The impact of current alcohol and drug use on outcomes among homeless veterans entering supported housing.

Permanent supported housing has increasingly been identified as a central approach to helping homeless individuals with disabilities exit from homelessness. Given that one third or more of homeless individuals actively use substances, it is important to determine the extent to which individuals who report using alcohol and/or drugs at the time of housing benefit from such programs. The current study examines data from the evaluation of the United States Department of Housing and Urban Development-Veterans Affairs (HUD-VA) Supported Housing (HUD-VASH) program to determine differences in housing and clinical outcomes among participants with two different levels of active alcohol or drug use at time of housing entry. Whereas veterans with 1-15 days of active use and 15-30 days of active use had significantly more days homeless than abstainers, albeit with small effect sizes (.06 and .19, respectively), there were no significant differences in days housed or days in institutions. Interaction analysis suggests that the highest frequency substance users who spent time in residential treatment prior to housing had the poorest housing outcomes, while those who were not in residential treatment had outcomes comparable to abstainers. Although active substance users clearly benefit from supportive housing with small differences in outcomes from abstainers, high frequency substance users who were admitted to residential treatment before housing placement, may be an especially vulnerable population.