Showing papers in "American Journal of Drug and Alcohol Abuse in 2002"
TL;DR: It was found that 90% of respondents with cannabis dependence had a lifetime mental disorder, compared to 55% without cannabis dependence, which underscores the importance of thorough and systematic evaluation of patients seeking treatment for cannabis dependence.
Abstract: Cannabis is the most widely used illegal drug in the U.S. population. Surveys have estimated that the lifetime prevalence rate for cannabis dependence is approximately 4%. Though the presence of a psychiatric disorder increases the likelihood of developing substance dependence, the field lacks data regarding the association between mental disorders and cannabis dependence. The aim of this study is to describe the prevalence of psychiatric disorders among individuals with cannabis dependence. The National Comorbidity Survey was used to obtain these data. We found that 90% of respondents with cannabis dependence had a lifetime mental disorder, compared to 55% without cannabis dependence. Alcohol dependence, antisocial personality disorder, and conduct disorder had the strongest associations with cannabis dependence, followed by anxiety and mood disorders. A large proportion of respondents with internalizing disorders developed mood or anxiety disorders prior to onset of their first cannabis dependence symptom. Data regarding the prevalence of comorbid mental disorders underscore the importance of thorough and systematic evaluation of patients seeking treatment for cannabis dependence. The failure to identify comorbidity may lead to inadequate treatment, and a poorer prognosis.
288 citations
TL;DR: There is a need for training in how to recognize the physical and behavioral phenotypes of children with prenatal alcohol exposure so that appropriate treatment can be initiated early.
Abstract: The purpose of this study was to describe psychiatric disorders exhibited by children with prenatal alcohol exposure. Twenty-three children between the ages of 5 and 13 years who were referred to the UCLA Fetal Alcohol and Related Disorders Clinic because of heavy exposure to alcohol in utero were evaluated. Children with intelligence quotients of 70 and above and their families were interviewed by the study child psychiatrist and psychologist and psychiatric diagnoses were based upon DSM-IV diagnostic criteria. Inter-observer reliability of diagnosis was established comparing clinical diagnoses with diagnoses made using the "best-estimate" procedure. For the best estimate method, items from the Child Behavior Checklist, the Fetal Alcohol Behavior Scale, the Child Symptom Inventory-4, the Conners' Rating Scale, as well as information from historical records were reviewed by two experienced clinicians who were blind to the diagnostic and alcohol exposure status of the children. Approximately 87% of the sample met criteria for a psychiatric disorder. The majority of the children (61%) were assigned a mood disorder diagnosis. Twenty-six percent were diagnosed with major depressive disorder or adjustment disorder with depressed mood and 35% met criteria for bipolar disorder. Psychiatric disorders are common in children with prenatal alcohol exposure. In particular, these children seem to be highly vulnerable to mood disorders. There is a need for training in how to recognize the physical and behavioral phenotypes of children with prenatal alcohol exposure so that appropriate treatment can be initiated early.
166 citations
TL;DR: Young female IDUs may compound their risk by having sex and injecting with higher risk partners, however, their propensity to practice protective behaviors may provide an opening for interventions to reduce their HIV risk and that of their social network members.
Abstract: Using epidemiological and social network research methods, this study examines gender differences in HIV risk and protective behaviors and social network characteristics among 193 young injection drug users (IDUs) and 127 referred members of their social networks. Respondents reported on their drug use, sexual behavior, and relationships within three types of social networks: hang out (i.e., friendship); drug use; and sexual networks. Most respondents were homeless and had experienced numerous life stressors. Females' social networks consisted more predominantly of drug injectors, and members more frequently appeared in multiple networks. Females reported needle sharing more frequently than males, but also reported more protective behaviors such as needle exchange use and carrying clean syringes. Young female IDUs may compound their risk by having sex and injecting with higher risk partners. However, their propensity to practice protective behaviors may provide an opening for interventions to reduce their...
142 citations
TL;DR: The results of the study indicate that increased frequency of cigarette smoking and being under the influence of marijuana, cocaine, and alcohol did frequently have an impact on adolescent academic achievement.
