Homelessness Predicts Attrition but Not Alcohol Abstinence in Outpatients Experiencing Co-Occurring Alcohol Dependence and Serious Mental Illness

Abstract

Individuals experiencing homelessness and co-occurring alcohol dependence and SMI receiving CM had higher rates of attrition, relative to those who were housed. Homelessness was not associated with differences in biologically assessed alcohol abstinence.

Targeting the Barriers in the Substance Use Disorder Continuum of Care With Peer Recovery Support

“…Having psychiatric co-morbidity is associated with not only higher odds of treatment dropout but also shorter stays in treatment. 56 - 58 Demographic characteristics such as younger age, 54 , 59 - 61 homelessness, 62 having a history of physical or sexual abuse, 63 unemployment, Black and Hispanic race/ethnicity, and being positive for Hepatitis C 54 , 61 , 64 , 65 have all been associated with early disengagement from substance use treatment. Insufficient or lack of functional social support from families, friends, and faith communities 66 , 67 and continued substance and polydrug use 58 have all been found to be predictors of early treatment dropout.…”

Examining outcomes for service users accessing the Breaking Free Online computer-assisted therapy program for substance use disorders via a ‘telehealth’ approach: protocol for a two arm, parallel group randomized controlled trial

“…Another potential limitation is the likely attrition rate from a study including individuals with SUD – previous research has demonstrated high levels of attrition in SUD intervention RCTs, especially when the intervention under investigation is digital [ 47 , 48 ]. Individuals with SUD may have mental health difficulties, financial and accommodation instability, and may experience periods of lapse and relapse; each of these factors may create difficulties when trying to support such individuals to remain engaged with treatment programs [ 49 , 50 ]. Although the fortnightly recovery check-in phone calls are intended to enhance retention of participants in the BFO arm of the study, it may be more challenging to retain participants in the study once the treatment period is over and they are no longer receiving the check-in phone calls—a prediction supported by previous systematic reviews into smoking cessation interventions [ 51 ].…”

Homeless Males Addicted to Alcohol about Helplessness: Secondary Qualitative Data Analysis

“…Nóżka et al (2013) indicated that these additional problems are: housing, personal difficulties (diseases, inability to cope with relationships, aggression, lack of goals in life), social (family problems, rejection), economic (lack of work, debts), and institutional (dependence on social welfare, difficulty in accessing help). Moreover, Leickly et al (2017), Collins et al (2018), andDoran et al (2018) wrote that addiction to alcohol or other substances is a significant problem for people experiencing homelessness. Additionally, Collins et al (2018) indicated that there is a lack of research on the perception of alcohol by the homeless, emphasising that there are also no studies concerning the negative effects of alcohol consumption by the homeless.…”

“…Homelessness and alcohol addiction have combined, for decades, the interests of various scientific fields, disciplines and their sub-disciplines, such as education, social work and disability studies. In social sciences, the world-wide quantitative, psychological and clinically-orientated research gives a rich insight into the context of homelessness and addiction to alcohol (Leickly et al, 2017;Collins et al, 2018;Doran et al, 2018). However, the constructivist and interpretivist approaches, as well as secondary qualitative data analysis of homeless masculinity and addictions to alcohol are still underrepresented in Poland.…”