title: A prospective study of substance use and housing stability in a homeless population.
abstract: OBJECTIVE
  This study examined self-report and urine test data about homeless substance use over time, prospectively comparing substance use with attainment of stable housing.
  
  
  METHODS
  400 homeless people systematically sampled from shelters and streets in St. Louis, Missouri were assessed with structured diagnostic interviews and urine substance testing annually over 2 years. Nearly two-thirds (n = 255) completed all three assessments, constituting the sample for this prospective study.
  
  
  RESULTS
  More than half (55%) of this homeless sample had detectable cocaine use during the study. Most cocaine users continued using during the next 2 years and failed to achieve and maintain stable housing. Cocaine use in the first follow-up year predicted housing patterns over the next 2 years, independent of lifetime diagnosis of cocaine use disorder. Alcohol abuse/dependence in the 2-year follow-up period did not predict housing outcomes.
  
  
  CONCLUSIONS
  The course of cocaine use and abuse/dependence, but not continuing alcohol addiction, was associated with subsequent attainment of stable housing, especially cocaine use in the first prospective year. Replication of these findings in other locations to determine generalizability may have implications for designing housing service models.
authors.affiliation: VA North Texas Health Care System, 4500 S. Lancaster Rd., Dallas, TX 75216, USA. carol.north@utsouthwestern.edu
authors.forename: Carol S
authors.initials: CS
authors.lastname: North
authors.forename: Karin M
authors.initials: KM
authors.lastname: Eyrich-Garg
authors.forename: David E
authors.initials: DE
authors.lastname: Pollio
authors.forename: Jagadisha
authors.initials: J
authors.lastname: Thirthalli
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology* / Q000706:statistics & numerical data; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008923:Missouri / Q000453:epidemiology; D011157:Population Dynamics; D011446:Prospective Studies; D015813:Substance Abuse Detection / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*