BACKGROUND:
The median age of the single adult homeless population is 50 and rising. While the prevalence of substance use decreases as individuals age, older adults now have a higher prevalence of substance use than older adults did ten 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:
We examined prevalence of and factors associated with substance use in a population-based sample (n = 350) of homeless individuals aged 50 and older in Oakland, CA. We examined the prevalence of and factors associated with moderate or greater severity illicit drug symptoms (ASSIST score ≥4) and moderate or greater alcohol symptoms (AUDIT score ≥8). Our 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 one illicit drug; 25.8% had moderate or greater severity alcohol symptoms. History of psychiatric hospitalization was associated with moderate or greater illicit drug symptoms (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.
