Does stimulant use impair housing outcomes in low-demand supportive housing for chronically homeless adults?

Recent research suggests low-demand housing (i.e., not contingent upon abstinence) is effective in helping people exit homelessness, even among recent active substance users. Whether active users of illicit drugs and stimulants have worse housing outcomes than primary alcohol users, however, is unknown.

A total of 149 participants in a multisite supportive housing program who reported high levels of active substance use at program entry were classified as either (1) predominantly "Alcohol Use" (>10 of 30 days alcohol, but not >10 days of drug use) or (2) "Illicit Drug Use" (>10 of 30 days any single illicit drug use with or without alcohol use). Sub-analysis of the "Illicit Drug Use" group compared participants reporting high levels of "Stimulant Use" (>10 days cocaine, crack, or methamphetamine use) to those with high levels of "Non-stimulant Use" (>10 days marijuana or other non-stimulant drug use). Group differences in housing outcomes were examined with mixed model multivariate regression.

During 24-month follow-up, days housed increased dramatically for both the "Alcohol Use" and the "Illicit Drug Use" groups without significant differences. Sub-analysis of illicit drug users showed stimulant use was associated with fewer days housed (p = .01) and more days homeless (p = .02) over time.

Among illicit drug users, stimulant users have somewhat less successful housing outcomes than other active drug and alcohol users, though both groups maintained substantial housing improvements in low-demand housing.