A naturalistic longitudinal study of the order of service provision with respect to cocaine use and outcomes in an urban homeless sample

E. R. Ayvaci, O. Obiri, D. Pollio, Carol S North

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Aims. Little is known about outcomes of drug abuse related to attainment of stable housing. This study examined outcomes of cocaine use and service provision in an urban homeless sample.Methods. Two-year longitudinal study of systematically selected homeless individuals (N = 255) in St. Louis, Missouri from 1999 to 2001. The sample was interviewed three times annually using a structured diagnostic interview. Urine drug testing was conducted at every interview, and service utilisation data were obtained from the structured interviews and the agency-provided service use data.Results. Cocaine use disorder and cocaine use proved to be distinct concepts because they predicted different outcomes across time. Cocaine use predicted subsequent poor housing outcomes, but stable housing had no apparent effect on subsequent use of cocaine. Service use predicted neither subsequent reduced cocaine use nor attainment of stable housing. Services used were appropriate to type of mental health need, but cocaine use may have reduced successful utilisation of appropriate psychiatric services.Conclusion. These findings reinforce the concept that homelessness represents a complex phenomenon and consequently, service systems need to address multiple problems. Service approaches are needed that simultaneously address the complex needs of homeless individuals.

Original languageEnglish (US)
Pages (from-to)611-618
Number of pages8
JournalEpidemiology and Psychiatric Sciences
Volume27
Issue number6
DOIs
StatePublished - Dec 1 2018

Keywords

  • Cocaine use
  • Housing First
  • homelessness
  • psychiatric disorders
  • service utilisation
  • substance use disorder

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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