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

Nicky J. Mehtani (), Chika C. Chuku, Meredith C. Meacham, Eric Vittinghoff, Samantha E. Dilworth and Elise D. Riley
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Nicky J. Mehtani: Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, CA 94143, USA
Chika C. Chuku: Department of Public Health Sciences, University of Miami, Coral Gables, FL 33136, USA
Meredith C. Meacham: Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, CA 94143, USA
Eric Vittinghoff: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143, USA
Samantha E. Dilworth: Department of Medicine, University of California, San Francisco, CA 94143, USA
Elise D. Riley: Department of Medicine, University of California, San Francisco, CA 94143, USA

IJERPH, 2023, vol. 20, issue 19, 1-10

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.

Keywords: homelessness; housing instability; women; methamphetamine; cocaine; housing policy; stimulant use disorder (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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