Homelessness is frequently complicated by substance abuse and related major health problems. In addition, homeless persons often have criminal histories, lack basic social and living skills, and have lived outside the mainstream of society for prolonged time periods. The proposed demonstration project integrates services for homeless substance abusers in Albuquerque, NM, extending already-existing outreach programs and adding a much-needed residential detoxification program. A prospective, randomized comparison also is proposed to determine the efficacy of three intervention strategies which provide transitional housing and varying levels of structured assistance. The target population will include single adults with no major organic brain dysfunction or mental illness. Persons completing detoxification who are eligible to participate will be randomly assigned to one of the three treatment groups for a four-month period following detoxification. The high intensity services group (Group 1) will receive supervised alcohol and drug free transitional housing, case management, and case manager-facilitated alcoholism/drug addiction recovery services. The medium intensity group (Group II) will receive supervised transitional housing and self-initiated treatment. House residents will be responsible for organizing group recovery activities. The low intensity group (Group III) will receive motel-based individual housing and self-initiated treatment. Data regarding baseline characteristics of participants will be collected prior to randomization; outcome data will be collected during follow-up investigations conducted 4 and 10 months after detoxification. Comparisons will be drawn among the three intervention groups for the following outcomes: 1) the number of drop-outs from the housing program; 2) frequency and quantity of alcohol and drug use, 3) economic stability; 4) employment status; and 5) measurements of depression and self-esteem. Comparisons also will be drawn between outcomes among populations of Hispanic, non-Hispanic white, and Native American participants. Finally. process evaluation will be used to critically evaluate program activities and determine the best strategies for dealing with special minority populations in this study. Systems linkages will be strengthened and evaluated to ensure provision and coordination of adjunct services.
| Lapham, S C; Hall, M; Skipper, B J (1995) Homelessness and substance use among alcohol abusers following participation in project H&ART. J Addict Dis 14:41-55 |
