Homelessness and Substance Misuse: A Tale of Two Cities

Abstract

In this article we examine the relationship between alcohol and drug misuse among the literally homeless (those living out of doors and in emergency shelters) in Hartford, Connecticut and Providence, Rhode Island, two northeastern U.S. cities of comparable size. We worked with homeless advocacy organizations in both cities, using a point-in-time census (N = 1058) and random sample (N = 66) in Hartford, and a sampling of clients (N = 82) of six shelters serving residents of Providence (N = 82). We found substance misuse relevant in 47.2% of the homeless in Hartford and in 45.1% of the homeless in Providence. We conclude that there is a great need for substance treatment services inside shelters, soup kitchens, and day centers so that homeless individuals have an opportunity to engage in treatment within their own milieu.

• Homeless
• Substance misuse
• Substance misuse treatment
• Urban poverty
• History of homelessness

Notes

In this article we employ the term alcohol misuse and drug misuse to indicate a large range of problem behaviors related to the use of alcohol and drugs. In the homeless population these problems include loss of job, loss of income, and ultimately, loss of housing and family support. We employ the term alcohol or drug abuse only when we have administered the Structured Clinical Interview for DSM-IV Alcohol and Other Substance Use Disorders and the individual has met the DSM-IV criteria for alcohol and/or drug abuse.

Additional information

Notes on contributors

Irene Glasser

Irene Glasser, Ph.D., is an anthropologist and a Research Fellow at the Center for Alcohol and Addiction Studies, Brown University. She is the author of More Bread: Ethnography of a Soup Kitchen (University of Alabama Press 1988), Homelessness in Global Perspective (G.K. Hall, Macmillan 1994) and Braving the Street: The Anthropology of Homelessness, with Rae Bridgman (Berghahn Books, 1999). She is currently engaged in treatment studies that focus on recovery from substance misuse within the homeless community.

William H. Zywiak

William H. Zywiak, Ph.D., is an associate research scientist at the Decision Sciences Institute of the Pacific Institute for Research and Evaluation. He has been conducting addictions research for more than 10 years. He has published several articles on alcohol treatment outcome, relapse, and health services research. As a project manager through the years, he has overseen the recruitment of more than 500 clients into alcohol research studies.