CMAPS: A Guide for Researchers and Program Developers
Last Updated: February 2026 | Reading Time: 6 minutes
The Canadian Managed Alcohol Program Study (CMAPS) is the most significant peer-reviewed research program examining cannabis substitution within harm reduction settings in Canada. Its findings span multiple published papers, multiple sites, and multiple methods – quantitative longitudinal analysis, qualitative thematic analysis, and community-based knowledge translation. This guide is intended for researchers and program developers who want a clear picture of what CMAPS is, what it has produced, and where the evidence base for cannabis substitution in managed alcohol programs goes from here.
What CMAPS Is
CMAPS is a long-running, multi-site research program evaluating the effectiveness, implementation, and impacts of managed alcohol programs (MAPs) across Canada. It was initiated in 2011 through the Canadian Institute for Substance Use Research (CISUR) at the University of Victoria, with Bernie Pauly and Tim Stockwell as principal investigators. Beginning in 2022, CMAPS received funding from Health Canada’s Substance Use and Addictions Program (SUAP) to conduct a multi-site pilot evaluation of cannabis substitution as an additional harm reduction intervention within existing MAPs.
The multi-site structure allows the evaluation to examine cannabis substitution across different program models, geographic contexts, and implementation approaches. Pilot sites included Ottawa, Victoria, and Vancouver. Each site operated its cannabis substitution program through a different community organization, with CMAPS researchers conducting an independent evaluation across all sites.
The Pre-Implementation Foundation
Before the pilots ran, CMAPS researchers conducted a feasibility assessment that established the evidence base for implementation. Pauly, Brown, Chow, Wettlaufer, Graham, Urbanoski et al. (2021, Harm Reduction Journal, 18: 65) – funded by CIHR’s Catalyst Grant for Cannabis Research in Urgent Priority Areas — surveyed six Canadian MAPs and found that 84% of clients, staff, and program leadership supported cannabis substitution, and that over 63% of enrolled clients were already using cannabis to substitute for alcohol informally. This paper established both the demand for formalized programming and the implementation requirements: peer infrastructure, regulated supply, and stable funding.
The Bailey, Harps, Belcher, Williams, Amos, Graham, Goulet-Stock et al. (2023) knowledge translation paper in the International Journal of Drug Policy (DOI: 10.1016/j.drugpo.2023.104244) documented the pre-implementation co-design process through which CMAPS, EIDGE, and SOLID Victoria incorporated lived-experience input from illicit drinkers — people with direct experience of the conditions the program was designed to address. The co-design methodology described there is a model for participatory research in harm reduction settings.
The Ottawa Findings: Published
The primary quantitative findings from the Ottawa MAP pilot are published open-access in Goulet-Stock, Hacksel, Scandiuzzi, Boyd, Pauly & Stockwell (2026), International Journal of Drug Policy, 147: 105083 (DOI: 10.1016/j.drugpo.2025.105083).
Key findings: N=35 participants, two years of longitudinal program records, with hierarchical mixed-effects modelling separating between-person and within-person effects. The between-person substitution effect showed that each additional 0.4-gram joint, containing an average of 15.2 standard THC units (approximately 76 mg THC), was associated with 2.43 fewer mean daily standard drinks. Within-person daily fluctuations were not significantly associated with same-day alcohol changes, indicating that the substitution effect operates through stable individual patterns over time rather than real-time trade-offs. Alcohol use also declined independently over time, separate from the cannabis substitution effect. Qualitative interviews with 14 participants provided further insight into the individual and contextual factors shaping those patterns.
The paper also notes High Hopes Research Society’s parallel Vancouver cannabis substitution program, establishing the multi-site context for the overall CMAPS evaluation.
The Vancouver Findings: In Peer Review
The Vancouver component of CMAPS, with High Hopes Research Society as program operator, is currently in peer review at Drug & Alcohol Review. This manuscript should not be cited until accepted. The following summary is for the researcher and program developer context only.
The Vancouver pilot enrolled participants from Vancouver’s PHS Drinkers Lounge – the city’s only managed alcohol program – from March to September 2024, with initial dispensing beginning March 25, 2024, to 43 enrolled members. Among interview participants, 66% identified as Indigenous. Key quantitative findings include a statistically significant association between grams of cannabis dispensed and sick cups dispensed per week, suggesting that increased cannabis access was associated with reduced acute withdrawal severity. Qualitative interviews found that 8 of 9 participants described cannabis as a substitute or moderating influence on alcohol use. The introduction of the cannabis program did not increase overall cannabis consumption – it redirected participants from grey-market cannabis to the licensed High Hopes supply.
Once accepted, the Vancouver manuscript will become Flora’s most direct first-person research asset: a peer-reviewed study in which High Hopes is named program operator and the findings are from the same supply and model Flora operates under.
The Research Network
CMAPS brought together a network of organizations whose collaboration is documented in the published literature:
CISUR/UVic – Lead evaluation institution High Hopes Research Society – Vancouver program operator; Flora Initiative operates under this society EIDGE (Eastside Illicit Drinkers Group for Education) – Peer-governed advocacy organization; provided peer research assistants for the Vancouver program, trained by OPPRA OPPRA (Overdose Prevention Peer Research Assistants) – Provided peer researcher training and support for the Vancouver program PHS Community Services Society – Operated Vancouver’s MAP; provided the site for High Hopes cannabis distribution Ottawa Inner City Health – Ottawa MAP operator; provided peer research support for the Ottawa pilot
What CMAPS Opens for Future Research
The CMAPS papers identify several directions for extending the evidence base for cannabis substitution as a harm reduction intervention. Goulet-Stock et al. (2026) call for replication at other pilot sites and in other communities, and specifically identify the need for research on perceived mechanisms of action, why substitution is occurring from the participant’s perspective, and the experiences of program providers. The Vancouver qualitative findings address the mechanism through participants’ described experiences. Neither study yet provides a controlled replication outside the MAP context.
Researchers building on CMAPS findings should plan for longitudinal designs with time horizons of at least 16–22 weeks, mixed-methods evaluation integrating quantitative longitudinal analysis with qualitative thematic analysis, between-person and within-person modelling using hierarchical mixed-effects approaches, and community-based participatory research infrastructure, specifically peer researchers drawn from the community under study, as a structural requirement for ecological validity.
Flora Initiative and High Hopes Research Society are available as research partners for investigators seeking to extend the CMAPS evidence base for cannabis substitution in MAP and harm reduction settings.
This article summarizes the CMAPS research program for an academic and institutional audience. The in-peer-review Vancouver findings are noted for context and should not be cited until accepted. Published findings are cited with full references below.
References
- Bailey, Harps, Belcher, Williams, Amos, Graham, Goulet-Stock et al. (2023). International Journal of Drug Policy. DOI: 10.1016/j.drugpo.2023.104244
- Goulet-Stock, Hacksel, Scandiuzzi, Boyd, Pauly & Stockwell (2026). International Journal of Drug Policy, 147: 105083. DOI: 10.1016/j.drugpo.2025.105083
- Pauly, Brown, Chow, Wettlaufer, Graham, Urbanoski et al. (2021). Harm Reduction Journal, 18: 65. DOI: 10.1186/s12954-021-00512-5