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Cited by 110Homelessness and Social IssuesSubstance Abuse Treatment and OutcomesHIV, Drug Use, Sexual Risk

Where harm reduction meets housing first: Exploring alcohol's role in a project-based housing first setting

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Collins, Susan E., Clifasefi, Seema L., Dana, Elizabeth A., Andrasik, Michele P., Stahl, Natalie, Kirouac, Megan, Welbaum, Callista, King, Margaret +1 more·2012·International Journal of Drug Policy
DOI 10.1016/j.drugpo.2011.07.010PMC PMC3726334
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Abstract

BACKGROUND: Housing first (HF) programmes provide low-barrier, nonabstinence-based, immediate, supportive and permanent housing to chronically homeless people who often have co-occurring substance-use and/or psychiatric disorders. Project-based HF programmes offer housing in the form of individual units within a larger housing project. Recent studies conducted at a specific project-based HF programme that serves chronically homeless individuals with alcohol problems found housing provision was associated with reduced publicly funded service utilisation, decreased alcohol use, and sizable cost offsets. No studies to date, however, have qualitatively explored the role of alcohol use in the lives of residents in project-based HF. METHODS: We collected data in a project-based HF setting via naturalistic observation of verbal exchanges between staff and residents, field notes taken during staff rounds, and audio recorded staff focus groups and resident interview sessions. Qualitative data were managed and coded using a constant comparative process consistent with grounded theory methodology. The goal of the analysis was to generate a conceptual/thematic description of alcohol's role in residents' lives. RESULTS: Findings suggest it is important to take into account residents' motivations for alcohol use, which may include perceived positive and negative consequences. Further, a harm reduction approach was reported to facilitate housing attainment and maintenance. Residents and staff reported that traditional, abstinence-based approaches are neither desirable nor effective for this specific population. Finally, elements of the moral model of alcohol dependence continue to pervade both residents' views of themselves and the community's perceptions of them. CONCLUSIONS: Findings suggest it is necessary to set aside traditional models of alcohol use and approaches to better understand, align with, and address this population's needs. In doing so, we might gain further insights into how to enhance the existing project-based HF approach by applying more tailored, alcohol-specific, harm reduction interventions.

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  • The single-site Housing First model has been used for chronically homeless people with alcohol dependence and has received empirical support.

    “The single-site Housing First (HF) model has been used to address the needs of chronically homeless people with alcohol dependence and has garnered empirical support.27–31”

    From Housing first is associated with reduced use of emergency medical services (2014) · cites this paper as [30]

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Research works printed but not linked: 5

  1. Glaser B Basics of grounded theory analysis 1992 Sociology Press Mill Valley, CA
  2. Locke G Khadduri J O’Hara A Housing models. Toward Understanding Homelessness: The 2007 National Symposium on Homelessness Research 2007 US Department of Housing and Urban Development and US Department of Health and Human Services Washington, DC Retrieved from http://www.huduser.org/publications/pdfTiomeless_symp_07.pdf
  3. O’Connell JJ Premature mortality in homeless populations: A review of the literature 2005 National Health Care for the Homeless Council, Inc. Nashville, TN
  4. Pollack JM Morality, ethics and human behavior Ethical dilemmas and decisions in criminal justice 2010 Wadsworth Belmont, CA 6th Edition
  5. Public Health - Seattle and King County King County 2003 Homeless Death Review 2004 Health Care for the Homeless Network Seattle, WA

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Authors
Collins, S. E., Clifasefi, S. L., Dana, E. A., Andrasik, M. P., Stahl, N., Kirouac, M., Welbaum, C., King, M., & Malone, D. K.
Affiliations
University of Washington (US)
Corresponding author
Collins, Susan E.
ORCID
Venue
International Journal of Drug Policy
Publisher
Elsevier BV
Published
2012-03
Volume
23
Issue
2
Pages
111-119
ISSN
0955-3959 (ISSN-L)
DOI
10.1016/j.drugpo.2011.07.010
PMC
PMC3726334
OpenAlex
W2162691488
Cited by
110
References
45
Citations by year
2026: 5 · 2025: 1 · 2024: 9 · 2023: 5 · 2022: 8 · 2021: 12 · 2020: 6 · 2019: 6 · 2018: 7 · 2017: 10 · 2016: 7 · 2015: 11 · 2014: 11 · 2013: 5 · 2012: 6
FWCI
13.08
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Drug Policy (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (4r01aa016281-10)
  • National Institute on Alcohol Abuse and Alcoholism (R01-AA016281, K22AA018384, 5R01AA016281-03S1)
Topics
  • Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
harm reduction, Housing First, chronic homelessness, alcohol consumption, alcoholism, drinking motives, housing maintenance, substance use disorders, mental illness, homelessness services
MeSH terms
Adult, Alcohol Drinking, Alcoholism, Mental Disorders, Data Collection, Female, Ill-Housed Persons, Housing, Humans, Male, Middle Aged, Motivation, Focus Groups, Diagnosis, Dual (Psychiatry), Substance-Related Disorders, Harm Reduction

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