1. METHODS Sample n=245 Women, 24% White, 72% Average age, 36.5 Never married, 51% Referral Sources (%) 12-Month DSM-IV Substance Dependence Prior to Entering the Residence (%) Procedure All residents entering the SLH’s were invited to participate in the study using an “intent to treat” procedure. Participants were interviewed within the first 2 weeks in the residence and re-interviewed at 6-month follow-up. Interviews lasted approximately 2 hours. Measures Outcome Measures Addiction Severity Index (medical, alcohol, drug, legal, employment and family/social) Number of days used alcohol past month Number of days used drug of choice past month Brief Symptom Inventory: Global Severity Index Services Desired and Services Received “Services Desired and Received” (Hser et. al., 1999) is an instrument that assesses different services residents desired at baseline and received at 6- months. Services desired was rated 0 (Not at all) to 4 (Very much). Services received were coded received or not received. SOBER LIVING HOUSES FOR SUBSTANCE USE DISORDERS: Do Residents Receive the Services They Need? CONCLUSIONS  At Least half of the residents entering SLH’s indicated a high desire to receive services in a number of areas: medical, medication, individual counseling, group counseling, vocational training/job placement finding permanent housing, recreation and self help groups.  Desire for services declines modestly at 6-month follow-up. At least half or the respondents at 6 months indicated a high desire for medical, medication, finding permanent housing, recreation and self help groups.  There were significant associations between types of services residents desired at baseline and 6 months and their level of problem severity in those areas (i.e., medical, family, employment and psychiatric).  In most service areas, those with a “High Desire” for a service had larger proportions receiving it than those who expressed “Some Desire”.  Service areas with larger proportions of “High Desire” respondents receiving the service included: self help groups, medical treatment, medication, recreation, and individual counseling.  Service areas with large proportions of “High Desire” respondents not receiving the service included: vocational training/job placement, family counseling, GED preparation, money management, legal assistance, and assistance finding permanent housing.  An overall ratio of services received/services desired was associated with number of days of alcohol use during the past 30 days but not other outcome measures (e.g., 6-month measures of substance use, ASI scales, 30 day drug use and psychiatric severity).  Findings here suggest that SLH's could be more responsive to resident needs by developing more linkages with the services that are highly desired by residents but infrequently accessed.  Additional research using a larger sample will examine how receipt of services within specific areas correlates with outcome measures within those areas. ABSTRACT Sober Living Houses (SLH's) are alcohol- and drug-free living environments for individuals attempting to maintain sobriety. They offer no formal treatment services but, rather, provide a social model living environment that emphasizes peer support and involvement in mutual help groups, such as Alcoholics Anonymous. Previous analyses comparing baseline and 6-month follow-up showed that residents of SLH's significantly reduce substance use, alcohol and drug problem severity, arrests, psychiatric symptoms, and unemployment. Remaining, however, is the important question of whether residents access auxiliary services for the variety of problems frequently associated with substance abuse (e.g., medical, psychiatric, family, vocational, legal, housing, etc). This analysis used the Services Desired/Received measure of Hser et. al. (1999) to assess different services residents desired at baseline and received over the next 6 months. The sample included 245 residents in 16 SLH's in Northern California (76% male, 72% white). At baseline, at least half of the residents indicated a “high desire” for 8 of the 14 service areas assessed. At 6 months, at least half indicated a “high desire” for 5 of the 14 service areas. In most service areas there was only a modest decrease in level of desire from baseline to 6 months. Findings indicated significant associations between types of services residents desired at baseline and their level of problem severity in those areas (i.e., medical, family, employment and psychiatric). In most service areas, those with a “high desire” for the service had larger proportions receiving it than those who expressed “some” desire. Some service areas had large proportions of residents who received services they desired: medical, medications (including psychiatric medications and methadone), mutual help groups, and recreation. Other areas had large proportions not receiving services they desired: vocational training/ job placement, family counseling, GED preparation, money management, legal services, and assistance finding permanent housing. An overall ratio of services received / services desired was associated with number of days of alcohol use during the past 30 days but not other outcome measures (e.g., 6- month measures of substance use, ASI scales, 30-day drug use and psychiatric severity). Additional research using a larger sample will examine how receipt of services within specific areas correlates with outcome measures within those areas. Findings here suggest that SLH's could be more responsive to resident needs by developing more linkages with the services that are highly desired by residents but infrequently accessed. Acknowledgments Research Staff Data collection Site Gantt Galloway, Pharm.D. Clean and Sober Transitional Living (CSTL) Diane Henderson, B.A. Fair Oaks, California Laura Jones, M.A. Joanna Knight, B.A. Rebecca Saulsbury Sara Shopkow, M.P.H This study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (R01 AA014030) BACKGROUND What Are Sober Living Houses? Alcohol-and drug-free living environments Self supported Social model recovery philosophy Can be used in conjunction with formal treatment or as an alternative The “Evaluation of Sober Living Houses” Project 5-year longitudinal study 300 sober living residents, 2 agencies, 21 Sober Living Houses Recruited within first week of entering the house In person interviews at baseline, 6, 12, and 18 months Baseline to 6-Month Improvements of Sober Living House Residents Reported in Previous Analyses Alcohol and drugs Use ASI alcohol severity ASI drug severity ASI work severity Psychiatric problems Arrests Unemployment Previous finding reported: Polcin, D. L. (2006). Where are clients going to live? Sober Living House options. Workshop: New Services Research from the Alcohol Research Group. Reengineering Our System of Services: Developing and Implementing a Comprehensive and Integrated Continuum of Services. California State Department of Alcohol and Drug Problems, Sacramento, CA, September 6–8. Douglas L. Polcin, Ed.D. & Rachael Korcha, M.A., Alcohol Research Group, Emeryville, CA Relationship between Services Received/Desired Ratio and Outcome Two variables were computed to assess a ratio of services received / services desired. The first, Baseline Ratio, used services received at 6 months over services desired at baseline. The second, 6- month Ratio, used services received at 6 months over services desired at 6 months. These variables were then correlated with a variety of outcome measures, including ASI scales (medical, legal, drug, alcohol, employment, and family/social), Brief Symptom Inventory Global score of psychiatric severity, 2 broad measures of substance use measuring a 6-month period (number of months used any substances and Peak Density of use during month of highest use), and number of days of alcohol and primary drug use over the past 30 days. Baseline ratio showed a trend with number of days of alcohol use at 6 months such that a higher ratio associated with lower number of days of alcohol use over the past 30 days (r= -0.16, p =0.06). The 6- month Ratio had a significant relationship with number of days of alcohol use in the same direction (r= - 0.19, p =0.03). Other comparisons with outcome measures were not significant.