title: Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics.
abstract: BACKGROUND
  The present study of homeless non-treatment-seeking problem drug users was designed to complement and extend previous studies which focused exclusively on treatment-seeking homeless problem drug users.
  
  
  METHODS
  Data were available for 866 primary care patients with drug problems, 30% homeless and 70% housed.
  
  
  RESULTS
  In the 2 years prior to baseline, homeless participants had less chronic medical co-morbidity than problem drug users who were housed yet were significantly more likely to have used emergency department services, to have used them more frequently, and at higher cost. Compared to their housed counterparts, homeless participants were also more likely to have been admitted to specialized chemical dependency treatment and/or detoxification services, to have been arrested for a felony or gross misdemeanor, and to report having psychiatric problems in the prior 30 days.
  
  
  CONCLUSIONS
  Additional support may be necessary for homeless patients presenting in primary care to benefit from substance abuse treatment given their more severe drug use problems coupled with their co-morbid health, psychiatric, and psychosocial problems.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA, USA. Electronic address: krupski@uw.edu.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Krupski
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA.
authors.forename: Meredith C
authors.initials: MC
authors.lastname: Graves
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Bumgardner
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle, WA, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Roy-Byrne
mesh_terms: D000328:Adult; D055030:Drug Users / Q000523:psychology*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D064876:Safety-net Providers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000523:psychology*
keywords: Arrests; Homeless; Medical service utilization and costs; Mental health problems; Primary care