Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Objectives: (1) To examine whether homelessness predicted earlier resumption of substance use after inpatient detoxification; and (2) to seek evidence concerning the impact of post-detoxification stabilization programs on homeless and housed persons in relation to recurrent substance use. Data Sources/Study Setting: Prospective six-month cohort of 470 addicted persons entering a publicly-funded urban detoxification program. Study Design: Survival analysis methods were used to determine the association between homelessness, stabilization program use, and time to recurrent substance use. Data Collection/Extraction Methods: The main analyses rely on baseline and six month interviews using standardized instruments. Additional analyses include interviews obtained after six months, and statewide administrative records of recurrent detoxification. Principal Findings: Among 254 persons available at six months, 76% reported recurrent substance use. Homeless persons not using stabilization programs experienced the greatest hazard of return to substance use after detoxification, Hazard Ratio (HR) 1.26, 95% CI (0.88,1.80). Homeless persons using these programs had the lowest rate of return to substance use: HR 0.61, 95% CI (0.40,0.94). A similar impact of stabilization programs was not seen among housed subjects. Analyses suggest that subjects available at six months were representative of the entire cohort. Conclusions: Post-detoxification stabilization programs were associated with improved outcomes for homeless addicted persons. / 2031-01-01

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