Housing First program reduced alcohol and cannabis use among homeless individuals

After 21 months, homeless individuals in a Housing First program showed significantly better outcomes for alcohol and cannabis use compared to treatment as usual, with additional psychiatric benefits for those with severe mental illness.

Ferreiro, Inés Campo et al.·Journal of psychosocial nursing and mental health services·2022·Moderate EvidenceRandomized Controlled Trial
RTHC-03838Randomized Controlled TrialModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
N=46

What This Study Found

The Housing First group (n=46) showed significantly lower alcohol and cannabis use at 21 months compared to the treatment-as-usual group (n=41). Among the subgroup with severe mental illness, Housing First participants also showed significant improvements in psychotic symptoms, anxiety, depression, and social relations.

Key Numbers

87 participants total (46 HF, 41 TAU). Significant improvements in alcohol and cannabis use at 21 months. Subgroup with severe mental illness showed improvements across psychotic symptoms, anxiety, depression, and social relations.

How They Did This

Unblinded randomized controlled trial comparing Housing First (HF, n=46) to treatment as usual (TAU, n=41) among people experiencing homelessness. Outcomes measured at baseline, 8, and 21 months using standardized quantitative measures.

Why This Research Matters

Housing First provides stable housing without requiring sobriety first. This study shows that providing housing stability can itself lead to reduced substance use, challenging the traditional treatment-first approach.

The Bigger Picture

These findings support the Housing First philosophy that stable housing is a foundation for addressing other challenges like substance use and mental health, rather than a reward for achieving sobriety first.

What This Study Doesn't Tell Us

Unblinded design. Relatively small sample. Cannot separate the effect of housing from other support services provided. Single-site study.

Questions This Raises

  • ?Which aspects of Housing First drive substance use reductions: housing stability, support services, or both?
  • ?Would results hold in different cultural contexts?

Trust & Context

Key Stat:
Significant reductions in alcohol and cannabis use at 21 months
Evidence Grade:
Randomized controlled trial, though unblinded and with a small sample size.
Study Age:
Published in 2022.
Original Title:
Impact of Housing First on Psychiatric Symptoms, Substance Use, and Everyday Life Skills Among People Experiencing Homelessness.
Published In:
Journal of psychosocial nursing and mental health services, 60(9), 46-55 (2022)
Database ID:
RTHC-03838

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

Frequently Asked Questions

Did participants have to be sober to get housing?

No. Housing First provides stable housing without requiring sobriety as a precondition. This study found that receiving housing first was itself associated with reduced alcohol and cannabis use over 21 months.

Were mental health outcomes also better?

Yes, particularly for participants with severe mental illness, who showed significant improvements in psychotic symptoms, anxiety, depression, and social relations compared to the control group.

Read More on RethinkTHC

Cite This Study

RTHC-03838·https://rethinkthc.com/research/RTHC-03838

APA

Ferreiro, Inés Campo; Cuadra, Maria Assumpta Rigol; Serqueda, Francesca Asensio; Abad, Josep Maria Haro. (2022). Impact of Housing First on Psychiatric Symptoms, Substance Use, and Everyday Life Skills Among People Experiencing Homelessness.. Journal of psychosocial nursing and mental health services, 60(9), 46-55. https://doi.org/10.3928/02793695-20220316-01

MLA

Ferreiro, Inés Campo, et al. "Impact of Housing First on Psychiatric Symptoms, Substance Use, and Everyday Life Skills Among People Experiencing Homelessness.." Journal of psychosocial nursing and mental health services, 2022. https://doi.org/10.3928/02793695-20220316-01

RethinkTHC

RethinkTHC Research Database. "Impact of Housing First on Psychiatric Symptoms, Substance U..." RTHC-03838. Retrieved from https://rethinkthc.com/research/ferreiro-2022-impact-of-housing-first

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.