Social Work Assistance and Stipends for Housing (SASH): Improving Outcomes for Homeless Patients Receiving Methadone for Opioid Use Disorder
Project Contact: Max Spaderna, MD
Patients receiving methadone for opioid use disorder (MOUD) might have a prevalence of homelessness as high as 25 percent. It is imperative to find interventions that can house this vulnerable population, as homelessness increases the risk of discontinuing life-saving MOUD. Evidence shows that providing permanent housing to homeless individuals receiving MOUD not only improves housing outcomes, but also improves retention in methadone treatment. Although obtaining permanent housing would benefit patients receiving MOUD, the supply of available housing is limited, so patients often remain homeless for an extended period of time before they can be housed. However, providing these patients with temporary housing as a bridge to obtaining permanent housing might overcome this barrier.
This study will recruit eight homeless patients receiving MOUD at the University of Maryland Addiction Treatment Program (ATP), a certified substance use treatment program that co-locates substance use, medical, and psychiatric treatment. For the first six months of the study, Social Work interns from the University of Maryland School of Social Work will manage monthly housing vouchers for the patients enrolled in the study. The housing vouchers will amount to $650 and will be used to secure temporary housing for the patients. Throughout the full twelve months of the study, the Social Work interns will schedule meetings with the patients to address any unmet housing or social work needs.
We hypothesize that the patients in the study will benefit from these interventions in several ways. First, their MOUD treatment will improve, as measured by the number of their missed and take-home methadone doses documented by the ATP. Second, their OUD will improve, as measured by their OUD scores and the results of their urine toxicology tests. Third, their quality of life will improve, as measured by their SF-36 scores and their responses from qualitative interviews administered to them at the end of the study. Fourth, housing outcomes will improve, as measured by the percent of days they are homeless during the six months housing vouchers are dispensed and at the end of the study.