MEDICAL OUTREACH TO HOMELESS SUBSTANCE USERS IN NEW YORK CITY: PRELIMINARY RESULTS*

Abstract

An innovative, experimental, medical out-reach initiative, using a fully-equipped mobile medical van with a staff of 2 part-time physicians, a physician assistant, a social worker, and a driver/medical aid serving the needs of 1048, mostly male, minority group, high-level, homeless New York City substance users with infectious diseases is described. The study sample (N = 250) was divided into experimental S's who received Intensive case management and a control group who could choose to refer themselves to the SW. Biological tests revealed high rates of cocaine use and infectious diseases. Preliminary 4-month outcomes (N=128) showed reductions in drug use, homelessness and health complaints in both groups; experimental subjects compared with controls received more Public Assistance and had fewer emergency room visits.

• Homelessness
• Case management
• Substance use
• Medical outreach

Additional information

Notes on contributors

Andrew Rosenblum

Andrew Rosenblum, Ph.D., is the Deputy Executive Director of the National Development and Research Institutes, Inc. He has served as principle investigator, co-investigator and project director on several research projects on substance use, including innovative interventions for the treatment of cocaine dependence, outreach to homeless populations, and an evaluation of a treatment linkage model for street-based sex workers.

Larry Nuttbrock

Larry Nuttbrock is currently a Project Director with the National Development and Research Institutes (NDRI). His recent work includes an evaluation of alternative treatment modalities for homeless mentally-ill chemical abusers, an assessment of mobile medical outreach to homeless people, and an analysis of the association between cocaine use and HIV infection among soup kitchen attendees in New York City.

Hunter McQuistion

Hunter L. McQuistion, M.D., is Medical Director of Project Renewal, Inc., New York City's leading nonprofit organization serving disabled adult homeless people. He teaches and publishes widely, and is an Associate Clinical Professor of Psychiatry at the Mount Sinai School of Medicine. Dr. McQuistion sub-specializes in community psychiatry, and has special interests in techniques of engaging difficult to reach clinical populations and in accessing indigent communities to integrated systems of health and social services. He is also Treasurer of the American Association of Community Psychiatrists and is a Fellow of the American Psychiatric Association.

Steve Magura

Stephen Magura, Ph.D., C.S.W., is Director of the Institute for Treatment and Services Researches at National Development and Research Institutes, Inc. He has designed and directed clinical trials, treatment outcome studies, health services research, social epidemiology studies, HIV prevention research, and policy analysis, as related to drug dependency. He has published over 100 articles and authored/edited several books and special journal issues on outcome evaluation and clinical trials, including Experimental Therapeutics in Addiction Medicine.

Herman Joseph

Herman Joseph, Ph.D., is a Senior Research Scientist at the New York State Office of Alcohol and Substance Abuse Services (OASAS). He has played a pivotal role in substance abuse treatment research in New York City. Along with Dr. Vincent Dole, he conducted one of the first follow-up studies that documented the benefits of methadone maintenance for the treatment of opiate dependence. He is founder and chairperson of the Chemical Dependency Research Working Group and is founder and executive chair of the International Substance Abuse and Pain Conference. His seminal publications have addressed AIDS and hepatitis C among homeless IV drug users, treatment of IVDUs in the criminal justice system, and methadone medical maintenance.