Browsing School, Graduate by Title "A Comparison of Treatment Outcomes for Participants Receiving Reinforcement-Based Treatment (RBT) versus Participants Receiving RBT plus Recovery Housing (RBT + RH)"
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A Comparison of Treatment Outcomes for Participants Receiving RBT versus Participants Receiving RBT plus Recovery Housing (RBT + RH)Opioid misuse is a serious and growing personal and public health hazard (McLellan & Turner, 2008). Although opioid medication therapies are effective for treating opioid misuse, alternative treatment options are needed for those who cannot access or do not desire medication therapies. RBT + RH is effective for increasing opioid and cocaine abstinence among opioid dependent individuals who have completed detoxification in Baltimore city (Gruber et al., 2000; Jones et al., 2005, Tuten et al., 2011). Results from this secondary data analysis study indicate that RBT and RBT + RH participants did not differ on the primary abstinence and secondary employment outcomes. However, regression analyses support that recovery housing was predictive of abstinence across several assessment points. Employment also was a predictive variable for opioid abstinence at three and six months but was not predictive for cocaine abstinence at one, three, and six months. Recovery housing was predictive of mean days worked at three and six month assessment, and was predictive of higher employment earnings at three month assessment. Abstinence was predictive of more days worked at three months and at six month assessment. Additionally, membership in the RBT group was predictive of more days worked and higher employment earnings at three month assessment. Sub-analyses showed that participants who accessed recovery housing-- whether self-pay (RBT +SPRH) or program sponsored (RBT +RH) -- had significantly improved abstinence and employment related outcomes compared to the RBT only group. The RBT + SPRH group participants showed the most consistent pattern of favorable abstinence and employment outcomes relative to RBT only group participants. The RBT + SPRH participants also reported more days worked three months compared to the RBT + RH group participants. Study findings suggest that recovery housing may play an important role in the success of RBT interventions. Further research is needed to evaluate the clinical and cost implications for providing case management for housing versus providing program sponsored recovery housing.