Slowing the revolving door: stabilization programs reduce homeless persons' substance use after detoxification

J Subst Abuse Treat. 2003 Apr;24(3):197-207. doi: 10.1016/s0740-5472(03)00026-6.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Halfway Houses / statistics & numerical data*
  • Humans
  • Ill-Housed Persons* / statistics & numerical data
  • Male
  • Massachusetts / epidemiology
  • Proportional Hazards Models
  • Recurrence
  • Substance Abuse Treatment Centers / statistics & numerical data*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / rehabilitation*
  • Substance-Related Disorders / therapy*
  • Time Factors
  • Urban Population