title: Six-month outcomes among socially marginalized alcohol and drug users attending a drop-in center allowing alcohol consumption.
abstract: Despite their experience of substance-related harm, few socially marginalized alcohol and other drug (AOD) users access substance use treatment. Thus, identifying alternative approaches for this population is important. This program evaluation documented substance use and health-related quality of life (QoL) following exposure to such an alternative approach: a harm-reduction drop-in center allowing alcohol consumption onsite.
  
  
  
  Participants (N=85) were socially marginalized AOD users (e.g., alcohol, heroin) attending a harm-reduction drop-in center in the French-speaking part of Switzerland. Time and drop-in center attendance were predictors of substance-use outcomes and mental and physical health-related QoL, which were measured at baseline, 1- and 6-month follow-ups.
  
  
  
  Findings indicated that, for each month of the evaluation, participants' alcohol use and related problems decreased by 5% and 7%, respectively. Drop-in center attendance predicted additional decreases in drug-related problem severity and improvements in mental health-related QoL.
  
  
  
  Participants' alcohol use and related problems decreased over time. Additionally, participants evinced improved mental health-related QoL and decreased drug-related problem severity with greater drop-in center attendance. Harm-reduction drop-in centers allowing alcohol consumption onsite are promising interventions for socially marginalized AOD users.
authors.affiliation: University of Lausanne, Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland; University of Washington-Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA. Electronic address: veronique.grazioli@chuv.ch.
authors.forename: Véronique S
authors.initials: VS
authors.lastname: Grazioli
authors.affiliation: University of Washington-Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA 98195, USA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Collins
authors.affiliation: University of Lausanne, Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Sophie
authors.initials: S
authors.lastname: Paroz
authors.affiliation: University of Lausanne, Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Caroline
authors.initials: C
authors.lastname: Graap
authors.affiliation: University of Lausanne, Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Daeppen
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D055030:Drug Users / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D040261:Harm Reduction; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D062487:Social Marginalization; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors
keywords: Alcohol; Drop-in center; Drugs; Harm reduction; Health-related QoL; Socially marginalized individuals