Substance use and homelessness among emergency department patients

•Substance use differs by homelessness status among emergency department (ED) patients.•Homelessness is associated with high rates and severity of alcohol and drug use.•Homelessness is associated with high rates of opioid overdose. Homelessness and substance use often coexist, resulting in high morb...

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Bibliographic Details
Published in:Drug and alcohol dependence 2018-07, Vol.188, p.328-333
Main Authors: Doran, Kelly M., Rahai, Neloufar, McCormack, Ryan P., Milian, Jacqueline, Shelley, Donna, Rotrosen, John, Gelberg, Lillian
Format: Article
Language:English
Subjects:
Adult
Alcohol
Alcohol Drinking - epidemiology
Alcohol Drinking - psychology
Alcohol Drinking - therapy
Alcohol use
Alcoholic beverages
Cohort Studies
Cross-Sectional Studies
Definitions
Drug abuse
Drug addiction
Drug overdose
Drug Users - psychology
Drugs
Emergency medical services
Emergency service
Emergency Service, Hospital - statistics & numerical data
Emergency services
Female
Heroin
Homeless people
Homeless Persons - psychology
Homelessness
Housing
Humans
Male
Middle Aged
Morbidity
Opioids
Overdose
Patients
Prospective Studies
Rangefinding
Sampling methods
Severity
Social factors
Social Problems - psychology
Substance abuse
Substance use
Substance-Related Disorders - epidemiology
Substance-Related Disorders - psychology
Substance-Related Disorders - therapy
Vulnerable populations
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Summary:•Substance use differs by homelessness status among emergency department (ED) patients.•Homelessness is associated with high rates and severity of alcohol and drug use.•Homelessness is associated with high rates of opioid overdose. Homelessness and substance use often coexist, resulting in high morbidity. Emergency department (ED) patients have disproportionate rates of both homelessness and substance use, yet little research has examined the overlap of these issues in the ED setting. We aimed to characterize alcohol and drug use in a sample of homeless vs. non-homeless ED patients. A random sample of urban hospital ED patients were invited to complete an interview regarding housing, substance use, and other health and social factors. We compared substance use characteristics among patients who did vs. did not report current literal (streets/shelter) homelessness. Additional analyses were performed using a broader definition of homelessness in the past 12-months. Patients who were currently homeless (n = 316, 13.7%) versus non-homeless (n = 1,993, 86.3%) had higher rates of past year unhealthy alcohol use (44.4% vs. 30.5%, p 
ISSN:0376-8716
1879-0046
DOI:10.1016/j.drugalcdep.2018.04.021