Abstract: This study uses the NELS data set to assess the relationship between adolescent patterns of the consumption of marijuana, cocaine, alcohol, and cigarette consumption and their academic achievement. The results of the study indicate that increased frequency of cigarette smoking and being under the influence of marijuana, cocaine, and alcohol did frequently have an impact on adolescent academic achievement. When all types of drug consumption were considered together, cigarette smoking, being drunk, and under the influence of alcohol while at school were the variables that produced the most consistent statistically significant effects. Being under the influence of cocaine generally produced the largest regression coefficients, but the effects were often not statistically significant, which may in part be due to the small portion of students who reported being under the influence of cocaine while at school. When examined separately, being under the influence of cocaine and marijuana each had consistently statistically significant effects on academic achievement.
135 citations
TL;DR: Examination of the relationship of demographic, drug use severity, and psychosocial factors with treatment attrition and the time of dropout in an outpatient cocaine abuse program found that participants with higher education levels and those with poorer psychiatric functioning tended to remain in treatment longer.
Abstract: Determining pre-treatment variables that predict attrition in an outpatient cocaine abuse program is critically important in efforts to enhance retention and ultimately improve client outcome Pote
110 citations
TL;DR: It is concluded that buprenorphine maintenance is feasible in a primary care setting and should be considered as a treatment option for heroin dependence.
Abstract: Buprenorphine is an effective treatment for heroin dependence. The feasibility and potential efficacy of buprenorphine with brief counseling in primary care is unknown. We enrolled 14 heroin dependent patients in a 13-week clinical trial using thrice weekly buprenorphine along with brief counseling in the primary care center of an urban medical center. Primary outcomes included urine toxicology and treatment retention. Opioid-positive urine toxicology tests reduced over the 13-week period from 95 to 25% (p < 0.05). Eleven patients (79%) had greater than or equal to one week of opioid-free urine toxicologies. Nine patients (64%) had greater than or equal to three weeks of opioid-free urine toxicologies. Eleven patients (79%) were retained through the maintenance phase. We conclude that buprenorphine maintenance is feasible in a primary care setting.
104 citations
TL;DR: A meta-analysis of family, twin, and adoption studies in which problem drinking and alcohol dependence served as the primary criterion measure showed that far from being an established “fact,” the genetic foundations of alcohol misuse are modest and heterogeneous.
Abstract: A meta-analysis was performed on 50 family, twin, and adoption studies in which problem drinking and alcohol dependence served as the primary criterion measure. The results showed that far from bei...
94 citations
TL;DR: Gender moderated the effect of parent figure transitions in a parallel analysis for drug use and only adolescent females had a higher likelihood of drug use as the number of family disruptions increased, and age was strongly associated with drug use for males.
Abstract: Children of substance abusing parents have an elevated risk for experiencing disruptions in household composition and for engaging in problem behaviors. This study investigated whether multiple parent figure transitions predicted the likelihood of delinquency and drug use among a sample of early adolescents with parents receiving methadone treatment for opiate addiction. Controlling for baseline delinquency, child characteristics, family conflict, parental depression, and parent criminal history, a greater number of parenting disruptions during the longitudinal study period was associated with a higher probability of delinquent behavior. Gender moderated the effect of parent figure transitions in a parallel analysis for drug use. After accounting for baseline drug use and potentially confounding factors, only adolescent females had a higher likelihood of drug use as the number of family disruptions increased. In contrast, age was strongly associated with drug use for males. A subgroup of youths who experienced tremendous family instability and had no single consistent parent figure during the study period were at extreme risk for delinquent behavior. The findings are interpreted in terms of cumulative stress resulting from multiple parenting disruptions over time and differential influences on the expression of problem behaviors depending on gender.
91 citations
TL;DR: Sexual abuse in adolescence was indirectly associated with lifetime crack use through running away from home and rape in adulthood, and such programs may provide the best setting for helping women with both substance use and sexual abuse issues.
Abstract: Subjects for this study were 1,478 community-recruited women sexual partners of male injection drug users who were participants in the National Institute on Drug Abuse (NIDA)-supported Women Helping to Empower and Enhance Lives (WHEEL) project. This study assessed the association between child/adolescent sexual abuse—including specific type of abuse and perpetrator of abuse—and lifetime crack use in this sample of women. About 64% of sample women had ever used crack; 56% had been sexually abused by age 18. In logistic regression analyses, any sexual abuse in childhood, penetrative sexual abuse in childhood, and sexual abuse by a family member in childhood were significantly associated with lifetime crack use. Sexual abuse in adolescence was indirectly associated with lifetime crack use through running away from home and rape in adulthood. Given that many of these subjects reported drug treatment experience, such programs may provide the best setting for helping women with both substance use and sexual abu...
