Abstract
OBJECTIVES: This study estimates the extent and distribution of specific drug problems among homeless adults. METHODS: A countywide probability sample of 564 homeless adults received structured interviews that included a standardized assessment of substance use disorders. RESULTS: Two thirds of the sample (69.1%) had a lifetime history of a substance use disorder (including abuse of or dependence on alcohol [52.6%] or drugs [52.2%]); half had a current (52.4%) substance use disorder (including alcohol [38.8%] or drugs [31.3%]). Current drug disorders were higher among respondents who were younger, homeless longer, or sampled from the city of Oakland, Calif. Alcohol use disorders were higher among men than among women; surprisingly, drug use disorders were not. CONCLUSION: Rates of current drug use disorders for homeless adults were more than eight times higher than general population estimates. However, estimates of drug problems among homeless adults vary as a function of case ascertainment and sampling strategy. Estimates based only on samples from urban areas may overestimate drug problems among the area's larger homeless populations.
Full text
PDF![221](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fe/1380798/5dc8ad6f7675/amjph00501-0079.png)
![222](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fe/1380798/068f9e110ef5/amjph00501-0080.png)
![223](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fe/1380798/4426e85f6005/amjph00501-0081.png)
![224](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fe/1380798/9fc9d73bc8d0/amjph00501-0082.png)
![225](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fe/1380798/5774582c2870/amjph00501-0083.png)
![226](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fe/1380798/026d088831bc/amjph00501-0084.png)
![227](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fe/1380798/a1bed959ddf7/amjph00501-0085.png)
![228](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fe/1380798/566a3cbfaa70/amjph00501-0086.png)
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bassuk E. L., Rubin L., Lauriat A. S. Characteristics of sheltered homeless families. Am J Public Health. 1986 Sep;76(9):1097–1101. doi: 10.2105/ajph.76.9.1097. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fischer P. J., Breakey W. R. The epidemiology of alcohol, drug, and mental disorders among homeless persons. Am Psychol. 1991 Nov;46(11):1115–1128. doi: 10.1037//0003-066x.46.11.1115. [DOI] [PubMed] [Google Scholar]
- Fischer P. J., Shapiro S., Breakey W. R., Anthony J. C., Kramer M. Mental health and social characteristics of the homeless: a survey of mission users. Am J Public Health. 1986 May;76(5):519–524. doi: 10.2105/ajph.76.5.519. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hosmer D. W., Taber S., Lemeshow S. The importance of assessing the fit of logistic regression models: a case study. Am J Public Health. 1991 Dec;81(12):1630–1635. doi: 10.2105/ajph.81.12.1630. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kessler R. C., McGonagle K. A., Zhao S., Nelson C. B., Hughes M., Eshleman S., Wittchen H. U., Kendler K. S. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994 Jan;51(1):8–19. doi: 10.1001/archpsyc.1994.03950010008002. [DOI] [PubMed] [Google Scholar]
- Koegel P., Burnam M. A. Alcoholism among homeless adults in the inner city of Los Angeles. Arch Gen Psychiatry. 1988 Nov;45(11):1011–1018. doi: 10.1001/archpsyc.1988.01800350045007. [DOI] [PubMed] [Google Scholar]
- Koegel P., Burnam M. A., Farr R. K. The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles. Arch Gen Psychiatry. 1988 Dec;45(12):1085–1092. doi: 10.1001/archpsyc.1988.01800360033005. [DOI] [PubMed] [Google Scholar]
- Robertson M. J., Winkleby M. A. Mental health problems of homeless women and differences across subgroups. Annu Rev Public Health. 1996;17:311–336. doi: 10.1146/annurev.pu.17.050196.001523. [DOI] [PubMed] [Google Scholar]
- Smith E. M., North C. S., Spitznagel E. L. Alcohol, drugs, and psychiatric comorbidity among homeless women: an epidemiologic study. J Clin Psychiatry. 1993 Mar;54(3):82–87. [PubMed] [Google Scholar]
- Spinner G. F., Leaf P. J. Homelessness and drug abuse in New Haven. Hosp Community Psychiatry. 1992 Feb;43(2):166–168. doi: 10.1176/ps.43.2.166. [DOI] [PubMed] [Google Scholar]
- Susser E., Conover S., Struening E. L. Mental illness in the homeless: problems of epidemiologic method in surveys of the 1980s. Community Ment Health J. 1990 Oct;26(5):391–414. doi: 10.1007/BF00761067. [DOI] [PubMed] [Google Scholar]
- Susser E., Conover S., Struening E. L. Problems of epidemiologic method in assessing the type and extent of mental illness among homeless adults. Hosp Community Psychiatry. 1989 Mar;40(3):261–265. doi: 10.1176/ps.40.3.261. [DOI] [PubMed] [Google Scholar]
- Susser E., Struening E. L., Conover S. Psychiatric problems in homeless men. Lifetime psychosis, substance use, and current distress in new arrivals at New York City shelters. Arch Gen Psychiatry. 1989 Sep;46(9):845–850. doi: 10.1001/archpsyc.1989.01810090087012. [DOI] [PubMed] [Google Scholar]
- Welte J. W., Barnes G. M. Drinking among homeless and marginally housed adults in New York State. J Stud Alcohol. 1992 Jul;53(4):303–315. doi: 10.15288/jsa.1992.53.303. [DOI] [PubMed] [Google Scholar]
- Winkleby M. A., Rockhill B., Jatulis D., Fortmann S. P. The medical origins of homelessness. Am J Public Health. 1992 Oct;82(10):1394–1398. doi: 10.2105/ajph.82.10.1394. [DOI] [PMC free article] [PubMed] [Google Scholar]