Social Work Assistance and Stipends for Housing (SASH): A pilot feasibility study for homeless patients receiving methadone for opioid use disorder

Summary Patients receiving methadone for opioid use disorder (MOUD) experience high rates of homelessness. Providing housing assistance for both temporary and permanent housing could improve outcomes for housing and MOUD treatment. Social work assistance and stipends for housing (SASH) was a 12-month, pilot study investigating the feasibility of providing a housing intervention to eight participants receiving MOUD. Participants were eligible for 6 months of US$650 housing stipends that could be used for temporary and permanent housing options, along with 12 months of intensive social work assistance to obtain housing. At months 6 and 12, participants completed qualitative interviews discussing their treatment, housing, and experience with SASH. A thematic analysis of the interview transcripts was completed. Findings One participant was removed soon after entering SASH. Six participants completed qualitative interviews at month 6, and five participants at month 12. Of those whose housing status was known, four were housed, and two were homeless at month 6; three were housed, and two were homeless at month 12. The thematic analysis identified several themes. Participants described SASH as a valuable experience, but they had difficulty obtaining suitable housing with the stipends despite the assistance. Being connected to citywide housing resources was the primary way participants obtained housing. Participants perceived that SASH improved their MOUD treatment. Applications Providing housing assistance with case management could benefit patients receiving MOUD and might not require the skills of a social worker. A more agile payment system capable of paying for temporary housing is needed for future studies with larger sample sizes.