Financing Cocaine Use in a Homeless Population

Abstract

Background: Cocaine use is highly prevalent among homeless populations, yet little is known about how it is financed. This study examined associations of income sources with cocaine use and financing of drugs in a longitudinal evaluation of a homeless sample. Methods: A homeless sample was recruited systematically in St. Louis in 1999–2001 and longitudinally assessed annually over two years using the Diagnostic Interview Schedule and the Homeless Supplement, with urine drug testing. Results: More than half (55%) of participants with complete follow-up data (N = 255/400) had current year cocaine use. Current users spent nearly $400 (half their income) in the last month on drugs at baseline. Benefits, welfare, and disability were negatively associated and employment and income from family/friends, panhandling, and other illegal activities were positively associated with cocaine use and monetary expenditures for cocaine. Conclusions: Findings suggest that illegal and informal income-generating activities are primary sources for immediate gratification with cocaine use and public entitlements do not appear to be primary funding sources used by homeless populations. Policy linking drug testing to benefits is likely to have little utility, and public expenditures on measures to unlink drug use and income might be more effectively used to fund employment and treatment programs.

Associations amongst form of cocaine used (powder vs crack vs both) and HIV-related outcomes

“…Among our sample of PWH, being Black, non-Hispanic/Latinx, having low education attainment, low household income, and recent homelessness or incarceration experiences were significant factors correlated with P12M cocaine use among PWH. These associations are consistent with past research ( John and Wu, 2017 , North and Pollio, 2017 , Zhao et al, 2018 ). A higher prevalence of P12M polysubstance use (including alcohol, marijuana, opioids, heroin, stimulants, and sedatives) was observed among cocaine users than non-users, supporting that polysubstance use is common among cocaine users ( Liu et al, 2019 , Liu et al, 2018 ).…”

Prediction of attempted suicide in men and women with crack-cocaine use disorder in Brazil

“…A recent systematic review found that worse economic status and unemployment has been associated with suicidal behavior [71]. Lack of economic resources seems to increase the burden of the preexisting clinical condition and it is common for users of a highly addictive drug to spend a significant part of their income on acquiring that drug [72][73][74]. This cycle most probably prolongs the burden related to economic vulnerability as long as drug use addictive behavior remains.…”

How Much Do They Make? A Systematic Review of Income Generated From Begging

“… a Reported income often appears in dollar values according to data collection year, not publication year. b Conversions to 2020 were done with the U.S. Bureau of Labor Statistics inflation calculator. c Studies that report past 30 days are indicated in table as monthly for time interval (e.g., Conroy, 2001; North & Pollio, 2017). d Income of panhandlers in past month, not necessarily only from panhandling. e Zlotnick and Robertson (1996) report a total, a sample with mental disorders (M.D.…”

“… c Studies that report past 30 days are indicated in table as monthly for time interval (e.g., Conroy, 2001; North & Pollio, 2017). …”

“…The same can be said of homeless youth; typically, less than 10%–15% of them engage in begging (Bal et al, 2010; Beyene & Berhane, 1997; Hassen & Mañus, 2018; Hosny et al, 2007; O’Grady & Gaetz, 2004). Additionally, small proportions of samples of drug-using persons are observed panhandling (DeBeck et al, 2007; North & Pollio, 2017).…”