Preliminary results from Brazil's first recovery housing program.

INTRODUCTION: The recovery housing (RH) program was initiated in São Paulo with the objective of providing treatment for substance use disorders and addressing users' housing and employment problems. The purpose of this study was to describe the model based on its first 11 months of operation, it was launched in June 2016 in Brazil. METHOD: We carried out a retrospective analysis of the records of all subjects treated in the RH of the Restart Program (Programa Recomeço) since its creation, from June 2016 to May 2017. RESULTS: Sixty-nine subjects were included. Thirty-five (51%) remained in the household until the end of treatment or were reinserted in society. Thirty-four (49%) presented recurrence during their stay, of which 16 (47%) volunteered for treatment in a therapeutic community or psychiatric hospital, 8 (23.5%) chose to continue with outpatient treatment only, 6 (17.7%) returned to their families and continued to receive outpatient treatment, and 4 (11.8%) discontinued the treatment. Of the 35 subjects who completed the RH program, 28 (80%) were in employment and 7 (20%) received governmental support for permanent disability on medical or psychiatric grounds. CONCLUSION: RH can be an important component of integrated care and is used in several countries. Although controversial, the use of urine tests to control relapse seems to have a positive impact on adherence to treatment and maintenance of abstinence. These preliminary findings corroborate, with clear limitations, the evidence available in the literature showing that RH programs are effective for the treatment of addictions.

Preliminary results from Brazil's first recovery housing program / Dados preliminares do primeiro programa de moradia monitorada no Brasil

Abstract Introduction: The recovery housing (RH) program was initiated in São Paulo with the objective of providing treatment for substance use disorders and addressing users' housing and employment problems. The purpose of this study was to describe the model based on its first 11 months of operation, it was launched in June 2016 in Brazil. Method: We carried out a retrospective analysis of the records of all subjects treated in the RH of the Restart Program (Programa Recomeço) since its creation, from June 2016 to May 2017. Results: Sixty-nine subjects were included. Thirty-five (51%) remained in the household until the end of treatment or were reinserted in society. Thirty-four (49%) presented recurrence during their stay, of which 16 (47%) volunteered for treatment in a therapeutic community or psychiatric hospital, 8 (23.5%) chose to continue with outpatient treatment only, 6 (17.7%) returned to their families and continued to receive outpatient treatment, and 4 (11.8%) discontinued the treatment. Of the 35 subjects who completed the RH program, 28 (80%) were in employment and 7 (20%) received governmental support for permanent disability on medical or psychiatric grounds. Conclusion: RH can be an important component of integrated care and is used in several countries. Although controversial, the use of urine tests to control relapse seems to have a positive impact on adherence to treatment and maintenance of abstinence. These preliminary findings corroborate, with clear limitations, the evidence available in the literature showing that RH programs are effective for the treatment of addictions.

Resumo Introdução: O Programa Moradia Monitorada (MM) foi iniciado em São Paulo com o objetivo de prover tratamento para transotrnos de uso de substâncias e problemas relacionados a moradia e emprego. O objetivo do presente estudo foi descrever o modelo com base nos primeiros 11 meses de operação (o programa foi lançado em junho de 2016 no Brasil). Métodos: Realizamos um estudo retrospectivo utilizando os registros de todos os indivíduos tratados no MM do Programa Recomeço desde a sua criação. Resultados: Sessenta e nove indivíduos foram incluídos. Trinta e cinco (51%) permaneceram no tratamento até o fim ou foram reinseridos socialmente com sucesso. Trinta e quatro sujeitos (49%) apresentaram recidiva durante a permanência. Destes, 16 (47%) se voluntariaram para tratamento em comunidades terapêuticas ou hospitais psiquiátricos, 8 (23,5%) escolheram permanecer apenas no tratamento ambulatorial, 6 (17.7%) retornaram para suas famílias e continuaram o tratamento em uma unidade ambulatorial próxima ao domicílio, e 4 (11.8%) descontinuaram o tratamento. Dos 35 pacientes que completaram o tratamento, 28 (80%) estavam empregados em serviço regular e 7 (20%) recebiam aposentadoria por questões clínicas e/ou psiquiátricas. Conclusão: O modelo MM pode ser um componente importante na via de cuidados integrados e é utilizado em vários países. Apesar de controverso, o uso de análise de urina para vigilância da recidiva e da recorrência parece ter um impacto positivo na adesão ao tratamento e na manutenção da abstinência. Nossos achados preliminares corroboram, com claras limitações, os resultados reportados previamente na literatura, de que os programas de MM são efetivos no tratamento da dependência química.