Long-Term Housing and Work Outcomes Among Treated Cocaine-Dependent Homeless Persons

  • Stefan G. KerteszEmail author
  • Ashley N. Mullins
  • Joseph E. Schumacher
  • Dennis Wallace
  • Katharine Kirk
  • Jesse B. Milby
Regular Article


Communities across the United States have initiated plans to end chronic homelessness. In many of these communities, addiction treatment programs remain the default point of entry to housing and services. This study examined the percentage of cocaine-using homeless persons (all with psychiatric distress) attaining stable housing and employment 12 months after entering a randomized trial of intensive behavioral day treatment, plus one of the following for 6 months: no housing; housing contingent on drug abstinence; housing not contingent on abstinence. Of 138 participants, the percentages with stable housing and employment at 12 months were 34.1 and 33.3%, respectively. Analyses suggested superior outcomes in trial arms that offered housing as part of the behavioral treatment. The majority of participants, however, did not achieve housing or employment, in part because of the limited capacity of the local housing programs to accommodate persons who had not achieved perfect abstinence. The findings demonstrate a helpful role for addiction treatment and suggest the need for services to support housing of persons who reduce but do not eliminate all substance use.


homeless persons randomized controlled trials addiction treatment rehabilitative outcomes employment contingency management health policy 



Data collection, analysis, and manuscript preparation were supported by the National Institute on Drug Abuse (awards DA08475, DA11789, K23-DA15487). The author is grateful for the analytic assistance of Tony Horn, MS and Young-il Kim, MS.


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Copyright information

© National Council for Community Behavioral Healthcare 2006

Authors and Affiliations

  • Stefan G. Kertesz
    • 1
    Email author
  • Ashley N. Mullins
    • 2
  • Joseph E. Schumacher
    • 3
  • Dennis Wallace
    • 4
  • Katharine Kirk
    • 5
  • Jesse B. Milby
    • 6
  1. 1.Division of Preventive Medicine, School of MedicineUniversity of Alabama at Birmingham and the Deep South Center on Effectiveness at the Birmingham Veterans’ Affairs Medical CenterBirminghamUSA
  2. 2.The Wright InstituteBerkeleyUSA
  3. 3.Division of Preventive Medicine, School of MedicineBirminghamUSA
  4. 4.Rho Federal Systems, Inc.Chapel HillUSA
  5. 5.Division of Preventive Medicine, School of Medicine and the Department of Biostatistics, School of Public HealthUniversity of Alabama at BirminghamBirminghamUSA
  6. 6.Department of PsychologyThe University of Alabama at BirminghamBirminghamUSA

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