83 citations
TL;DR: The relationships between the level of childhood maltreatment and current psychological distress were examined in a community sample of 676 substance abusing men and women using a validated self-report instrument designed to measure physical, emotional, and sexual abuse and physical and emotional neglect.
Abstract: The relationships between the level of childhood maltreatment and current psychological distress were examined in a community sample of 676 substance abusing men and women using a validated self-report instrument (the Childhood Trauma Questionnaire) designed to measure physical, emotional, and sexual abuse and physical and emotional neglect. Current levels of self-reported psychological distress/symptoms were measured using a 53-item Brief Symptom Inventory. Prevalence of early trauma ranged from 44% for emotional neglect to 65% for sexual abuse. The severity of all forms of childhood maltreatment were directly associated with current psychological distress.
82 citations
TL;DR: Homeless individuals with substance dependence have many vulnerabilities beyond their substance dependence that should be dealt with in treatment or other service settings before lasting housing can be achieved.
Abstract: We studied a community probability sample of 1185 homeless individuals to examine substance dependence in relationship to other personal and social vulnerabilities linked to homelessness, including sociodemographics, childhood/adolescent factors, prehomelessness factors, multiple episodes of homelessness, and the quality of shelter in their current episode of homelessness These vulnerability factors were significantly concentrated in homeless individuals with lifetime and recent substance dependence, especially among those with both alcohol and drug dependence In addition, the profiles of the homeless with alcohol dependence alone were distinct from those with drug dependence alone or both, with older age, more males, longer histories of homelessness, and significantly poorer quality shelter during the previous 30 days Therefore, homeless individuals with substance dependence have many vulnerabilities beyond their substance dependence that should be dealt with in treatment or other service settings before lasting housing can be achieved
TL;DR: The data presented here indicate that a number of social and perceptual correlates of inhalant use operate similarly across Mexican American, American Indian and non-Latino white adolescents.
Abstract: The abuse of volatile solvents, or inhalants, is an enduring problem among adolescents although a number of factors obscure the nature and extent of this drug using behavior. The data presented here indicate that a number of social and perceptual correlates of inhalant use operate similarly across Mexican American, American Indian and non-Latino white adolescents. Peer factors appear to dominate, although they are somewhat less important for Mexican American and Indian youth. Increased perception of harm reduces inhalant use for all groups. Of particular significance in the findings here are the continued increase of inhalant use among females compared to males and the strong pattern of decreases in inhalant use among American Indian adolescents over the last decade. A number of implications for increased effectiveness of prevention are discussed.
TL;DR: For adolescents with alcohol-related problems, alcohol causing problems at home, school, or other settings predicted entry into alcohol treatment, and drug use and poor health status were also associated with receiving alcohol treatment services.
Abstract: Objective: This study examined factors associated with adolescents' use of alcohol treatment services.Method: Data on adolescents (aged 12–17) from the 1994 National Household Survey on Drug Abuse ...
TL;DR: Facilitating the uptake of health insurance services at NEP sites may improve the access to health care for drug users who are currently not utilizing the health care system.
Abstract: Objective: To determine the characteristics associated with health care and drug treatment utilization among a distinctly high-risk sub-population of injectors participating in a needle exchange program (NEP). Methods: Between June 1998 and May 1999, study staff collected demographic and health services utilization data on participants of the Baltimore NEP. Odds ratios and logistic regression were used to identify the participant characteristics associateds with utilizing primary health care and drug treatment during the prior 3 years. Results: Among 269 participants, 81% were African–American and 66% were male. Over half (56%) had not graduated from high school, 89% were unemployed, 70% did not have health insurance, and the median age was 39 years. Fifty-eight percent of the participants reported utilizing primary care (i.e., visited a physician or other health care provider) and 44% had utilized drug treatment during the prior 3 years. Primary care utilization was associated with age≥39 [adjusted odds ...
TL;DR: Data suggest that ethnic differences in substance use becomes less important among those alcohol involved, and future research should focus on the interaction of alcohol and other substances on injury occurrence.
Abstract: Objective: While substantial literature exists on the role of alcohol in injury occurrence, little is known about other substance use or abuse and injury, or drug use among the alcohol involved at the time of the emergency room (ER) visit.Method: A probability sample of 1429 patients attending the ER at Santa Clara Valley Medical Center (CA) was interviewed and was asked questions pertaining to licit and illicit drug use and alcohol use within 6 hr prior to the event, and drug use within the last year.Results: While drug use within the 6 hr prior to the event was not found to be significantly different between injured and noninjured patients, injured patients were more likely to report drug use during the last year, and those with violence-related injuries were more likely to report drug use during both time periods compared to those with other injuries. Drug use was associated with ethnicity, with whites more likely than blacks or Hispanics to report use. Among Hispanics, acculturation was related to dru...
