Disaffiliation, Substance Use, and Exiting Homelessness

Abstract

This study tested whether social affiliation was associated with exits from homelessness for a county-wide probability sample of 397 homeless adults who were followed over a 15-month period culminating in 1992. For the total sample, support from family or friends and service use were related to an increased likelihood of exiting from homelessness. Surprisingly, exits from homelessness were associated with social affiliation (i.e., support from family/friends and services use) only among homeless adults who did not have current substance-use disorders. This relationship did not hold for those with current substance-use disorders. Findings suggest that homeless adults without current substance-use disorders may be better able to engage services and support from family/friends to exit homelessness than homeless adults who have current substance-use disorders. Perhaps service providers who are targeting homeless adults with substance-use disorders and want to help them exit homelessness need to emphasize initiating substance-use treatment before addressing other issues.

• Homelessness
• Substance abuse
• Disaffiliation
• Case management

Additional information

Notes on contributors

Cheryl Zlotnick

Cheryl Zlotnick, R.N., Dr.P.H., is a Scientist at both the Alcohol Research Group and Children's Hospital Oakland. Dr. Zlotnick began working with homeless individuals and families as a clinical nurse specialist and team coordinator more than 15 years ago. Since then, she has worked as a project director, evaluator, and researcher on projects targeting individuals and families who are homeless or are at-risk of homelessness. Currently, Dr. Zlotnick is the principal investigator of the NIAAA-funded study, “Alcohol Services, Treatment & Work among Homeless Adults.”

Tammy Tam

Tammy Tam, Ph.D., is a Scientist at the Alcohol Research Group. Her areas of interest include methodological issues of screening in national surveys, bias in community-based prevalence estimates, and the development of culture-specific measurement of alcohol consumption among Asian Americans. Her substantive research includes service utilization among problem drinkers and alcohol treatment clients in different health care settings; and risk functions for alcohol-related problems. Currently, Dr. Tam is the principal investigator of the NIAAA-funded study, “Alcohol Use and Alcohol-Related Problems in Asian Americans.”

Marjorie J. Robertson

Marjorie Robertson, Ph.D., is a Senior Scientist at the Alcohol Research Group. She is a research psychologist with a specialization in psychiatric epidemiology. She has 18 years of experience conducting services research and research on the epidemiology of alcohol, drug, and mental health problems among homeless and other indigent populations. More recently, her research has expanded to include infectious disease in these groups, including HIV and hepatitis B and C.