A qualitative study of health, social, and community professionals’ practices to reduce alcohol- related risks among people living in social precarity in the Greater Paris region

People living in social precarity have greater risk of developing alcohol use disorder. Current alcohol use disorder healthcare guidelines recommend implementing partial abstinence-based harm reduction practices, particularly for most-at-risk groups, to minimize the consequences of such a radical change on users and their loved ones. This qualitative study described and analyzed alcohol harm reduction practices adopted by health, social, and community professionals working with people living in social precarity in the Greater Paris region. A thematic analysis of the data revealed the following three alcohol harm reduction practices: (i) authorizing the consumption of alcohol in care facilities, (ii) reducing alcohol consumption, and (iii) providing prevention interventions and information on alcohol consumption. The facilities share a common focus on building trust and cultural adaptation, with varying levels of patient engagement from passive to active involvement. Alcohol harm reduction practices differ based on location, population served, and users' level of precarity, while addressing both social needs and alcohol consumption simultaneously. A standard definition of the concept of alcohol harm reduction among people living in social precarity is essential so that harm reduction practices can be standardized and their effects objectively assessed.