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.