The effects of the therapeutic workplace and heavy alcohol use on homelessness among homeless alcohol-dependent adults

Background A clinical trial demonstrated that a therapeutic workplace could promote alcohol abstinence in homeless, alcohol-dependent adults. This secondary-data analysis examined rates of homelessness and their relation to the therapeutic workplace intervention and alcohol use during the trial. Methods In the trial, homeless, alcohol-dependent adults could work in a therapeutic workplace for 6 months and were randomly assigned to Unpaid Training, Paid Training, or Contingent Paid Training groups. Unpaid Training participants were not paid for working. Paid Training participants were paid for working. Contingent Paid Training participants were paid for working if they provided alcohol-negative breath samples. Rates of homelessness during the study were calculated for each participant and the three groups were compared. Mixed-effects regression models were conducted to examine the relation between alcohol use (i.e., heavy drinking, drinks per drinking day, and days of alcohol abstinence) and homelessness. Results Unpaid Training, Paid Training, and Contingent Paid Training participants did not differ in the percentage of study days spent homeless (31%, 28%, 17%; respectively; F(2,94) = 1.732, p = 0.183). However, participants with more heavy drinking days (b = 0.350, p < 0.001), more drinks per drinking day (b = 0.267, p < 0.001), and fewer days of alcohol abstinence (b = −0.285, p < 0.001) spent more time homeless. Conclusions Reducing heavy drinking and alcohol use may help homeless, alcohol-dependent adults transition out of homelessness.