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Housing Instability Associated with Return to Stimulant Use among Previously Abstaining Women

Year: 2023

Type: article

Abstract: Stimulant use among unstably housed individuals is associated with increased risks of psychiatric co-morbidity, violence, HIV transmission, and overdose. Due to a lack of highly effective treatments, evidence-based policies targeting the prevention of stimulant use disorder are of critical importance. However, little empirical evidence exists on risks associated with initiating or returning to stimulant use among at-risk populations. In a longitudinal cohort of unstably housed women in San Francisco (2016-2019), self-reported data on stimulant use, housing status, and mental health were collected monthly for up to 6 months, and factors associated with initiating stimulants after a period of non-use were identified through logistic regression. Among 245 participants, 42 (17.1%) started using cocaine and 46 (18.8%) started using methamphetamine. In analyses adjusting for demographics and socio-structural exposures over the preceding month, experiencing street homelessness was associated with initiating cocaine use (AOR: 2.10; 95% CI: 1.04, 4.25) and sheltered homelessness with initiating methamphetamine use (AOR: 2.57; 95% CI: 1.37, 4.79). Other factors-including race, income, unmet subsistence needs, mental health, and treatment adherence-did not reach levels of significance, suggesting the paramount importance of policies directed toward improving access to permanent supportive housing to prevent stimulant use among unstably housed women.

Source: International Journal of Environmental Research and Public Health

DOI: 10.3390/ijerph20196830

Authors: Nicky J. Mehtani, Chika C. Chuku, Meredith C. Meacham, Eric Vittinghoff, Samantha E. Dilworth, Elise D. Riley

Institutions: University of California, San Francisco, San Francisco Department of Public Health, University of Miami

Language: English

Topic: Homelessness and Social Issues

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDGs: Good health and well-being, Sustainable cities and communities

Open Access status: gold

Estimated APC paid: $2,780