U.S. study backs shelter, drink for homeless alcoholics

CHICAGO (Reuters) - A program that gives shelter to homeless alcoholics but allows them to keep drinking and not be forced into treatment could save taxpayers millions in public costs, according to a study published on Tuesday.

A campsite at a homeless tent city in Sacramento California March 15, 2009. REUTERS/ Max Whittaker

The study also found that daily alcohol consumption fell by 2 percent per month for those in the shelter.

The results were based on a look at 95 people admitted to a program in Seattle called Housing First from 2005 to 2007. They were compared with others who were still on the street and on waiting lists to get into the shelter.

“Our study suggests that homeless alcoholics who qualify to take part in Housing First can stay out of jails and (hospital) emergency rooms and cost the taxpayer a lot less money as a result,” said Mary Larimer, professor of psychiatry and behavioral sciences at the University of Washington, who led the study.

“We also found that these benefits increase over time and that they are possible without requiring that participants stop drinking. And yet, the longer the participants stay in the housing program, the less they drink,” Larimer said.

The report was published in this week’s Journal of the American Medical Association.

After 12 months in the shelter the total public costs relating to the care of the 95 individuals was cut by more than $4 million compared to the year before, the researchers said.


In the year before entering the shelter, those who got in had run up more than $4,000 each per month in costs for jail, detox center use, hospital-based medical services, publicly funded alcohol and drug programs, emergency medical services and the like, the study team said.

But after they entered the housing arrangement, their individual monthly costs for using such services fell to $1,492 after six months and to $958 after a year -- a reduction in total costs of more than $4 million, the researchers said.

“Each of them had cost state and local governments an average of $86,062 per year before being housed, compared to an average of $13,440 it costs per person per year to administer the housing program,” Larimer said.

Housing First is a concept employed in a number of cities across the country to address the needs of the homeless generally. Such programs rely on a mix of private and public funding, according to the National Alliance to End Homelessness.

The authors of the study said such programs so far have generally been used for homeless people with severe mental illness and concurrent substance abuse. The Seattle shelter, called 1811 Eastlake, has been controversial because it allows drinking on the premises, the research team said, in a program where meals, shelter and other cost ran $1,120 per person monthly during the study.

The study said the median number of drinks for participants started at 15.7 a day but fell to 14, 12 and 10 a day at after six, nine and 12 months, respectively.

William Hobson, executive director of the group that runs the Seattle project, said the stable housing environment is a factor in reduced drinking. He said there also were discussions of the problem with residents, which leads to reassessment of drinking.

Editing by Andrew Stern and Bill Trott