Background: With the passage of the 2016 Comprehensive Addiction and Recovery Act (CARA), the Department of Veterans Affairs expanded efforts to improve health outcomes among Veterans with substance use disorders by including coverage of complementary and integrative health (CIH) services. All VA medical centers offer at least the following CIH services: yoga, Tai Chi/Qigong, guided meditation, acupuncture, biofeedback, massage, clinical hypnosis, and chiropractic care. Substance use is a particularly pervasive condition among Veterans experiencing homelessness (VEH). One program that provides care to VEH with substance use disorders is the domiciliary care for homeless veterans (DCHV). DCHV programs provide time limited residential treatment to Veterans to address both their health and social issues. Completion of DCHV programs is associated with improved quality of life and reduced mortality, yet upwards of 25% of Veterans leave before they complete the program.

Objective: The objective of this study was to examine the use of CIH services at one DCHV program and determine if there is an association between CIH service use and DCHV program completion.

Methods: VA administrative data was used to collect demographics, program completion status, substance use conditions, and CIH service use. Veterans enrolled at one DCHV program between September 1, 2021 and September 15, 2023 were included. Descriptive statistics were used for demographics, substance use conditions, and CIH service use. Multivariable logistic regression was used to examine the association between DCHV program completion and use of CIH services.

Results: There were 227 Veterans in the sample. The majority of participants were male (97%), white (74%) and single or divorced (89%). Average age was 48.9 years. Over 72% had co-occurring drug use and alcohol use disorders. DCHV program completion rate was 71%. The average number of CIH services was 6.25 (+/- 4.6) with the most commonly utilized being meditation and yoga. Multivariable logistic regression analysis revealed that for each additional CIH service utilized there was a 10% increase in the odds of completing the DCHV program, (OR= 1.10, 95% CI [1.02, 1.19]).

Conclusion: Results of this study indicated that CIH services were associated with improved DCVH program completion. CIH services offer alternative approaches for pain and stress management and complement existing recovery-oriented programming for VEH with substance use disorders. DCHVs and other programs that provide care for VEH with substance use disorders should consider including or improving access to CIH services in their programs.