Disparities in Utilization of Recovery Residences among People Attending an Intensive Outpatient Program for Co-occurring Disorders.

People with mental health and substance use disorders (SUDs) experience worse outcomes, including increased mortality risk, compared to those with SUDs alone. Access to safe, stable housing, in conjunction with treatment, such as intensive outpatient programs (IOP), is vital in early recovery. Nevertheless, those with historically marginalized identities may experience increased disparities in accessing and utilizing services. The aim of this study was to examine disparities in the utilization of recovery residences among adults receiving treatment for mental health disorders and SUDs in an IOP. Participants (n = 2803) were recruited as part of an ongoing program evaluation at a large Midwestern treatment agency offering to cover some of the monthly cost of living in independently operated recovery residences while admitted to the IOP. Collected data included demographic information and outcome variables. Logistic regression models examined factors associated with recovery residence enrollment. Most participants (80.5%, n = 2258) lived in a recovery residence during IOP. People who were female, Black-only, multiracial, had less education, or a legal history were less likely to live in recovery residences. Those with a prior treatment history, recently unhoused, or with more days abstinent from substances were more likely to live in recovery residences. In short, even with reduced cost barriers, disparities persist in the utilization of recovery residences in conjunction with IOPs, particularly those from historically marginalized groups. Future research should prioritize understanding this utilization gap and developing effective strategies to support individuals in utilizing recovery residences alongside IOP for improved outcomes.