after clients entered the program, visits to the city's sober living center dropped 92%, visits to the emergency room dropped more than 70%, and calls to emergency medical services and Hospital visits were cut in half, the Chronicle reported.
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City officials have previously said that just five residents struggling with alcohol addiction had cost the city more than $4 million in ambulance transports over a five-year period, with as many as 2,000 ambulance transports during that time, according to the Chronicle.
The San Francisco Fire Department has spoken positively about the program, telling the outlet that the alcohol monitoring program “has proven to be an incredibly impactful intervention” in reducing the use of emergency services for a “small but highly vulnerable”.
Other countries, including Canada, Portugal and the United Kingdom, have adopted controlled alcohol programs at a much faster pace than the United States. Canada has more than 40 such programs, according to the Canadian Institute for Substance Use Research at the University of Victoria.
A 2022 study of alcohol programs run in Canada found that homeless people with severe alcoholism had a reduced risk of death and fewer hospitalizations after participating.
