Associations of Housing Status With Substance Abuse Treatment and Service Use Outcomes Among Veterans

Buchholz, Jonathan; Malte, M.S.W. Carol A.; Calsyn, Donald A.; Baer, John; Nichol, Paul; Kivlahan, Daniel R.; Caldeiro, Ryan M.; Saxon, Andrew J.

doi:10.1176/ps.2010.61.7.698

Cited by 28 publications

(16 citation statements)

References 30 publications

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“…One study found that 22.8% of ED patients with high-risk substance use were homeless, but no comparison was given for patients without high-risk use (Hankin et al, 2013). Our findings are consistent with research conducted in other groups including primary care patients, and Veterans and others entering substance use treatment (Buchholz et al, 2010; Eyrich-Garg et al, 2008; Krupski et al, 2015; Welte and Barnes, 1992). …”

Section: Discussionsupporting

confidence: 90%

Substance use and homelessness among emergency department patients

Doran

Rahai

McCormack

et al. 2018

Drug and Alcohol Dependence

120

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Section: Discussionsupporting

confidence: 90%

Substance use and homelessness among emergency department patients

Doran

Rahai

McCormack

et al. 2018

Drug and Alcohol Dependence

120

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“…Homelessness is a costly problem, partly as a result of the associated increased health care costs, particularly among those with substance use disorders. 48–50 Our findings suggest that, if eligible for Medicaid coverage, homeless adults are just as likely as the housed to enroll, which will likely increase their odds of entering treatment, ultimately improving their health status and reducing costs to society.…”

Section: Discussionmentioning

confidence: 91%

Medicaid Expansion Initiative in Massachusetts: Enrollment Among Substance-Abusing Homeless Adults

Zur

Mojtabai

2013

Am J Public Health

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Objectives We assessed whether homeless adults entering substance abuse treatment in Massachusetts were less likely than others to enroll in Medicaid after implementation of the MassHealth Medicaid expansion program in 1997. Methods We used interrupted time-series analysis in data on substance abuse treatment admissions from the Treatment Episode Data Set (1992–2009) to evaluate Medicaid coverage rates in Massachusetts and to identify whether trends differed between homeless and housed participants. We also compared Massachusetts data with data from 17 other states and the District of Columbia combined. Results The percentage of both homeless and housed people entering treatment with Medicaid increased approximately 21% after expansion (P = .01), with an average increase of 5.4% per year over 12 years (P = .01). The increase in coverage was specific to Massachusetts, providing evidence that the MassHealth policy was the cause of this increase. Conclusions Findings provide evidence in favor of state participation in the Medicaid expansion in January 2014 under the Affordable Care Act and suggest that hard-to-reach vulnerable groups such as substance-abusing homeless adults are as likely as other population groups to benefit from this policy.

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“…Unstable housing and homelessness are associated with greater substance use severity (Eyrich-Garg, Cacciola, Carise, Lynch, & McLellan, 2008) and higher service utilization costs (Buchholz et al, 2010), and a substantial number of those in substance abuse treatment are affected. Among a sample of 5,629 treatment-seekers at 158 substance abuse treatment programs across the US, 12% were homeless and an additional 20% were marginally housed and at risk for homelessness (Eyrich-Garg et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Substance Abuse Treatment Patients in Housing Programs Respond to Contingency Management Interventions

Rash¹,

Alessi²,

Petry³

2017

Journal of Substance Abuse Treatment

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Use of homeless and transitional housing (e.g., recovery homes) programs can be associated with success in substance abuse treatment, perhaps because many of these programs encourage or mandate sobriety. In this study, we examined whether contingency management (CM) protocols that use tangible incentives for submission of drug-free specimens or other specific behaviors are effective for treatment-seeking substance abusers whose behavior may also be shaped by housing programs. Of 355 participants in randomized trials of CM, 56 (16%) reported using transitional housing during the 12-week treatment period. Main and interaction effects of housing status and treatment condition were evaluated for the primary substance abuse treatment outcomes: a) longest duration of abstinence from alcohol, cocaine, and opioids, b) percentage of samples submitted that were negative for these substances, and c) treatment retention. After controlling for demographic and clinical characteristics, those who accessed housing programs submitted a higher percentage of negative samples (75%) compared to those who did not access housing programs (67%). Housing status groups did not differ in terms of longest duration of abstinence (accessed housing: M = 3.1 weeks, SE = 0.6; did not access housing: M = 3.9 weeks, SE = 0.3) or retention in substance abuse treatment (accessed housing: M = 6.4 weeks, SE = 0.6; did not access housing: M = 6.6 weeks, SE = 0.3). Regardless of housing status, CM was associated with longer durations of abstinence and treatment retention. No interactive effects of housing and treatment condition were observed (p > .05). Results suggest that those who accessed housing programs during substance abuse treatment benefit from CM to a comparable degree as their peers who did not use such programs. These effects suggest that CM remains appropriate for those accessing housing in community-based programs.

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Associations of Housing Status With Substance Abuse Treatment and Service Use Outcomes Among Veterans

Abstract: Homelessness affects substance abuse treatment outcomes and costs. Interventions are needed to reduce homelessness among veterans entering substance abuse treatment.

Cited by 28 publications

References 30 publications

Substance use and homelessness among emergency department patients

Substance use and homelessness among emergency department patients

Medicaid Expansion Initiative in Massachusetts: Enrollment Among Substance-Abusing Homeless Adults

Substance Abuse Treatment Patients in Housing Programs Respond to Contingency Management Interventions

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