Slowing the revolving door: stabilization programs reduce homeless persons' substance use after detoxification.
This study examined whether homelessness predicted earlier resumption of substance use after detoxification, and sought evidence concerning the impact of post-detoxification stabilization programs among homeless and nonhomeless individuals. Kaplan-Meier plots and proportional hazards models were used to determine the association between homelessness, stabilization program use, and recurrent substance use in a prospective cohort of persons entering inpatient detoxification (n=470). Among 254 persons available at 6 months, 76% reported recurrent substance use. Homeless persons not using stabilization programs experienced the highest hazard of return to substance use after detoxification, Hazard Ratio (HR) 1.26, 95% CI (0.88, 1.80). Homeless persons using these programs had the lowest rate of return to substance use: HR 0.61, 95% CI (0.40, 0.94). A similar impact of stabilization programs was not seen among nonhomeless subjects. Post-detoxification stabilization programs were associated with improved outcomes for homeless addicted persons. This treatment modality may slow the "revolving door" phenomenon of relapse after detoxification among homeless persons.
Kertesz
Stefan G
SG
Divisions of Preventive Medicine and General Internal Medicine, Department of Medicine, University of Alabama at Birmingham, 1530 3rd Avenue South, MT608, Birmingham, AL 35294-4410, USA. skertesz@uab.edu
Horton
Nicholas J
NJ
Friedmann
Peter D
PD
Saitz
Richard
R
Samet
Jeffrey H
JH
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006208:Halfway Houses / Q000706:statistics & numerical data*; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D016016:Proportional Hazards Models; D012008:Recurrence; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation* / Q000628:therapy*; D013997:Time Factors; D014505:Urban Population