Carole C Upshur1,2, Darlene Jenkins3, Linda Weinreb1, Lillian Gelberg4, Elizabeth Aaker Orvek2. 1. a Department of Family Medicine and Community Health , University of Massachusetts Medical School , Worcester , MA , USA. 2. b Department of Quantitative Methods , University of Massachusetts Medical School , Worcester , MA , USA. 3. c National Health Care for the Homeless Council , Nashville , TN , USA. 4. d Department of Family Medicine, David Geffen School of Medicine, and Department of Health Policy and Management, Fielding School of Public Health , University of California at Los Angeles , Los Angeles , CA , USA.
Abstract
BACKGROUND: Homeless women are at high risk for substance use disorder (SUD), and are a growing proportion of the homeless population. However, homeless women experience barriers to engaging in substance use services. OBJECTIVES: Among homeless women with SUD, to explore service use, motivation to change, service barriers, and willingness to have substance use and mental health problems addressed in primary health care. METHODS: Women with SUD were sampled from 11 Health Care for the Homeless (HCH) primary care clinics in 9 states, yielding 241 with either an alcohol or drug use disorder who then completed questions about SUD services. RESULTS: Over 60% of women with dual alcohol and drug use disorders used some type of SUD service in the past year, while 52% with a drug only disorder, and 44% with an alcohol only disorder used services. The most mentioned barrier to service use was depression, but cost, wait time, where to find treatment, and facilities located too far away, were also frequently noted. A large proportion across all groups indicated high motivation for treatment and willingness to discuss their SUD in a primary care setting. CONCLUSION: There are continued barriers to SUD service use for homeless women despite high motivation for treatment, and willingness to be asked about SUD and mental health problems in primary care. HCH primary care sites should more systematically ask about SUD and mental health issues and address women's expressed need for support groups and alternative therapies to more holistically address their SUD needs.
BACKGROUND: Homeless women are at high risk for substance use disorder (SUD), and are a growing proportion of the homeless population. However, homeless women experience barriers to engaging in substance use services. OBJECTIVES: Among homeless women with SUD, to explore service use, motivation to change, service barriers, and willingness to have substance use and mental health problems addressed in primary health care. METHODS:Women with SUD were sampled from 11 Health Care for the Homeless (HCH) primary care clinics in 9 states, yielding 241 with either an alcohol or drug use disorder who then completed questions about SUD services. RESULTS: Over 60% of women with dual alcohol and drug use disorders used some type of SUD service in the past year, while 52% with a drug only disorder, and 44% with an alcohol only disorder used services. The most mentioned barrier to service use was depression, but cost, wait time, where to find treatment, and facilities located too far away, were also frequently noted. A large proportion across all groups indicated high motivation for treatment and willingness to discuss their SUD in a primary care setting. CONCLUSION: There are continued barriers to SUD service use for homeless women despite high motivation for treatment, and willingness to be asked about SUD and mental health problems in primary care. HCH primary care sites should more systematically ask about SUD and mental health issues and address women's expressed need for support groups and alternative therapies to more holistically address their SUD needs.
Authors: Michael F Fleming; Marlon P Mundt; Michael T French; Linda Baier Manwell; Ellyn A Stauffacher; Kristen Lawton Barry Journal: Alcohol Clin Exp Res Date: 2002-01 Impact factor: 3.455
Authors: Stefan G Kertesz; Mary Jo Larson; Debbie M Cheng; Jalie A Tucker; Michael Winter; Ashley Mullins; Richard Saitz; Jeffrey H Samet Journal: Med Care Date: 2006-03 Impact factor: 2.983
Authors: Scott T Walters; Eun-Young Mun; Zhengqi Tan; Justin M Luningham; Emily T Hébert; Jason A Oliver; Michael S Businelle Journal: Alcohol Clin Exp Res Date: 2022-08-07 Impact factor: 3.928
Authors: Michael Liu; Lucie Richard; Michael A Campitelli; Rosane Nisenbaum; Naheed Dosani; Irfan A Dhalla; Rishi K Wadhera; Salimah Z Shariff; Stephen W Hwang Journal: Addiction Date: 2022-02-14 Impact factor: 7.256
Authors: Laura E Gressler; Nabil M Natafgi; Bruce R DeForge; Barbarajean Shaneman-Robinson; Christopher Welsh; Fadia T Shaya Journal: J Subst Use Date: 2019-07-09