Background: In Philadelphia, opioid use disorder (OUD) has been one of the main drivers of the dramatic increase of unsheltered homeless persons. To address both housing and treatment needs, the city funded Pathways to Housing PA to expand their Housing First (HF) program and create a pilot service team specifically for persons with OUD.

The goal of this program is to end homelessness for people with OUD by providing 1) immediate access to permanent supportive housing with no preconditions, 2) immediate access to primary care and person-centered recovery planning, including medication-assisted treatment (MAT), and 3) comprehensive overdose prevention.

Methods: A retrospective review was used to evaluate our program and identify patterns of engagement in housing and MAT. We examined participant demographics, SUD treatment history, comorbid medical conditions, overdose rates, participant goals, and housing retention of the first 145 participants admitted into the program.

Results: The average age of participants was 43 years (SD 10.0). The majority were male (68%), white (67%), and non-Hispanic (80%). The most common concurrent psychiatric diagnoses were mood disorders and trauma-related disorders, and the most frequently reported co-occurring chronic health conditions were Hepatitis C and HIV. Almost half of the participants were diagnosed with multiple substance use disorders. In initial evaluation, the program has provided overdose prevention education and naloxone to 100% of participants, and 26% of participants have been linked to on-site MAT. Preliminary housing retention rate of the first 83 participants was 93%.

Conclusions: Housing outcomes are similar to those reported by other HF programs, suggesting that participants with OUD can be supported with maintaining housing and engaging in services. Additional program data is being collected regarding health status, OUD treatment, overdose rates, and participant goals and will be available at the time of presentation.