VA Disability Compensation and Money Spent on Substance Use Among Homeless Veterans: A Controversial Association

Abstract

Objective-There has long been concern that public support payments are used to support addictive behaviors. This study examined the amount of money homeless veterans spend on alcohol and drugs and the association between public support income, including VA disability compensation, and expenditures on alcohol and drugs.Methods-Data were from 1,160 veterans from 19 sites on entry into the Housing and Urban Development-Veterans Affairs Supportive Housing program. Descriptive statistics and nonparametric analyses were conducted.Results-About 33% of veterans reported spending money on alcohol and 22% reported spending money on drugs in the past month. No significant association was found between public support income, VA disability compensation, and money spent on alcohol and drugs.Conclusions-A substantial proportion of homeless veterans spend some income on alcohol and drugs, but disability income, including VA compensation, does not seem to be related to substance use or money spent on addictive substances.Substance abuse has been identified as one of the main risk factors for homelessness (1, 2). Many homeless adults continue to purchase and use substances while homeless (3, 4), even though they lack money for food, housing, and other basic necessities. It is not well understood how much money and what sources of income homeless adults are using to fund their substance use. Moreover, there has been concern about the possibility that public support payments, and disability payments in particular, may be a trigger that facilitates substance use and that disability income is used to purchase alcohol and drugs. One wellcited study of nonhomeless adults with schizophrenia who abused cocaine found that patterns of cocaine use were associated with the timing of disability payments, referred to as the "check effect" (5). There is a longstanding policy debate about whether public support or disability payments made as in-kind provision of goods or services, instead of cash transfers, would reduce this risk. This debate has been concerned with who decides how to spend such transfer payments (the state or the client), because even in-kind provisions are fungible (6, 7).The authors report no financial relationships with commercial interests. U.S. Department of Veterans Affairs VA Author ManuscriptVA Author Manuscript VA Author ManuscriptThese issues are of special relevance for U.S. veterans who receive disability compensation from the U.S. Department of Veterans Affairs (VA) for service-related injuries and illnesses, some of whom are returning from recent conflicts in the Middle East. Although there has been nearly universal support for providing disability benefits to veterans, examination of the link between benefits and substance use may be important for homeless services and research.Studies have shown that disability and public support income do not appear to contribute to overall levels of substance abuse among homeless veterans (8-10). These findings largely suggest that homeless veterans do not use their d...

Financing Cocaine Use in a Homeless Population

“…The findings from these analyses suggest that income from public sources (employment benefits, welfare, and disability) are unlikely to be used to finance cocaine use, as opposed to employment and income from informal and illegal sources which were found to support financing of cocaine use. These results are generally consistent with those of previous studies demonstrating associations of drug use in homeless populations with personal earnings, public entitlement income, monetary handouts, and illegal sources of income [ 4 , 9 , 10 , 11 , 12 , 13 , 14 , 22 ], and specifically studies also demonstrating significant associations with drug-related risky behaviors [ 23 , 24 ].…”

“…Either way, these findings indicate that public funding did not appear to promote cocaine use in this sample. These results are consistent with a recent study of military veterans experiencing homelessness that did not find drug use to be associated with public welfare support (including unemployment, welfare, and disability benefits) or with disability benefits [ 4 ].…”

“…Concerns have been raised about the potential for diversion of taxpayer funding of welfare and disability benefits for homeless populations into resources for substance use [ 4 ]. The findings from this study suggest that this concern is unwarranted; in fact, the opposite appears to be true.…”

“…Members of homeless populations by definition lack sufficient income to maintain secure housing. However, substance use and abuse are highly prevalent in homeless populations [ 1 , 2 , 3 , 4 ], implying that sources of funding must be available for obtaining substances of abuse. In particular, homeless populations have been demonstrated to have a very high prevalence of cocaine use [ 5 , 6 , 7 , 8 ].…”