TL;DR: The smoking cessation intervention did not result in greater participation in formal outpatient smoking cessation treatment and was not associated with either enhanced smoking cessation (6 vs. 0%) or greater smoking reduction at follow-up.
Abstract: This preliminary study evaluated the efficacy of a brief smoking cessation intervention (30 controls, 34 intervention groups) on a smoke-free inpatient unit for substance use detoxification. Controls received usual care, including the transdermal nicotine patch and referral to an outpatient smoking program. The intervention group additionally received a structured motivational enhancement program. Biochemically confirmed smoking cessation rate and abstinence/reduction of alcohol or other drug use were the main outcome measures taken 6 months after treatment initiation. The smoking cessation intervention did not result in greater participation in formal outpatient smoking cessation treatment and was not associated with either enhanced smoking cessation (6 vs. 0%) or greater smoking reduction at follow-up. Both groups significantly reduced the number of cigarettes smoked per day (cpd) from about 24 at baseline to 10 cpd. The groups did not differ on abstinence from nonnicotine addictive substances. Smoking ...
TL;DR: Clients in the FC received more treatment services in the first 2 weeks than those in the PC, but there were no differences at subsequent points, and matching effects were not obtained with medical or psychiatric severity, or readiness to change.
Abstract: This study evaluated the relative effectiveness of two forms of publicly funded substance abuse treatment provided in Washington State: The full continuum (FC), in which clients receive approximately three weeks of inpatient treatment prior to outpatient care, and the partial continuum (PC), in which clients are admitted directly to outpatient treatment. Data on treatment process/proximal outcomes, such as psychological distress and readiness to change, were assessed at 8 weeks post intake, and data on treatment services received were obtained at 2, 4, 8, and 12 weeks. Multidimensional outcomes, including alcohol and drug use as well as a number of psychosocial functioning outcomes, were assessed at 3 and 9 months post intake. Results indicated that clients in the FC had greater alcohol, drug, and legal problem severity at intake than those in the PC, whereas medical and employment problem severity was greater in the PC. Clients in the FC received more treatment services in the first 2 weeks than those in the PC, but there were no differences at subsequent points. Outcome analyses at 3 and 9 months indicated that clients in the FC had greater improvements in alcohol, drug, and psychiatric severity than those in the PC. Matching analyses indicated that clients with greater substance-use severity at baseline improved to a greater degree in the FC as compared to the PC. Matching effects were not obtained with medical or psychiatric severity, or readiness to change.
TL;DR: An organizing framework for empirical analyses of substance abuse treatment program effectiveness is presented, based on relevant theories of organization and public management and the body of substance Abuse treatment studies, and is applied in analyses of treatment program data.
Abstract: Objective: This study presents an organizing framework for empirical analyses of substance abuse treatment program effectiveness, based on relevant theories of organization and public management and the body of substance abuse treatment studies, and is applied in analyses of treatment program data Method: We use descriptive analyses of data from the National Treatment Improvement Evaluation Study that were collected from 519 substance abuse treatment service delivery units and 6593 patients to identify instruments of policy and management that might either frustrate or facilitate the implementation of “best practices” in substance abuse treatment Results: The analyses show statistically significant and substantively interesting relationships among measures of organizational structure and mission, financial management (eg, revenues per patient and revenue sources), human resources management (eg, staffing levels, the use of case managers, etc), and measures of service technology (eg, the provision
TL;DR: Findings support the importance of the individual's perception of “readiness” to change their substance-abusing behavior and enter treatment.
Abstract: The predictive validity of a treatment readiness measure designed for out-of-treatment drug users, tapping dimensions of perceived problem severity, perceived need for formal treatment, motivation for treatment, and negative attitudes toward treatment is examined using data from a National Institute on Drug Abuse (NIDA)-funded HIV outreach intervention in San Antonio, Texas. Logistic regression is used to predict use of substance abuse treatment services three months after program intake on the basis of readiness scores, controlling for demographic and drug history variables. Analyses of data from 673 drug users in an HIV outreach intervention indicated that treatment readiness dimensions accounted for a 12% increase in variation in "use of any modality" and 14% for "use or attempted service use". Only Motivation to Quit was a significant predictor of "use of any modality" and both Perceived Need for Treatment and Motivation to Quit were significant predictors of "use or attempted use". Findings support the importance of the individual's perception of "readiness" to change their substance-abusing behavior and enter treatment.
