Effects of sustained abstinence among treated substance-abusing homeless persons on housing and employment

Am J Public Health. 2010 May;100(5):913-8. doi: 10.2105/AJPH.2008.152975. Epub 2009 Oct 15.

Abstract

Objectives: We examined whether cocaine-dependent homeless persons had stable housing and were employed 6, 12, and 18 months after they entered a randomized controlled trial comparing 2 treatments.

Methods: One group (n = 103) received abstinence-contingent housing, vocational training, and work; another group (n = 103) received the same intervention plus cognitive behavioral day treatment. We examined baseline and early treatment variables for association with long-term housing and employment.

Results: Although the enhanced-treatment group achieved better abstinence rates, the groups did not differ in long-term housing and employment stability. However, consecutive weeks of abstinence during treatment (and to a lesser extent, older age and male gender) predicted long-term housing and employment stability after adjustment for baseline differences in employment, housing, and treatment.

Conclusions: Our data showed a relationship of abstinence with housing stability. Contrasting these results with the increasingly popular Housing First interventions reveals important gaps in our knowledge to be addressed in future research.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alabama
  • Cocaine-Related Disorders / therapy*
  • Employment*
  • Female
  • Housing*
  • Humans
  • Ill-Housed Persons*
  • Male
  • Middle Aged
  • Patient Compliance*
  • Time Factors
  • Treatment Outcome