title: Long-term housing and work outcomes among treated cocaine-dependent homeless persons.
abstract: Communities across the United States have initiated plans to end chronic homelessness. In many of these communities, addiction treatment programs remain the default point of entry to housing and services. This study examined the percentage of cocaine-using homeless persons (all with psychiatric distress) attaining stable housing and employment 12 months after entering a randomized trial of intensive behavioral day treatment, plus one of the following for 6 months: no housing; housing contingent on drug abstinence; housing not contingent on abstinence. Of 138 participants, the percentages with stable housing and employment at 12 months were 34.1 and 33.3%, respectively. Analyses suggested superior outcomes in trial arms that offered housing as part of the behavioral treatment. The majority of participants, however, did not achieve housing or employment, in part because of the limited capacity of the local housing programs to accommodate persons who had not achieved perfect abstinence. The findings demonstrate a helpful role for addiction treatment and suggest the need for services to support housing of persons who reduce but do not eliminate all substance use.
authors.affiliation: Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham and Deep South Center on Effectiveness at Birmingham Veterans' Affairs Medical Center, 1530 3rd Ave South MT608, Birmingham, AL 35294-4410, USA. skertesz@uab.edu
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Kertesz
authors.forename: Ashley N
authors.initials: AN
authors.lastname: Mullins
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schumacher
authors.forename: Dennis
authors.initials: D
authors.lastname: Wallace
authors.forename: Katharine
authors.initials: K
authors.lastname: Kirk
authors.forename: Jesse B
authors.initials: JB
authors.lastname: Milby
mesh_terms: D000328:Adult; D000407:Alabama; D001524:Behavioral Medicine; D019970:Cocaine-Related Disorders / Q000628:therapy*; D003631:Day Care, Medical; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation