Rashmi Ghonasgi, Zachary Budesa, Ph.D., Rachel Winograd, Ph.D.
Final Abstract for URS Program
Medical treatment for Opioid Use Disorder (MOUD) can be highly effective, but may be particularly difficult to access among individuals who are unhoused. This study investigated how experiencing insecure housing affects the receipt of and retention rates of MOUD among participants in the St. Louis region’s Engaging Patients in Care Coordination (EPICC)—a peer-based program designed to connect people with evidence-based OUD treatment. We hypothesized EPICC clients who were unhoused received MOUD less often than clients who were housed, and that EPICC clients who were unhoused were retained in treatment for shorter periods of time than EPICC clients who were housed. Analyses were based on 2020-2022 data from the EPICC database, which contained counts of housed and unhoused individuals, whether or not they received initial MOUD, and whether or not they were retained in treatment at the 30-day, three month, and six month timepoints. Chi-square tests indicated initial receipt rates of MOUD of both housed and unhoused individuals were similarly high, at 93% and 92% for housed and unhoused individuals, respectively. Additionally, there were no differences in retention rates between housed and unhoused individuals at 30 days, three months, and six months. Results did not support the initial hypotheses predicting lower MOUD receipt and retention among unhoused individuals. Rather, findings suggest efforts by the EPICC program are comparably effective in reaching both groups. Given these results, the question of if a program such as EPICC works may not be as important as how and why. Further research is needed to identify which aspects of the EPICC program are most actively facilitating the MOUD receipt and retention among unhoused individuals. Investigating these aspects may aid in streamlining and expanding programs like EPICC to other areas throughout the country.