TL;DR: The results indicate that persons diagnosed with APD, with histories of substantial drug abuse and criminality, can benefit from TC treatment with aftercare in the community or at the very least, do as well as those with no APD.
Abstract: There is a belief that persons diagnosed with antisocial personality disorder (APD) do not respond well to treatment, but the existing research has not supported this hypothesis. This study examined the relationship of APD to therapeutic community (TC) treatment outcomes. A total of 275 men and women were randomly assigned to two TCs. It was hypothesized that clients diagnosed with APD via the Millon Clinical Multiaxial Inventory (MCMI-II) would have poorer treatment outcomes than those with no APD. The MCMI-II was used to diagnose APD because of its focus in underlying pathological personality traits, as opposed to strict behavioral criteria as used in the Diagnostic and Statistical Manual of Mental Disorders classifications for APD; this hypothesis was not supported. Logistic regression analyses indicated that an MCMI-II diagnosis of APD was unrelated to treatment outcomes. Treatment completion was the most important factor in reducing recent drug use and post-discharge arrests. The results indicate that persons diagnosed with APD, with histories of substantial drug abuse and criminality, can benefit from TC treatment with aftercare in the community or at the very least, do as well as those with no APD. In light of the high prevalence rates of APD in substance-abusing populations, future research should continue to explore the many issues surrounding the diagnosis of APD, as well as its relationship to treatment outcomes.
TL;DR: It can be concluded that unemployment without looking for work, difficulties relating to self and others, not having received prior outpatient treatment, and having poorer physical health can signal the possible presence of coexisting mental health problems.
Abstract: This study identified comorbidity (coexistence of substance abuse and mental health diagnoses) rates and characteristics among 104 clients in a substance abuse treatment setting. To identify commonly collected intake variables that can be used for early identification of drug users with coexisting mental health concerns, participants completed a demographics questionnaire, brief symptom inventory, behavior and symptom identification scale (BASIS-32), and a drug and alcohol assessment. Results revealed a comorbidity rate of 45% and significant relationships between comorbidity and the following variables: absence of prior treatment, greater rates of unemployment, poorer physical health, poorer functioning in a variety of areas, greater symptom severity regarding drug use, poorer mental health, and greater rates of homelessness. Of these, the first four variables were the most powerful predictors of comorbidity. It can be concluded that unemployment without looking for work, difficulties relating to self and others, not having received prior outpatient treatment, and having poorer physical health can signal the possible presence of coexisting mental health problems. Implications for early detection and subsequent treatment planning are discussed.
TL;DR: Women reporting indicators of social isolation were more likely to have been physically abused by their most-recent sexual partners than nonisolated women and substance dependence was not related significantly to domestic violence.
Abstract: The objective of this study was to examine the association between social isolation, domestic violence, and substance dependence among street-recruited female drug users. Hierarchical logistic regr...
TL;DR: The results showed that marijuana users were more likely to support legalizing marijuana, but they were less likely toSupport the legalization of cocaine and heroin, while users of crack, cocaine, heroin, speedball, and/or methamphetamines were morelikely to support legalize all drugs including cocaine andHeroin.
Abstract: Research shows that support for legalization of drugs varies significantly among different sociodemographic and political groups. Yet there is little research examining the degree of support for legalization of drugs among drug users. This paper examines how frequency and type of drug use affect the support for legalization of drugs after adjusting for the effects of political affiliation and sociodemographic characteristics. A sample of 188 drug users and non-drug users were asked whether they would support the legalization of marijuana, cocaine, and heroin. Respondents reported their use of marijuana, crack, cocaine, heroin, speedball, and/or methamphetamines during the previous 30 days. Support for legalization of drugs was analyzed by estimating three separate logistic regressions. The results showed that the support for the legalization of drugs depended on the definition of "drug user" and the type of drug. In general, however, the results showed that marijuana users were more likely to support legalizing marijuana, but they were less likely to support the legalization of cocaine and heroin. On the other hand, users of crack, cocaine, heroin, speedball, and/or methamphetamines were more likely to support legalizing all drugs including cocaine and heroin.
TL;DR: Employees with more deviance indicators were particularly susceptible to recent drug use and problem drinking when they worked in drinking climates or exposed to co-worker drinking.
