• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of amjphAmerican Journal of Public Health Web SiteAmerican Public Health Association Web SiteSubmissionsSubscriptionsAbout Us
Am J Public Health. 1997 February; 87(2): 221–228.
PMCID: PMC1380798

Drug use disorders and treatment contact among homeless adults in Alameda County, California.


OBJECTIVES: This study estimates the extent and distribution of specific drug problems among homeless adults. METHODS: A countywide probability sample of 564 homeless adults received structured interviews that included a standardized assessment of substance use disorders. RESULTS: Two thirds of the sample (69.1%) had a lifetime history of a substance use disorder (including abuse of or dependence on alcohol [52.6%] or drugs [52.2%]); half had a current (52.4%) substance use disorder (including alcohol [38.8%] or drugs [31.3%]). Current drug disorders were higher among respondents who were younger, homeless longer, or sampled from the city of Oakland, Calif. Alcohol use disorders were higher among men than among women; surprisingly, drug use disorders were not. CONCLUSION: Rates of current drug use disorders for homeless adults were more than eight times higher than general population estimates. However, estimates of drug problems among homeless adults vary as a function of case ascertainment and sampling strategy. Estimates based only on samples from urban areas may overestimate drug problems among the area's larger homeless populations.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.7M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Fischer PJ, Breakey WR. The epidemiology of alcohol, drug, and mental disorders among homeless persons. Am Psychol. 1991 Nov;46(11):1115–1128. [PubMed]
  • Koegel P, Burnam MA. Alcoholism among homeless adults in the inner city of Los Angeles. Arch Gen Psychiatry. 1988 Nov;45(11):1011–1018. [PubMed]
  • Spinner GF, Leaf PJ. Homelessness and drug abuse in New Haven. Hosp Community Psychiatry. 1992 Feb;43(2):166–168. [PubMed]
  • Welte JW, Barnes GM. Drinking among homeless and marginally housed adults in New York State. J Stud Alcohol. 1992 Jul;53(4):303–315. [PubMed]
  • Winkleby MA, Rockhill B, Jatulis D, Fortmann SP. The medical origins of homelessness. Am J Public Health. 1992 Oct;82(10):1394–1398. [PMC free article] [PubMed]
  • Susser E, Conover S, Struening EL. Problems of epidemiologic method in assessing the type and extent of mental illness among homeless adults. Hosp Community Psychiatry. 1989 Mar;40(3):261–265. [PubMed]
  • Koegel P, Burnam MA, Farr RK. The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles. Arch Gen Psychiatry. 1988 Dec;45(12):1085–1092. [PubMed]
  • Fischer PJ, Shapiro S, Breakey WR, Anthony JC, Kramer M. Mental health and social characteristics of the homeless: a survey of mission users. Am J Public Health. 1986 May;76(5):519–524. [PMC free article] [PubMed]
  • Hosmer DW, Taber S, Lemeshow S. The importance of assessing the fit of logistic regression models: a case study. Am J Public Health. 1991 Dec;81(12):1630–1635. [PMC free article] [PubMed]
  • Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994 Jan;51(1):8–19. [PubMed]
  • Smith EM, North CS, Spitznagel EL. Alcohol, drugs, and psychiatric comorbidity among homeless women: an epidemiologic study. J Clin Psychiatry. 1993 Mar;54(3):82–87. [PubMed]
  • Bassuk EL, Rubin L, Lauriat AS. Characteristics of sheltered homeless families. Am J Public Health. 1986 Sep;76(9):1097–1101. [PMC free article] [PubMed]
  • Susser E, Struening EL, Conover S. Psychiatric problems in homeless men. Lifetime psychosis, substance use, and current distress in new arrivals at New York City shelters. Arch Gen Psychiatry. 1989 Sep;46(9):845–850. [PubMed]
  • Susser E, Conover S, Struening EL. Mental illness in the homeless: problems of epidemiologic method in surveys of the 1980s. Community Ment Health J. 1990 Oct;26(5):391–414. [PubMed]
  • Robertson MJ, Winkleby MA. Mental health problems of homeless women and differences across subgroups. Annu Rev Public Health. 1996;17:311–336. [PubMed]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...