Kelly M Doran1, Neloufar Rahai2, Ryan P McCormack2, Jacqueline Milian2, Donna Shelley3, John Rotrosen4, Lillian Gelberg5. 1. Department of Emergency Medicine, NYU School of Medicine, 462 1st Avenue Room A-345, New York, NY, 10016, USA; Department of Population Health, NYU School of Medicine, 227 E. 30th Street, New York, NY, 10016, USA. Electronic address: kelly.doran@nyumc.org. 2. Department of Emergency Medicine, NYU School of Medicine, 462 1st Avenue Room A-345, New York, NY, 10016, USA. 3. Department of Population Health, NYU School of Medicine, 227 E. 30th Street, New York, NY, 10016, USA. 4. Department of Psychiatry, NYU School of Medicine, One Park Avenue 8th Floor, New York, NY, 10016, USA. 5. Department of Family Medicine, David Geffen School of Medicine at UCLA, Department of Health Policy and Management, UCLA Fielding School of Public Health, Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, CA, 90024, USA.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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 < .0001), any drug use (40.8% vs. 18.8%, p < .0001), heroin use (16.7% vs. 3.8%, p < .0001), prescription opioid use (12.5% vs. 4.4%, p < .0001), and lifetime opioid overdose (15.8% vs. 3.7%, p < .0001). In multivariable analyses, current homelessness remained significantly associated with unhealthy alcohol use, AUDIT scores among unhealthy alcohol users, any drug use, heroin use, and opioid overdose; past 12-month homelessness was additionally associated with DAST-10 scores among drug users and prescription opioid use. CONCLUSIONS: Patients experiencing homelessness have higher rates and greater severity of alcohol and drug use than other ED patients across a range of measures. These findings have implications for planning services for patients with concurrent substance use and housing problems.
BACKGROUND: 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. METHODS: 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. RESULTS: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 < .0001), any drug use (40.8% vs. 18.8%, p < .0001), heroin use (16.7% vs. 3.8%, p < .0001), prescription opioid use (12.5% vs. 4.4%, p < .0001), and lifetime opioid overdose (15.8% vs. 3.7%, p < .0001). In multivariable analyses, current homelessness remained significantly associated with unhealthy alcohol use, AUDIT scores among unhealthy alcohol users, any drug use, heroin use, and opioid overdose; past 12-month homelessness was additionally associated with DAST-10 scores among drug users and prescription opioid use. CONCLUSIONS:Patients experiencing homelessness have higher rates and greater severity of alcohol and drug use than other ED patients across a range of measures. These findings have implications for planning services for patients with concurrent substance use and housing problems.
Authors: Kristin E Schneider; Ju Nyeong Park; Sean T Allen; Brian W Weir; Susan G Sherman Journal: Drug Alcohol Depend Date: 2019-06-06 Impact factor: 4.492
Authors: Majid Afshar; Andrew Phillips; Niranjan Karnik; Jeanne Mueller; Daniel To; Richard Gonzalez; Ron Price; Richard Cooper; Cara Joyce; Dmitriy Dligach Journal: J Am Med Inform Assoc Date: 2019-03-01 Impact factor: 4.497
Authors: Noele P Nelson; Mark K Weng; Megan G Hofmeister; Kelly L Moore; Mona Doshani; Saleem Kamili; Alaya Koneru; Penina Haber; Liesl Hagan; José R Romero; Sarah Schillie; Aaron M Harris Journal: MMWR Recomm Rep Date: 2020-07-03
Authors: Rebecca J Fisk; Veronica L Richards; Robert F Leeman; Babette Brumback; Christa Cook; Robert L Cook Journal: Subst Use Misuse Date: 2021-03-26 Impact factor: 2.164
Authors: Edouard Coupet; Gail D'Onofrio; Marek Chawarski; E J Edelman; Patrick G O'Connor; Patricia Owens; Shara Martel; David A Fiellin; Ethan Cowan; Lynne Richardson; Kristen Huntley; Lauren K Whiteside; Michael S Lyons; Richard E Rothman; Michael Pantalon; Kathryn Hawk Journal: Drug Alcohol Depend Date: 2020-11-26 Impact factor: 4.492