Factors Associated with Substance Use in Older Homeless Adults: Results from the Hope Home Study. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Spinelli, Matthew A.; Ponath, Claudia; Tieu, Lina; Hurstak, Emily E.; Guzman, David; Kushel, Margot
• Is Part Of: Substance abuse. Volume 38:Issue 1(2017)
• Page Start: 88
• Page End: 94
• Publication Date: 2017-01
• Subjects: Aging -- homeless persons -- substance-related disorders; Substance abuse -- Periodicals; Medical education -- Periodicals; Education, Medical -- periodicals; Substance Abuse -- periodicals; 362.29
• DOI: 10.1080/08897077.2016.1264534
• Languages: English
• ISSNs: 0889-7077

Abstract

Background : The median age of the single adult homeless population is 50 and rising. Although the prevalence of substance use decreases as individuals age, older adults now have a higher prevalence of substance use than older adults did 10 years ago. Homeless individuals have a higher prevalence of substance use disorders than the general population. However, little is known about substance use in older homeless adults. Methods : The objective of the study was to examine prevalence of and factors associated with substance use in a population-based sample ( N = 350) of homeless individuals aged 50 and older in Oakland, California. Dependent variables included moderate or greater severity illicit drug symptoms (Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) score >3) and moderate or greater alcohol symptoms (Alcohol Use Disorders Identification Test (AUDIT) score >7). Independent variables included demographics, mental health problems, and negative life course events such as physical and sexual abuse, school expulsion, and onset of homelessness. Results : Almost two thirds of participants, 64.6%, had moderate or greater severity symptoms for at least 1 illicit drug; 25.8% had moderate or greater severity alcohol symptoms. History of psychiatric hospitalization was associated with moderate or greater illicit drug symptoms (adjusted odds ratio [AOR] = 1.9, 1.0–3.6). The presence of major depressive symptoms was associated with moderate or greater severity alcohol symptoms (AOR = 1.8, 1.1–3.0). Conclusions : In this sample of older homeless adults, substance use is common. There is a need for substance use treatment programs, integrated with mental health services, which are targeted towards the needs of older homeless adults.