I am assistant professor at the École de travail social at University of Montreal. I completed my doctorate in cultural anthropology at the University of California, Davis. My focus of interest are harm reduction interventions adapted to the living conditions of Indigenous people who use substances.

Background: Hazardous alcohol use is one of the major risk factors for people’s health worldwide and certain populations, such as indigenous people (IP) experiencing homelessness, are disproportionately affected by its consequences. A myriad of interventions that target these complex issues have been developed. Among them, managed alcohol programs (MAPs) are harm reduction interventions that aim to reduce the effects of severe alcohol use and homelessness. MAPs provide accommodation, social and health support in addition to regular doses of alcoholic beverages to stabilize drinking patterns and replace the use of non-beverage alcohol (mouthwash, hand sanitizer, etc.). Although the positive impacts of MAPs have been reported, very little is known about how to adapt this program to the living conditions of urban IP.
Objectives: This paper aims to discuss the results of a qualitative evaluation of the first MAP in Montreal (Canada), implemented by the indigenous organization Projets autochtones de Montréal.
Methods: Ethnographic methods (participant observation and informal interviews), and semi-structured interviews (n=12) were used to explore the adaption of the MAP and its effects on the lives of its residents. The collected data was thematically analyzed.
Results: Efforts to adapt the MAP model to urban indigenous people encountered challenges such multiplicity of cultural identities and diversity of lifestyles. However, the flexibility of the MAP’s harm reduction approach allowed accommodation of diverse indigenous values and practices, fostering a sense of belonging among its residents. Several beneficial impacts such as stabilization of alcohol use, and reduction/cessation of drug use were also reported. Improvement of residents’ health (e.g., cessation of chronic conditions such Hepatitis C and skin infections; recovery from accidental injuries, etc.) was also noted.
Conclusion: The harm reduction approach of the Montreal MAP foster sense of belonging among its residents. Beneficial changes on substance use patterns and health improvement were also reported.