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Daily Substance Use and Mental Health Symptoms among a Cohort of Homeless Adults in Vancouver, British Columbia

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Abstract

Substance use can be a barrier to stable housing for homeless persons with mental disorders. We examined DSM-IV symptoms among homeless adults (N = 497), comparing those who reported daily substance use (DSU) with non-daily substance users. Multivariable linear regression modeling was used to test the independent association between DSU and symptoms using the Colorado Symptom Index total score. DSU was independently associated with higher symptoms (beta = 3.67, 95 % CI 1.55–5.77) adjusting for homelessness history, age, gender, ethnicity, education, marital status, and mental disorder sub-type (adjusted R 2 = 0.24). We observed a higher prevalence of DSU in our sample than has been previously reported in a Housing First intervention. DSU was also independently associated with more DSM-IV symptomatology. We have an opportunity to observe this cohort longitudinally and examine if there are changes in substance use based on treatment assignment and commensurate changes in housing stability, community integration, health status, and quality of life.

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References

  1. Velasquez MM, Crouch C, von Sternberg K, Grosdanis I. Motivation for change and psychological distress in homeless substance abusers. J Subst Abuse Treat. 2000; 19(4): 395–401.

    Article  PubMed  CAS  Google Scholar 

  2. Edens EL, Mares AS, Rosenheck RA. Chronically homeless women report high rates of substance use problems equivalent to chronically homeless men. Womens Health Issues. 2011; 21(5): 383–389.

    Article  PubMed  Google Scholar 

  3. Alterman AI, Erdlen DL, Laporte DJ, Erdlen FR. Effects of illicit drug use in an inpatient psychiatric population. Addict Behav. 1982; 7(3): 231–242.

    Article  PubMed  CAS  Google Scholar 

  4. Weisner C, Matzger H, Kaskutas LA. How important is treatment? One-year outcomes of treated and untreated alcohol-dependent individuals. Addiction. 2003; 98(7): 901–911.

    Article  PubMed  Google Scholar 

  5. Beijer U, Andreasson S, Agren G, Fugelstad A. Mortality and causes of death among homeless women and men in Stockholm. Scand J Public Health. 2011; 39(2): 121–127.

    Article  PubMed  Google Scholar 

  6. Patterson M, Somers J, Moniruzzaman A. Prolonged and persistent homelessness: multivariable analyses in a cohort experiencing current homelessness and mental illness in Vancouver, British Columbia. Mental Health Subst Use. 2012; 2: 85–101.

    Article  Google Scholar 

  7. Padgett D, Gulcur L, Tsemberis S. Housing First services for people who are homeleess with co-occurring serious mental illness and substance abuse. Res Soc Work Pract. 2006; 16(1): 74–83.

    Article  Google Scholar 

  8. Palepu A, Marshall BD, Lai C, Wood E, Kerr T. Addiction treatment and stable housing among a cohort of injection drug users. PLoS One. 2010; 5(7): e11697.

    Article  PubMed  Google Scholar 

  9. Canadian Alcohol and Drug Use Monitoring Survey [http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/stat/_2010/tables-tableaux-eng.php#t2]. Accessed 31 August 2012.

  10. Goering PN, Streiner DL, Adair C, Aubry T, Barker J, Distasio J, Hwang SW, Komaroff J, Latimer E, Somers J, et al. The At Home/Chez Soi trial protocol: a pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities. BMJ Open. 2011; 1(2): e000323.

    Article  PubMed  Google Scholar 

  11. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998; 59(Suppl 20): 22–33. quiz 34-57.

    PubMed  Google Scholar 

  12. Marsden J, Gossop M, Stewart D, Best D, Farrell M, Lehmann P, Edwards C, Strang J. The Maudsley Addiction Profile (MAP): a brief instrument for assessing treatment outcome. Addiction. 1998; 93(12): 1857–1867.

    Article  PubMed  CAS  Google Scholar 

  13. Conrad KJ, Yagelka JR, Matters MD, Rich AR, Williams V, Buchanan M. Reliability and validity of a modified Colorado Symptom Index in a national homeless sample. Ment Heal Serv Res. 2001; 3(3): 141–153.

    Article  CAS  Google Scholar 

  14. Kertesz SG, Crouch K, Milby JB, Cusimano RE, Schumacher JE. Housing First for homeless persons with active addiction: are we overreaching? Milbank Q. 2009; 87(2): 495–534.

    Article  PubMed  Google Scholar 

  15. Larimer ME, Malone DK, Garner MD, Atkins DC, Burlingham B, Lonczak HS, Tanzer K, Ginzler J, Clifasefi SL, Hobson WG, et al. Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems. JAMA. 2009; 301(13): 1349–1357.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Centre for Health Evaluation and Outcome Sciences, Department of Medicine, University of British Columbia, 588B-1081 Burrard Street, Vancouver, BC, V6Z 1Y6 , Canada

    Anita Palepu

  2. Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada

    Michelle Patterson, Verena Strehlau, Akm Moniruzzamen & Julian Somers

  3. School of Population and Public Health, Vancouver, BC, Canada

    Jason Tan de Bibiana & James Frankish

  4. Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

    Michael Krausz

Authors
  1. Anita Palepu
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  2. Michelle Patterson
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  3. Verena Strehlau
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  4. Akm Moniruzzamen
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  5. Jason Tan de Bibiana
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  6. James Frankish
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  7. Michael Krausz
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  8. Julian Somers
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Correspondence to Anita Palepu.

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Palepu, A., Patterson, M., Strehlau, V. et al. Daily Substance Use and Mental Health Symptoms among a Cohort of Homeless Adults in Vancouver, British Columbia. J Urban Health 90, 740–746 (2013). https://doi.org/10.1007/s11524-012-9775-6

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  • DOI: https://doi.org/10.1007/s11524-012-9775-6

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