Abstract

Introduction: Persons discharging from residential or inpatient substance use treatment experience the highest level of vulnerability to relapse in first three months post-treatment. Participation in long-term continuing care, also known as post-treatment aftercare, following initial inpatient or residential SUD treatment supports individuals in sustaining their recovery efforts. Due to the well-established role of aftercare participation in long-term recovery, the factors associated with aftercare participation warrant attention. As individuals with SUDs experience better longterm recovery outcomes when they are stably housed, the predictive factors of entering a SLE after the completion of residential or inpatient treatment also merit study. Methods: A de-identified dataset was obtained from a non-profit agency, which provides SUD treatment and prevention services in a large urban county. The dataset included a sample of 200 clients admitted to abstinence-based residential SUD treatment between August 1, 2017, and March 1, 2018. The dataset included information provided by the clients during their ASAM Multidimensional Assessment and the treatment disposition, prognosis, and aftercare services listed in the Discharge/Transfer Form. The sole dependent variable of interest in this study for those clients’ who successfully completed residential SUD treatment (n = 95), a categorical variable, was clients’ enrollment in aftercare services. Results: Based on the likelihood ratio tests, the following variables were found to be significant in predicting participants’ treatment outcomes: living arrangement (p < .003) and duration of participation in treatment (p < .012). Compared to participants who completed residential SUD treatment and did not pursue aftercare services, participants identifying as homeless were 5.442 times more likely to participate in both intensive outpatient treatment and SLE. However, there were no significant predictors of participation in standalone intensive outpatient treatment compared to those who completed residential SUD treatment and did not pursue aftercare services. Conclusions: Housing insecurity appears to be a strong motivator for clients to participate in aftercare services, when access to no-cost SLE is contingent upon participation in intensive outpatient treatment services. As participation in post-treatment aftercare services increase the likelihood of long-term recovery, government and social service agencies should enhance access to no-cost SLEs for Medicaid beneficiaries who enroll in intensive outpatient treatment services.