Homeless housing program that lets residents drink saves money, reduces alcohol use – UW study finds
A Seattle homeless housing program that allows residents with severe alcohol problems to continue to drink in their rooms substantially reduced their healthcare use and costs, University of Washington researchers report.
In addition, the residents gradually reduced their alcohol intake as well, the researchers said.
“These findings suggest that stable housing provided to people who are still drinking and addicted to alcohol can reduce their use of crisis services and ultimately their consumption of alcohol, said Professor Mary E. Larimer of UW’s Department of Psychiatry and Behavioral Sciences and lead author of the study, which appears in today’s issue of JAMA, the Journal of the American Medical Association.
Traditionally, homeless shelters require residents to stop drinking and attend mandatory alcohol treatment programs.
But these requirements often lead many homeless people with alcohol dependence to stay on the streets.
Many of these men and women repeatedly end up in jail or in sobering centers and frequently need high-cost medical care from emergency medical services or in emergency rooms and hospitals.
The Seattle program, called 1811 Eastlake after its street address, is based on a model called “Housing First” that does not require homeless housing residents to be sober or to participate in treatment.
The facility, which is run by Seattle’s Downtown Emergency Service Center, does offer counseling and healthcare services and has social workers on-site to work with those residents who want treatment.
The cost of the housing and services at 1811 Eastlake by averages $1120 per month for each resident.
In the JAMA study, the UW team compared use and costs of services of two groups: 95 individuals who were able to were able to get a room at 1811 Eastlake and 39 individuals who were put on a wait-list for the facility.
They also looked at the costs incurred by residents in the year before they entered the program and during the year they were in the program..
Among the costs the researchers looked at included the cost their jail time, the cost their use of emergency shelters and of sobering centers, and the cost of their use of healthcare and drug detoxification services.
The researchers estimate that in the year before the 1811 Eastlake residents moved into the facility they incurred more than $8 million in total costs for such services for a median cost per person of more than $4,000 a month.
After just six months, the costs of services consumed by those that have moved in the facility fell to a median of about $1,500 and in 12 months, to about $960.
Overall, housing in the facility cut their use of other services by more than $4 million.
Even factoring in the cost of housing, the savings were still substantial: half of those who were wait-listed.
The researchers also found that residents reported that they were gradually drinking less the longer they were in the facility from a median of nearly 16 drinks a day before entering 1811 Eastlake to roughly 10 drinks a day at the end of a year, and residents reported being intoxicated less often.
These declines, the researchers note, occurred “despite no requirement to abstain from or reduce drinking to remain housed.”
The researchers conclude: “These findings support the basic premise of Housing First: providing housing to individuals who remain actively addicted to alcohol, without conditions such as abstinence or treatment attendance, can reduce the public burden associated with overuse of crisis services and reduce alcohol consumption.”
The study was funded by the Robert Wood Johnson Foundation’s Substance Abuse Policy Research Program.
PHOTO CREDIT: Photos courtesy of Downtown Emergency Service Center
To learn more:
- Read the original paper in JAMA (fee or subscription may be required)/
- Visit the Downtown Emergency Service Center for additional information about 1811 Eastlake and other DESC programs.
- Alcohol Anonymous (AA)/Seattle: www.seattleaa.org
- MetroKC Alcohol and Other Drug Prevention program:www.metrokc.gov/health/atodp
- MetroKC Mental Health & Substance Abuse Links: www.metrokc.gov/dchs/mhd/mhlinks.htm
- Northeast Seattle Coalition to Prevent Underage Drinking: www.preventionworksinseattle.org
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