Homelessness and publicly funded substance use disorder treatment in California, 2016–2019: Analysis of treatment needs, level of care placement, and outcomes

Original research
by
Padwa, Howard, Brittay Bass & Darren Urada

Release Date

2021

Geography

USA

Language of Resource

English

Full Text Available

No

Open Access / OK to Reproduce

No

Peer Reviewed

Yes

Objective

The objective of this paper is to develop a better understanding of the SUD services that PEH receive in publicly funded treatment programs by (1) describing the characteristics and needs of the PEH population served in publicly funded SUD treatment programs, compared to non-PEH populations; (2) determining if differences exist in treatment placement (level of care) for PEH and non-PEH; and (3) gauging how successful programs are in treating PEH compared to non-PEH.

Findings/Key points

PEH were significantly more likely than non-PEH to be having methamphetamine or heroin as their primary substance. PEH had greater frequency of primary substance use prior to entering treatment, greater ER and hospital utilization, more criminal justice involvement, and greater prevalence of mental health diagnoses and unemployment. PEH were 9.82% more likely than non-PEH to receive residential treatment and 7.11% less likely than non-PEH to receive treatment intensive outpatient modalities. Homelessness was associated with an 11.90% decrease in retention, and a 19.40% decrease in successful discharge status. These trends were consistent across outpatient, intensive outpatient, and residential modalities.

Design/methods

Observational study using a two-way fixed effect model to determine associations among homelessness, retention, and outcomes among Medicaid beneficiaries receiving SUD treatment in California from 2016 to 2019 (n = 638,953).

Keywords

Wrap-around services
About PWUD
Outcomes
Poverty
Housing
Legal system/law enforcement
Illegal drugs
Mental health