Abstract: Previous studies have noted that employees who work in jobs with physical risk report more substance use than employees working in nonrisky jobs. This study examined the extent to which this relati...
TL;DR: Using the national longitudinal survey of youth 1994 data, forward multiple regression analyses revealed that impulsivity, A+M use, age, sex, religiosity, frequency of substance use, and impulsivity were associated with a higher number of behavioral problems.
Abstract: Alcohol and other drug problems experienced by adolescents who use only alcohol compared to those who use both alcohol and marijuana (A + M) is studied. Using the national longitudinal survey of youth 1994 data, forward multiple regression analyses revealed that impulsivity, A + M use (compared to alcohol-only use), age, sex, religiosity, frequency of substance use were associated with a higher number of behavioral problems. Youth with more alcohol problems were found to be binge drinkers, impulsive, more frequent alcohol users, and nonHispanic. Implications and future research needs are discussed.
TL;DR: Heavy alcohol use among crack-abusing African–American women may be a marker for a host of underlying problems that require special attention and HIV prevention programs and substance abuse treatment programs that provide services to crack- abusing women should screen for heavy drinking.
Abstract: Objective: The purpose of this study was to categorize the quantity and frequency of alcohol use among African–American women who were abusing crack cocaine and to explore relationships between cat...
TL;DR: Behavioral counseling techniques may be especially helpful in addressing the complex needs of high-risk methadone patients, which in turn may facilitate treatment process and positive outcomes.
Abstract: A task-based behavioral contingency—the “treatment reinforcement plan” (TRP)—was implemented with cocaine-using methadone patients to increase treatment engagement and retention. Subjects (N=57) we...
TL;DR: The RAFFT performed well in adults with SUD and was not influenced by factors such as gender, race, socioeconomic status, or the co-existence of psychiatric disorders.
Abstract: The purpose of this study was to evaluate the specificity and sensitivity of the RAFFT, a brief screening tool, in adult patients with substance use disorders (SUD) when presenting to a psychiatric emergency room. A total of 215 patients were evaluated with the RAFFT, the CAGE, the Mini International Neuropsychiatric Interview, and urine drug screens. The RAFFT performed well in adults with SUD and was not influenced by factors such as gender, race, socioeconomic status, or the co-existence of psychiatric disorders. In alcohol use disorders, the CAGE performed better than the RAFFT, due to the lower specificity (or more false positive answers) of the latter.
TL;DR: After controlling for potentially confounding factors, students reporting lifetime inhalant use were less likely to be financially supported by their parents/guardians, more likely to use alcohol/tobacco, marijuana, and cocaine, and morelikely to carry weapons and consider suicide.
Abstract: This cross-sectional study describes the prevalence of lifetime inhalant use and identifies demographic, psychosocial, and other risk behavior characteristics of students reporting lifetime inhalant use. The sample consisted of 354 students attending alternative high schools (dropout prevention/recovery schools) in Texas. The prevalence of lifetime inhalant use was 27.7%. After controlling for potentially confounding factors, students reporting lifetime inhalant use were less likely to be financially supported by their parents/guardians, more likely to use alcohol/tobacco, marijuana, and cocaine, and more likely to carry weapons and consider suicide. Study results may allow school officials, parents, researchers, and health care providers to gain a better understanding of inhalant use among students at risk for dropping out of school, a group which has not been extensively studied by previous researchers.
TL;DR: Most homeless adults were not consistently in the labor force and those who were, did not receive public entitlement benefits and this finding poses an interesting dilemma since previous studies indicated that homeless adults, who are consistent public entitlement recipients, were more likely to get housed than those who are not.
Abstract: Objectives: We measured the proportion of homeless adults in the labor force and examined the impact of substance use on labor force participation. Methods: A county-wide probability sample of 397 homeless adults was interviewed three times in a 15-month period. Results: Almost 80% of homeless adults were employed or looking for work at one point in time; however, only 47.7% remained in the labor force over the 15-month study period. Recent drug users were only 5% as likely as other homeless adults to be in the labor force; and consistent public entitlement recipients were only 18% as likely as other homeless adults to be in the labor force. Conclusions: Recent illicit drug use posed a deterrent to labor force participation among homeless adults, but heavy alcohol use did not. Most homeless adults were not consistently in the labor force and those who were, did not receive public entitlement benefits. This finding poses an interesting dilemma since previous studies indicated that homeless adults, who are ...