Lived Experience of Heavy Drinkers Guided Development of Cannabis Substitution Resources for Alcohol Programs | Research

The takeaway

Researchers collaborated with people who drink illicitly to create cannabis education resources for managed alcohol programs, drawing on drinkers' informal harm reduction strategies and creating standardized cannabis unit equivalencies for program delivery.

Harm reduction practitioners, managed alcohol program staff, and people interested in cannabis substitution for alcohol

First cannabis substitution resources for MAPs

What the researchers found

The collaboration between researchers, clinicians, and organizations of people with lived experience produced tailored client-facing and provider-facing cannabis education resources. Standard cannabis unit equivalencies were created to support program delivery. The lived expertise of heavy drinkers proved essential for creating materials that were accurate, relevant, and accessible to the target population.

Why it matters

Cannabis substitution is emerging as a harm reduction strategy for severe alcohol use. This study shows that effective resources require input from the people who will use them, and that heavy drinkers have valuable informal knowledge about harm reduction that can be formalized.

The numbers in context

10+ years of collaboration; created standard cannabis unit equivalencies; produced client-facing and provider-facing resources; multiple MAP sites in Canada interested in cannabis substitution pilots

How the study worked

Community-based participatory research drawing on 10+ years of collaboration between the Canadian Managed Alcohol Program Study (CMAPS) and organizations of people with lived experience (EIDGE and SOLID Victoria). Focus groups and meetings engaged peers in creating educational resources.

What this study cannot tell us

No outcomes data on whether cannabis substitution actually reduces alcohol-related harm. Resources developed for specific Canadian context. Cannabis substitution may not be appropriate for all alcohol-dependent individuals. Long-term effects of switching from alcohol to cannabis unknown.

How to read the evidence

Community-based resource development drawing on extensive collaboration, but no outcomes data on substitution effectiveness

When this study was published

2023 study

The bigger picture

As cannabis legalization expands, its potential role in reducing alcohol harm becomes more practically feasible. Managed alcohol programs serving people with severe alcohol use disorder represent one setting where substitution might reduce the catastrophic health effects of extreme drinking.

Questions still open

Does cannabis substitution actually reduce alcohol consumption and harms in MAP settings? Are there risks of developing cannabis dependence? How should programs handle patients who use both substances rather than substituting?

Common questions

Can cannabis help people drink less?

This study did not measure outcomes but describes the development of resources to support cannabis substitution in managed alcohol programs. The concept is that cannabis, which has lower overdose risk than alcohol, might reduce extreme drinking harms.

What are managed alcohol programs?

MAPs are harm reduction programs that provide controlled amounts of alcohol to people with severe alcohol use disorder, typically those experiencing homelessness, to reduce the harms of unregulated drinking like consuming hand sanitizer or mouthwash.

Read the original research

Translating the lived experience of illicit drinkers into program guidance for cannabis substitution: Experiences from the Canadian Managed Alcohol Program Study.

The International journal on drug policy, 122, 104244

View on PubMed ↗Publisher’s paper ↗

Citation

Bailey, Aaron; Harps, Myles; Belcher, Clint; Williams, Henry; Amos, Cecil; Donovan, Brent; Sedore, George; Victoria, Solid; Graham, Brittany; Goulet-Stock, Sybil; Cartwright, Jenny; Robinson, Jennifer; Farrell-Low, Amanda; Willson, Mark; Sutherland, Christy; Stockwell, Tim; Pauly, Bernie. (2023). Translating the lived experience of illicit drinkers into program guidance for cannabis substitution: Experiences from the Canadian Managed Alcohol Program Study.. The International journal on drug policy, 122, 104244. https://doi.org/10.1016/j.drugpo.2023.104244