{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:10:06Z","timestamp":1780510206851,"version":"3.54.1"},"reference-count":28,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 crisis presents new challenges and opportunities in managing alcohol use disorders, particularly for people unable to shelter in place due to homelessness or other reasons. Requiring abstinence for shelter engagement is impractical for many with severe alcohol use disorders and poses a modifiable barrier to self-isolation orders. Managed alcohol programs (MAPs) have successfully increased housing adherence for those with physical alcohol dependence in Canada, but to our knowledge, they have not been implemented in the United States. To avoid life-threatening alcohol withdrawal syndromes and to support adherence to COVID-19 self-isolation and quarantine orders, MAPs were piloted by the public health departments of San Francisco and Alameda counties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Development of MAPs<\/jats:title>\n                    <jats:p>We describe implementation of a first-in-the-nation alcohol use disorder intervention of a MAP that emerged at three public health isolation settings within San Francisco and Alameda counties in California. All three interventions utilized a similar process to develop the protocol and implement the MAP that included identification of champions for system-level advocacy and engagement of stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implementation of MAPs<\/jats:title>\n                    <jats:p>We describe the creation and implementation of the distinct protocols. We provide examples of iterative changes to workflow processes and key lessons learned pertaining to protocol development, acceptability by stakeholders, alcohol procurement, documentation, and assessment. We discuss safety considerations, noting that there were no deaths or serious adverse events in any of the patients of the MAP during the 2-month implementation period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MAP pilots have been implemented in the US to aid adherence to isolation and quarantine setting guidelines. Lessons learned provide a foundation for their expansion as a recognized public health intervention for individuals with severe alcohol use disorders who are unable to stabilize within existing care systems. Based on the success of MAP implementation, efforts are under way to investigate alcohol management in homeless populations more broadly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1080\/08897077.2021.1892012","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T20:52:38Z","timestamp":1618433558000},"page":"140-147","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Successful Implementation of Managed Alcohol Programs in the San Francisco Bay Area during the Covid-19 Crisis"],"prefix":"10.1177","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6308-6604","authenticated-orcid":false,"given":"Jessica","family":"Ristau","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4277-6889","authenticated-orcid":false,"given":"Nicky","family":"Mehtani","sequence":"additional","affiliation":[{"name":"Division of HIV, ID and Global Medicine, University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth","family":"Gomez","sequence":"additional","affiliation":[{"name":"Health Care for the Homeless, Alameda County Health Care Services Agency, San Leandro, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Nance","sequence":"additional","affiliation":[{"name":"Department of Whole Person Integrated Care, San Francisco Department of Public Health, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devora","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Whole Person Integrated Care, San Francisco Department of Public Health, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Surlyn","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Eveland","sequence":"additional","affiliation":[{"name":"San Francisco Department of Public Health, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0701-8361","authenticated-orcid":false,"given":"Shannon","family":"Smith-Bernardin","sequence":"additional","affiliation":[{"name":"School of Nursing-Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"key":"e_1_3_3_2_1","unstructured":"Applied Survey Research. Alameda County homeless count & survey: comprehensive report 2019. Alameda County CA: 2019. https:\/\/everyonehome.org\/wp-content\/uploads\/2019\/07\/2019_HIRDReport_Alameda_FinalDraft_8.15.19.pdf. Accessed June 29 2020."},{"key":"e_1_3_3_3_1","unstructured":"Applied Survey Research. San Francisco homeless count & survey: comprehensive report 2019. San Francisco CA; 2019. https:\/\/hsh.sfgov.org\/wp-content\/uploads\/2020\/01\/2019HIRDReport_SanFrancisco_FinalDraft-1.pdf. Accessed June 29 2020."},{"key":"e_1_3_3_4_1","unstructured":"Hartlaub P. Economist: homelessness could spike 20% in California as jobless struggle during pandemic. San Francisco Chronicle. May 15 2020. https:\/\/www.sfchronicle.com\/bayarea\/article\/Economist-Homelessness-could-rise-20-in-15273847.php. 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