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Principal Investigator: Matthew Eisenberg
Organization: JOHNS HOPKINS UNIVERSITY
Fiscal Year: 2024
Award: $707,029
Funding agency: National Institute of Nursing Research
Project Summary
Substance use disorder (SUD), overdose risk, and housing insecurity have reached crisis levels in the US. In
2019, over 8 million individuals met criteria for SUD, and nearly 37 million households were spending more
than 30% of their income on housing. Since the start of the COVID-19 pandemic, already-high overdose
mortality rates soared, and millions of households have fallen behind on their rent. Beyond initiatives focused
on people without housing such as housing first, there has been a paucity of research focusing on the
intersection of SUD and housing insecurity. Even less is known about whether policy attempts designed to
support housing security have the potential to improve engagement in substance use treatment and reduce
fatal and non-fatal overdose. Innovative housing policies enacted during the COVID-19 pandemic—including
eviction moratoriums, emergency rental assistance, and legal representation to tenants facing eviction (right to
counsel)—offer an unprecedented opportunity to fill this vital knowledge gap. Widespread variation across
states in whether and how these policies were implemented allow them to be rigorously studied using causal
methods with mechanisms and potential mechanisms explored using qualitative approaches. In Aims 1-2, we
will conduct a 50-state study using a difference-in-differences approach to examine the effects of the three
housing policies of interest on rates of substance use treatment and fatal and non-fatal drug overdose. Data
sources for Aims 1-2 will include 50-state administrative databases capturing services delivered in the general
medical sector (IQVIA LRx/Dx and HCUP) and specialty addiction treatment sector (TEDS), as well as CDC
fatal drug overdose data. In Aim 3, we will conduct in-depth qualitative interviews with people with recent
histories of drug use as well as providers and policy officials in urban and rural counties. Our study will yield
actionable evidence to inform policy development and implementation at the intersection of housing and SUD
designed to enhance engagement in addiction treatment and prevent drug overdose.
Terms: <Accident and Emergency department><Achievement><Achievement Attainment><Adanon><Address><Affect><Althose><Ambulatory Care><Behavioral><Buprenorphine><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 affected><COVID-19 consequence><COVID-19 crisis><COVID-19 effect><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 impact><COVID-19 impacted><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><CV-19><Centers for Disease Control><Centers for Disease Control and Prevention><Centers for Disease Control and Prevention (U.S.)><Color><Communities><Coronavirus Infectious Disease 2019><Costs and Benefits><Counseling><Data><Data Sources><Death Rate><Delaware><Dolophine><Drug usage><Drugs><Economic Income><Economical Income><Emergencies><Emergency Department><Emergency Situation><Emergency room><Ensure><Epidemiology><Ethnic Origin><Ethnicity><FDA approved><Fatality rate><Funding><Health Care Costs><Health Costs><Health Services Evaluation><Health Services Research><Healthcare Costs><History><Household><Housing><Income><Individual><Inpatients><Intervention><Intervention Strategies><Interview><Knowledge><Legal><Life><Life Expectancy><Maryland><Measures><Medical><Medical Care Research><Medication><Methadone><Methadose><Methods><Nalorex><Naltrexone><Nemexin><Outcome><Outpatient Care><Overdose><Pennsylvania><Persons><Pharmaceutical Agent><Pharmaceutical Preparations><Pharmaceuticals><Pharmacologic Substance><Pharmacological Substance><Policies><Policy Developments><Policy Maker><Policy Research><Population><Provider><Qualitative Methods><Race><Races><ReVia><Recording of previous events><Recovery><Research><Risk><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Security><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Specialty><Speed><Structural Racism><Structure><Substance Use Disorder><Time><United States Centers for Disease Control><United States Centers for Disease Control and Prevention><Variant><Variation><Vivitrol><West Virginia><addiction><addictive disorder><administrative data base><administrative database><coronavirus disease 2019><coronavirus disease 2019 consequence><coronavirus disease 2019 crisis><coronavirus disease 2019 effect><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 impact><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19><coronavirus disease-19 global pandemic><coronavirus disease-19 impact><coronavirus disease-19 pandemic><coronavirus infectious disease-19><design><designing><drug use><drug/agent><epidemiologic><epidemiological><evidence base><experience><health economics><health service use><health service utilization><histories><improved><incomes><innovate><innovation><innovative><interest><interventional strategy><medical specialties><mortality rate><mortality ratio><opiate use disorder><opioid use disorder><outpatient treatment><overdose death><overdose fatalities><overdose risk><pandemic><pandemic disease><pharmaceutical><population based><post-pandemic><prevent><preventing><psychiatric co-morbidity><psychiatric comorbidity><public health emergency><qualitative reasoning><racial><racial background><racial origin><relapse risk><rural counties><service programs><service providers><services research><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><substance use><substance use and disorder><substance use treatment><substance using><supported housing><supportive housing><treatment and outcome><treatment risk><treatment services>