GUIDE
Substance Use Guidelines: Alcohol September 2023
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Introduction
Alcohol is a well-known, easily accessible, and legal depressant of the central nervous system. The prevalence of Alcohol Use Disorder (AUD) is approximately 40% among people experiencing homelessness (PEH), compared to 10.6% in the general population. i,ii,iii Alcohol Use Disorder has been shown to be a risk factor for experiencing homelessness, and many patients identify the stressors of homelessness as causing or exacerbating their AUD. iv Experiencing homelessness creates significant barriers to treatment. Patients may have a more limited social network to draw on for support, and treatment may be a secondary priority to addressing basic needs. v The presence of AUD did not hinder attainment of stable housing compared with PEH without AUD, and attainment of housing was correlated with increased accessing of treatment for AUD. vi Of the 140,000 people who die each year from excessive alcohol use, their lives were shortened by an average of 26 years. vii Genetics account for about 50% of the risk of developing alcohol use disorder. viii Causes of death from alcohol use includes motor vehicle accidents, poisonings, suicides, as well as increased rates of liver disease, cancer, and heart disease.vii
Key Terms and Definitions
Alcohol Use Disorder: A medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. ix Alcohol Withdrawal Syndrome: Symptoms that occur when a person stops using alcohol after a period of heavy drinking. Symptoms of alcohol withdrawal can vary widely in severity. In severe cases, the condition can be life-threatening. This can manifest as tremors, confusion, hallucinations, and seizures, and if severe and untreated, can be fatal. Trauma-informed care (TIC): A patient-centered approach to care that recognizes the impacts of trauma and actively works to prevent re-traumatization and promote recovery. The principles of TIC are grounded in establishing a trusting relationship and a safe physical and psychological space in which to address needs. Harm reduction: A philosophical approach to care that establishes individual agency and selfdetermination as central to all efforts toward well-being. Harm reduction approaches call for the non-judgmental, non-coercive provision of services and resources to people who use substances to assist them in reducing harms related to their substance use or other health behaviors. Harm reduction-based care is collaborative, provides education on available interventions, and centers the goals of the individual in care planning.
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