title: Substance use among Dutch homeless people, a follow-up study: prevalence, pattern and housing status.
abstract: BACKGROUND
  Previous studies have shown that substance use among homeless people is a prevalent problem that is associated with longer durations of homelessness. Most studies of substance use among the homeless were carried out outside Europe and have limited generalizability to European countries. This study therefore aimed to address the prevalence of substance use among homeless people in the Netherlands, the pattern of their use and the relationship with housing status at follow-up.
  
  
  METHODS
  This study included 344 participants (67.1% of the initial cohort) who were followed from baseline to 18 months after the baseline interview. Multinomial logistic regression analyses examined the relationship between substance use and housing status.
  
  
  RESULTS
  The most reported substances which were used among these homeless people were cannabis (43.9%) and alcohol (≥5 units on one occasion) (30.7%). Other substances were used by around 5% or less of the participants. Twenty-seven percent were classified as substance misuser and 20.9% as substance dependent. The odds to be marginally housed (4.14) or institutionalized (2.12) at follow-up compared to being housed of participants who were substance users were significantly higher than those of participants who did not use substances. The odds to be homeless were more than twice as high (2.80) for participants who were substance dependent compared with those who were not.
  
  
  CONCLUSIONS
  Homeless people who use substances have a more disadvantageous housing situation at follow-up than homeless people who do not use substances. Attention is needed to prevent and reduce long-term homelessness among substance-using homeless people.
authors.affiliation: 1 Erasmus Medical Centre, Rotterdam, the Netherlands 2 IVO Addiction Research Institute, Rotterdam, the Netherlands straaten@ivo.nl.
authors.forename: Barbara
authors.initials: B
authors.lastname: Van Straaten
authors.affiliation: 1 Erasmus Medical Centre, Rotterdam, the Netherlands 2 IVO Addiction Research Institute, Rotterdam, the Netherlands.
authors.forename: Gerda
authors.initials: G
authors.lastname: Rodenburg
authors.affiliation: 3 Radboud university medical center, Radboud Institute for Health Sciences, Impuls - Netherlands Center for Social Care Research Nijmegen, Nijmegen, the Netherlands 4 Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
authors.forename: Jorien
authors.initials: J
authors.lastname: Van der Laan
authors.affiliation: 3 Radboud university medical center, Radboud Institute for Health Sciences, Impuls - Netherlands Center for Social Care Research Nijmegen, Nijmegen, the Netherlands.
authors.forename: Sandra N
authors.initials: SN
authors.lastname: Boersma
authors.affiliation: 3 Radboud university medical center, Radboud Institute for Health Sciences, Impuls - Netherlands Center for Social Care Research Nijmegen, Nijmegen, the Netherlands.
authors.forename: Judith R L M
authors.initials: JR
authors.lastname: Wolf
authors.affiliation: 1 Erasmus Medical Centre, Rotterdam, the Netherlands 2 IVO Addiction Research Institute, Rotterdam, the Netherlands 5 Department of Health Promotion, Maastricht University, Maastricht, the Netherlands.
authors.forename: Dike
authors.initials: D
authors.lastname: Van de Mheen
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology*