Effects of Sustained Abstinence Among Treated Substance-Abusing Homeless Persons on Housing and Employment.

Author(s): Milby JB, Schumacher JE, Wallace D, Vuchinich R, Mennemeyer ST, Kertesz SG

Affiliation(s): University of Alabama at Birmingham.

Publication date & source: 2009-10-15, Am J Public Health., [Epub ahead of print]

Publication type:

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.