title: Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status.
abstract: BACKGROUND
  Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status.
  
  
  METHODS
  Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses.
  
  
  RESULTS
  Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2) but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3)).
  
  
  CONCLUSIONS
  Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.
authors.affiliation: Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St, Michael's Hospital, Toronto, Canada. michelle.grinman@utoronto.ca
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Grinman
authors.forename: Shirley
authors.initials: S
authors.lastname: Chiu
authors.forename: Donald A
authors.initials: DA
authors.lastname: Redelmeier
authors.forename: Wendy
authors.initials: W
authors.lastname: Levinson
authors.forename: Alex
authors.initials: A
authors.lastname: Kiss
authors.forename: George
authors.initials: G
authors.lastname: Tolomiczenko
authors.forename: Laura
authors.initials: L
authors.lastname: Cowan
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Hwang
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006304:Health Status; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D011594:Psychometrics; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000453:epidemiology*