A hospital emergency room might provide a few nights of relief for people with addiction without a home to return to.
An inpatient rehab alternative might offer a bed for 30 days.
But too many will end up relapsing, advocates say, even as they’re seeking help. That’s because many medical settings can’t address the social and economic issues that keep people without housing from continuing addiction treatment.
The nonprofit Project HOME said recently it is launching a new project to address lacking support in the health-care system. It aims to integrate medical care and addiction treatment and provide permanent housing for unhoused people with addiction through a $25 million donation from philanthropists Pam Estadt and Ira Lubert.
The money will fund the Estadt-Lubert Collaborative for Housing and Recovery for five years, but Project HOME hopes to raise $100 million over 10 years to fully fund the program. It will get patients into both shorter-term, dormitory-style housing that doesn’t require sobriety and is intended to help immediately house and stabilize them — as well as provide permanent apartment-style housing for people in recovery.
“There’s a lot of ways that people fall off the screen and the radar and then go back to square one,” said Sister Mary Scullion, Project HOME’s founder and president. “We want to give people the best shot to recover.”
Lubert, a real estate and private equity magnate, said that he and Estadt have not dealt with addiction in their own families. Philadelphia’s record 1,276 overdose deaths in 2021 spurred him and Estadt to make the contribution. “This city has been incredibly generous to me in my career. So we just wanted to find a way to help. We wanted to try something new and different and hopefully have positive results,” he said.
As part of the initiative, Project HOME will partner with some of the Philadelphia area’s major health systems to connect people with addiction with treatment from emergency rooms, and then quickly get them into housing once they are well enough to leave the hospital. Participants will also have access to regular primary care and support from peers in recovery, who help others navigate the addiction treatment system.
Under the new program, Penn Medicine, Temple Health and Jefferson Health will partner with Project HOME; outreach workers will be able to call ahead to emergency rooms citywide to let doctors know that a client is coming in and needs help addressing their addiction or a health condition or a health condition related to it.
“We’ve been doing a lot of work informally, calling ahead and giving ERs a heads-up,” said Laura Caron Weinstein, the director of Jefferson’s addiction medicine fellowship.
But after hospital treatment, or even inpatient treatment for drug addiction, many patients don’t have housing lined up.
Offering patients permanent housing instead of a 30-day stay in a rehab can help promote long-term recovery, said Jeanmarie Perrone, the director of addiction medicine initiatives in Penn’s emergency department.
She sees people come into her ER asking for inpatient treatment who could be helped outside of the hospital with medication. “What they really want is just respite from being on the street,” she said.
It can also help patients whose drug use has been complicated by xylazine, the animal tranquilizer that has contaminated much of the city’s supply of fentanyl, the synthetic opioid behind the city’s soaring rate of overdose deaths.
Xylazine also causes a number of serious side effects like wounds that are easy to open and slow to heal.
Those wounds can keep people out of inpatient care, or some housing options if staff at those facilities feel they’re not able to care for them. But many wounds, Weinstein said, don’t necessarily need highly specialized treatment. “We know what heals wounds:”It’s things like soap and water — and housing,” she said.
A handful of beds have already been set aside for participants, Scullion said, and the program eventually hopes to have 150 dedicated to the program.