PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jurbhealthspringer.comThis journalToc AlertsSubmit OnlineOpen ChoiceThis journal
 
J Urban Health. 2004 December; 81(4): 606–617.
PMCID: PMC3455928

Substance-abusing urban homeless in the late 1990s: How do they differ from non-substance-abusing homeless persons?

Abstract

Much of our understanding of substance abuse and homelessness comes from data from the 1980s and may not necessarily reflect issues or trends prevalent during the 1990s. We report data from a two-city, community-based, populations-proportionate sample of 531 randomly selected homeless adults; the study was conducted in 1997 and compared substance-abusing to non-substance-abusing respondents. Most (78.3%) met criteria for substance abuse/dependence and were abusing either cocaine or alcohol and cocaine (68.5%). In the multiple logistic regression model, male gender (odds ratio [OR] 2.94, 95% confidence interval [CI] 1.70–5.09), less than a 12th grade education (OR 1.96, 95% CI 1.11–3.46), bustling or stealing for sustenance (OR 3.14, 95% CI 1.15–8.55), and identifying a need to learn how to manage one’s money (OR 2.41, 95% CI 1.45–3.98) were independently associated with substance abuse/dependence. Drug abuse/dependence and polysubstance use among urban homeless persons became a more prevalent issue in the late 1990s. These individuals have unique needs that will require tailored interventions.

Full Text

The Full Text of this article is available as a PDF (102K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
1. Fischer PJ. Estimating the prevalence of alcohol, drug and mental health problems in the contemporary homeless population: a review of the literature. Contemp Drug Probl. 1989;16:333–360.
2. Lehman AF. Prevalence of alcohol, drug, and metal disorders among the homeless: one more time. Contemp Drug Probl. 1993;20:355–383.
3. McCarty D, Argeriou M, Huebner RB, Lubran B. Alcoholism, drug abuse, and the homeless. Am Psychol. 1991;46:1139–1148. doi: 10.1037/0003-066X.46.11.1139. [PubMed] [Cross Ref]
4. Fischer PJ, Breakey WR. The epidemiology of alcohol, drug, and mental disorders among homeless persons. Am Psychol. 1991;46:1115–1128. doi: 10.1037/0003-066X.46.11.1115. [PubMed] [Cross Ref]
5. Lambert EY, Caces MF. Correlates of drug abuse among homeless and transient people in the Washington, DC, metropolitan area in 1991. Public Health Rep. 1995;110:455–461. [PMC free article] [PubMed]
6. O’Toole TP, Gibbon JL, Hanusa BH, Fine J. Urban homelessness and poverty during economic prosperity and welfare reform: changes in self-reported co-morbidities, insurance, and sources for usual care 1995–1997. J Urban Health. 2002;79:200–210. [PMC free article] [PubMed]
7. What America’s users spend on illegal drugs 1988–1988. December 2000. Available at: http://www.whitehousedrugpolicy.gov/publications. Accessed August 1, 2003.
8. Jencks C. The Homeless. Cambridge, MA: Harvard University Press; 1995.
9. Carrasquillo O, Himmelstein DU, Woolhandler S, Bor DH. Can Medicaid managed care provide continuity of care to new Medicaid enrollees? An analysis of tenure on Medicaid. Am J Public Health. 1998;88:464–466. [PubMed]
10. Pennsylvania P.L. Act 35, 1996.
11. Telephone Substance Dependence Needs Assessment Questionnaire. Cambridge, MA: North Charles Planning and Research Group; May 1994.
12. O’Toole TP, Gibbon JL, Hanusa BH, Fine J. Utilization of health care services among subgroups of urban homeless and housed poor. J Health Polit Policy Law. 1999;24:91–114. [PubMed]
13. Robertson MJ, Ropers RH, Boyer R. The Federal Response to the Homeless Crisis. Hearing before the Subcommittee of the Committee on Government Operations. US House of Representatives. Washington, DC: Government Printing Office; 1985. The homeless of Los Angeles County: an empirical evaluation; pp. 1016A–1016A.
14. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed., rev. Washington, DC: American Psychiatric Association; 1987.
15. Robertson MJ, Zlotnick C, Westerfelt A. Drug use disorders and treatment contact among homeless adults in Alameda County California. Am J Public Health. 1997;87:221–228. [PubMed]
16. Kushel MB, Vittinghoff E, Haas JS. Factors associated with the health care utilization of homeless persons. JAMA. 2001;285:200–206. doi: 10.1001/jama.285.2.200. [PubMed] [Cross Ref]
17. Homelessness, Health, and Human Needs. Washington, DC: National Academy Press; 1988.
18. Brickner PW, Scharer LK, Conanan BA, Savarese M, Scanlan BC. Under the Safety Net. The Health and Social Welfare of the Homeless in the United States. New York, NY: W. W. Norton; 1990.
19. Gelberg L, Linn LS, Usatine RP, Smith MH. Health, homelessness, and poverty. A study of clinic users. Arch Intern Med. 1990;150:2325–2330. doi: 10.1001/archinte.150.11.2325. [PubMed] [Cross Ref]
20. Gelberg L, Linn LS. Demographic differences in health status of homeless adults. J Gen Intern Med. 1992;7:601–608. [PubMed]
21. Fischer PJ. Criminal activity among the homeless: a study of arrests in Baltimore. Hosp Community Psychiatry. 1988;39:46–51. [PubMed]
22. O’Toole TP, Gibbon JL, Hanusa BH, Freyder PJ, Conde AM, Fine MJ. Self-reported changes in drug and alcohol use upon becoming homeless. Am J Public Health. 2004;94:830–835. doi: 10.2105/AJPH.94.5.830. [PubMed] [Cross Ref]

Articles from Journal of Urban Health : Bulletin of the New York Academy of Medicine are provided here courtesy of New York Academy of Medicine