237455 Social context of homeless men's substance use

Tuesday, November 1, 2011

Harmony Rhoades, PhD , School of Social Work, University of California, Los Angeles, CA
Suzanne Wenzel, PhD , School of Social Work, University of Southern California, Los Angeles, CA
Daniela Golinelli, PhD , RAND Corporation, Santa Monica, CA
Joan Tucker, PhD , RAND Health, RAND Corporation, Santa Moncia, CA
Annie Jie Zhou, MS , RAND, Santa Monica, CA
Purpose: Homeless men may be at particular risk for the negative effects of substance use. This cross-sectional study investigates individual and social risk factors for substance use in this vulnerable population. Data & Methods: Participants were a representative probability sample of 305 heterosexually active homeless men interviewed from meal programs in the Skid Row region of LA. Interviews assessed individual, personal network, and substance use characteristics. Logistic regression examined individual and network-level predictors of the most prevalent substances. Results: In the past 6 months, the 3 most prevalent substances were marijuana (56%), crack (40%), and alcohol to intoxication (38%). Mental health status was associated with substance use, with depression more likely among binge drinkers (OR=1.97; 95% CI=1.04, 3.75) and PTSD more common among those who used crack (OR=3.26; 95% CI=1.62, 6.58). Riskier networks (comprised of a larger proportion of drug users) were associated with marijuana use (OR=8.00; 95% CI=2.44, 26.17), and normative social ties (family or school/work) were associated with a decreased likelihood of crack use (OR=0.04; 95% CI=0.00, 0.52; OR=0.05; 95% CI=0.00, 0.49, respectively). Conclusion and recommendations: Mental health problems and riskier personal networks are associated with homeless men's substance use. These findings underscore the importance of interventions that focus on: mental health, mitigating the drug-using norms of personal networks, and helping men to maintain contact with normative, low-risk alters. Mental health care and peer-based, network interventions to reduce substance use should be a priority for homeless men.

Learning Areas:
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
1. Describe how social networks may influence substance use. 2. Explain the individual and social network correlates of homeless menís substance use. 3. Discuss promising directions for interventions to reduce substance use among homeless men.

Keywords: Homelessness, Substance Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a postdoctoral research associate on this project, and have expertise in social networks and health prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.