# Housing Policies and their Impact on Engagement in Substance Use Treatment and Overdose Risk during the COVID-19 Pandemic

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $707,029

## Abstract

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.

## Key facts

- **NIH application ID:** 10872129
- **Project number:** 5R01NR020854-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Matthew Eisenberg
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $707,029
- **Award type:** 5
- **Project period:** 2022-09-26 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10872129

## Citation

> US National Institutes of Health, RePORTER application 10872129, Housing Policies and their Impact on Engagement in Substance Use Treatment and Overdose Risk during the COVID-19 Pandemic (5R01NR020854-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10872129. Licensed CC0.

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