Treating the substance abusive homeless: Implications of the New Orleans homeless substance abusers project
Description
Among the range of social and economic problems known to disproportionately affect homeless persons, research has repeatedly confirmed that homeless populations are substantially more likely to indicate problems with substance abuse than are evidenced in housed populations. Those considering the potential causal implications associated with this correlation have frequently implicated drug abuse as a key precipitant of downward mobility among the substance abusive homeless, emphasizing its acknowledged potential for undermining work or family or other social ties. Cued by such logic, the past decade has witnessed the development of numerous remedial endeavors geared primarily toward aiding homeless abusers to alter their drug behaviors. These programs have continually encountered limited success, as high rates of program attrition and relapse subsequent to treatment have continually conspired to frustrate the ambitions of administrators. This dissertation considers the crucial question of why such outcomes have been so common Explored in this project are the presumably crucial roles played by motivational factors in promoting 'recovery.' Using data from one treatment agenda that targeted the drug problems of adult homeless substance abusers, connections between the drug using habits of program clients and a range of alternative social or economic problems known to affect homeless populations are systematically examined. Analyses reveal that clients facing the most severe employment- and family-related handicaps were the least likely to report improvements with respect to drug consumption, consistent with the premise that incentives to retire these habits are significantly less among those indicating the least to gain, economically or socially, from retention of sobriety. Insofar as findings reinforce the conclusion that drug usage is likely as much an effect as a source of other hardships to which homeless abusers are associated, they bear relevance for treatment providers. These data suggest that, unless future programs are equipped to deal with other economic and social problems of homeless abusers, success rates will continue to be discouraging