Risk factors for stimulant use among homeless and unstably housed adult women

Abstract

Background One of the most common causes of death among homeless and unstably housed women is acute intoxication where cocaine is present. While correlates of stimulant use have been determined in prior research, few studies have assessed risk factors of use specifically in this high-risk population. Methods We sampled biological women with a history of housing instability from community-based venues to participate in a cohort study. Baseline and 6-month follow-up data were used to determine the relative risk of stimulant use (crack cocaine, powder cocaine or methamphetamine) among individuals who did not use at baseline. Results Among 260 study participants, the median age was 47 years, 70% were women of color; 47% reported having unmet subsistence needs and 53% reported abstinence from stimulants at baseline. In analyses adjusting for baseline sociodemographics and drug treatment, the risk of using stimulants within 6 months was significantly higher among women who reported recent sexual violence (Adjusted Relative Risk [ARR] = 4.31; 95% CI:1.97–9.45), sleeping in a shelter or public place (ARR = 2.75; 95% CI:1.15–6.57), and using unprescribed opioid analgesics (ARR = 2.54; 95% CI:1.01–6.38). Conclusion We found that almost half of homeless and unstably housed women used stimulants at baseline and 14% of those who did not use began within 6 months. Addressing homelessness and sexual violence is critical to reduce stimulant use among impoverished women.

Understanding of the life experience of homeless women

“…To have these needs met, 46% of them spent nights in shelters (12) . The participants also mentioned weather conditions as another aspect faced in their daily life on the streets.…”

“…However, the challenge presented is in the viability for the implementation of these offices, that is, in health teams being able to perform on the singularities of this public, in order to implement rights to health care for this social group (8) . National and international studies approach several aspects that affect the issue of homeless people's health care, with emphasis on the difficulties of access to healthcare services (9)(10) ; meanings and practices of health/illness (9,11) ; use of drugs (12)(13) , and mental disorders (14)(15) . Regarding the life experience of homeless people, the literature shows that this is marked by the use of drugs as a destabilized factor in these people's life (16) .…”

Higher prevalence of detectable troponin I among cocaine-users without known cardiovascular disease

“…Specifically, the prevalence of crack cocaine use is approximately 50–60% among impoverished women (Riley et al, 2015; Torchalla et al, 2011). Between 30% and 40% of all cocaine users from communities with a high prevalence of poverty report daily use (Hayashi et al, 2016; Kuo et al, 2014), and the median number of years used among active cocaine users is as high as nine (Parker and Anthony, 2014).…”

Viver em situação de rua: experiência de mulheres que utilizam o albergue para pernoitar

“…A literatura nacional e internacional traz esta realidade, ao apontar que o envolvimento com drogas, especialmente o crack, figura como um elemento importante na ida de pessoas para a rua (Brown e Mueller, 2014;Riley et al, 2015;Santos, 2013). (Riley et al, 2015).…”

“…Estudo realizado em São Francisco, EUA, também destacou esta questão, ao revelar que aproximadamente metade das mulheres em situação de rua estudadas não tinham suas necessidades de higiene, alimentação e repouso atendidas, sendo que 46% delas dormiam em abrigos (Riley et al, 2015).…”