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Multiply disadvantaged: Health and service utilisation factors faced by homeless injecting drug consumers in Australia


Whittaker, E and Swift, W and Roxburgh, A and Dietze, P and Cogger, S and Bruno, R and Sindicich, N and Burns, L, Multiply disadvantaged: Health and service utilisation factors faced by homeless injecting drug consumers in Australia, Drug and Alcohol Review, 34, (4) pp. 379-387. ISSN 0959-5236 (2015) [Refereed Article]

Copyright Statement

Copyright 2015 Australasian Professional Society on Alcohol and other Drugs

DOI: doi:10.1111/dar.12257


Introduction and Aims: Homelessness status is strongly correlated with higher rates of substance use. Few studies, however, examine the complex relationship between housing status and substance use in people who inject drugs (PWID). This study extends previous research by comparing the physical and mental health status and service utilisation rates between stably housed and homeless PWID.

Design and Methods: A cross-sectional sample of 923 PWID were recruited for the 2012 Illicit Drug Reporting System. Multivariate models were generated addressing associations between homelessness and the domains of demographics; substance use; and health status, service utilisation and criminal justice system contact, with significant correlates entered into a final multivariate model.

Results: Two-thirds of the PWID sample were male. The median age was 39 years and 16% identified as Indigenous. Almost one-quarter (23%) reported that they were homeless. Homeless PWID were significantly more likely to be unemployed [adjusted odds ratio (AOR) 2.83, 95% confidence interval (CI) 1.26, 6.34], inject in public (AOR 2.01, 95% CI 1.38, 3.18), have poorer mental health (AOR 0.98, 95% CI 0.97, 1.00), report schizophrenia (AOR 2.31, 95% CI 1.16, 4.60) and have a prison history (AOR 1.53, 95% CI 1.05, 2.21) than stably housed PWID.

Discussion and Conclusions: Findings highlight the challenge of mental health problems for homeless PWID. Our results demonstrate that further research that evaluates outcomes of housing programs accommodating PWID, particularly those with comorbid mental health disorders, is warranted. Results also emphasise the need to better utilise integrated models of outreach care that co-manage housing and mental health needs.

Item Details

Item Type:Refereed Article
Keywords:injecting drug use; homelessness
Research Division:Psychology
Research Group:Other psychology
Research Field:Other psychology not elsewhere classified
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Bruno, R (Associate Professor Raimondo Bruno)
ID Code:99360
Year Published:2015
Web of Science® Times Cited:32
Deposited By:Psychology
Deposited On:2015-03-23
Last Modified:2017-11-07

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