CASE MANAGED RESIDENTIAL CARE FOR HOMELESS ADDICTS

拟议的示范项目将测试一种新的、 长期无家可归退伍军人强化多阶段干预模式 有酗酒和/或吸毒问题 案例管理住宅 护理（CMRC）计划将提供五天的密集医院“排毒” 然后是一个渐进式的降压治疗， 在CMRC计划期间和第六个第n期善后期间进行管理。 据推测，CMRC计划将降低相关成本 对退伍军人管理局和社会的无家可归的药物滥用者的治疗 梗概. 还假设客户在参与 CMRC将证明他们的酒精和/或药物使用减少， 提高他们居住稳定性， 经济/就业状况和心理健康状况。 这项研究将是一项为期三年的前瞻性实验， 大约270名无家可归的男性退伍军人 大多数受试者将 黑人，平均年龄42-43岁，范围25-70岁。 所有人都将 DSM III R药物滥用/依赖诊断;以及 70%的患者同时患有精神疾病。 在五天的排毒期后，受试者将被随机分为两组， 组：1）将进入CMRC计划的实验组和2） 对照组将接受当前VA的常规治疗 药物滥用股 受试者的结构化访谈将在入组研究时进行， 出院、入院后6个月和入院后12个月。 在分析中，将比较两组的禁欲情况， 精神、社会和职业功能以及利用 医疗和心理健康服务。成本效益分析将决定 实验性干预的成本是否被 减少其他服务的使用。

The proposed demonstration project will test the effectiveness of a new, intensive multiphasic intervention model for chronically homeless veterans with alcohol and/ or drug problems. The proposed Case Managed Residential Care (CMRC) program will provide five days of intensive hospital "detox" followed by a graduated step down therapy featuring intensive case management during the CMRC program and during a six nth aftercare period. It is hypothesized that the CMRC program will reduce the costs associated with the treatment of homeless substance abusers to the VA and to society in general. It is also hypothesized that clients, after participating in CMRC, will demonstrate a decrease in their alcohol and/or drug use, an increase in their residential stability and improvement in their economic/employment status and mental health status. The study will be a three year prospective experiment involving approximately 270 homeless male veterans. The majority of subjects will be Black with an average age of 42-43 and a range of 25-70. All will have DSM III R diagnosis of substance abuse/dependency; and a significant number (70%) will also have co-existing mental disorders. After the five day detox phase, subjects will be randomized into two groups: 1) the experimental group which will enter the CMRC program and 2) the control group which will receive the usual treatment of the current VA substance abuse unit. Structured interviews with subjects will occur at entry into the study, at discharge, six mouths post admission, and 12 months post admission. In the analyses, the two groups will be compared on abstinence, psychiatric, social and vocational functioning and the utilization of medical and mental health services. A cost benefit analysis will determine whether the costs of the experimental intervention are offset by the reduction in the use of other services.