If you were to give Lisa Goss a magic wand, the executive director of Winnipeg's Main Street Project has already envisioned her first wish.
A place where chronic alcohol abusers, virtually all homeless, could be supplied a managed amount of booze under staff supervision. It's called a managed-alcohol-reduction program, and Goss believes it's overdue for Winnipeg's Main Street population.
"A lot of our homeless community use," Goss said. "So if you're in that place, you're spending your money, your EI, whatever your income is on alcohol. We have people that are elderly, that need assisted living or a group home or managed centre who need to use in a supportive environment. So they're binge-drinking (less). There are (fewer of them) going into the public intoxicated and risk getting hit by a car and being injured.
"When people binge-drink, it's harder on their liver, their body, their health," Goss added. "People, when they're intoxicated, take more risks than they usually do. That leads to more interactions with police."
Similar programs exist in cities such as Ottawa, Toronto and Vancouver. But not Winnipeg.
'People, when they're intoxicated, take more risks than they usually do. That leads to more interactions with police' —Lisa Goss, executive director of Winnipeg's Main Street Project, on why she believes a managed-alcohol program for chronic abusers is long overdue
In Thunder Bay, Ont., a managed-alcohol program was founded at Shelter House in 2012. Just this week, a study by the Centre for Addictions Research at the University of Victoria found the Thunder Bay model reduced the number of police interactions and hospital admissions from 40 to 80 per cent for 18 participants. (Compared with another 20 individuals who were not in the program.)
Participants were also given stable housing, meals and staff counselling.
At Shelter House, alcohol — typically six ounces of wine — was provided every 90 minutes from 8 a.m. to 11 p.m.
Many of the participants had a history of abusing substances other than conventional alcohol, such as hand sanitizer, rubbing alcohol, mouthwash or hairspray.
"People were dying on the street of long-term health problems, of violence," Patty Hajdu, director of Shelter House, told the Free Press, in explaining how the project was established.
Shelter House has an annual operating budget of $500,000, funded by all three levels of government. Hajdu acknowledged such programs are controversial, both on a financial and ideological level.
But she added, "The tax-dollar argument is easily defeated."
The program in Thunder Bay costs about $31,000 per individual, she said, for the centre's 15 clients. The cost of homeless individuals with the same chronic abuse issues on social services can run an average of $131,000 per person, when costs for hospital admissions, police and criminal involvement, jail cells and shelters are tallied.
"It's very controversial, and that's why we wanted to take a good, hard look at the data," University of Victoria researcher Dr. Tim Stockwell told The Canadian Press.
Hajdu said such programs are reserved for the most hardened, chronic abusers, a population that would be around 40 in Thunder Bay. But improvement can be seen in even the most dire cases, she said.
"You can't really have a conversation with them because they're so sick," Hajdu said. "And within a couple weeks they come out of their shell. They start talking."
Goss said the program identifies addicts who can suffer through life-threatening withdrawals during detox.
Under a managed-alcohol system, "Instead of constantly drinking... they're meeting the needs of that withdrawal so they can function better," Goss said.
"It's about reaching people where they're at," she added. "When you're trying to push them along this continuum where they're not there or can never be there... some of the clients who end up clogging the system are people who are in more need of physical help. There isn't a lot of space in personal care homes."
Richard Walls, who operates the Red Road Lodge, a transitional homeless shelter on Main Street, said "there's a huge need for it (a managed-alcohol facility) and we'd be very supportive of it." At the same time, Walls admits to being a "little skeptical" if such a project could land government funding.
"It's an interesting experiment," Walls added. "But where do you stop and start? It's a bottomless pit."
Hajdu understands the limits of public funding, but she said it's a pay-now or pay-later scenario. "I'm hoping as a society we can see harm reduction has its place," she said.
"I think the more evidence we have, the more we can prove it's a fiscally responsible approach, as well as a humane one."
Randy Turner spent much of his journalistic career on the road. A lot of roads. Dirt roads, snow-packed roads, U.S. interstates and foreign highways. In other words, he got a lot of kilometres on the odometer, if you know what we mean.