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Predictors of Frequent Withdrawal Management Unit Use among Chronically Homeless, Homeless, and Housed Men: A Retrospective Cohort Study
Author(s) -
Svoboda Tomislav
Publication year - 2013
Publication title -
the american journal on addictions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.997
H-Index - 76
eISSN - 1521-0391
pISSN - 1055-0496
DOI - 10.1111/j.1521-0391.2012.12039.x
Subject(s) - abstinence , medicine , demography , population , detoxification (alternative medicine) , retrospective cohort study , cohort , unit (ring theory) , gerontology , psychiatry , environmental health , psychology , alternative medicine , pathology , sociology , mathematics education
Background and Objectives Reports suggest that repeat users of detoxification services are less likely to get rehabilitated. The goal of this study is to determine rates and predictors of detoxification unit visits among individuals who are chronically homeless with severe drinking problems compared to those who are housed and in the general homeless population. Methods Visit records ( n = 1027) from all inner city Toronto detoxification units ( n = 5) by men ( n = 169) over a 6 year period were analyzed and linked to structured interview data for three populations: chronically homeless individuals with severe drinking problems (CHDP, n = 50); members of the general homeless population (GH, n = 61); and low‐income housed individuals (LIH, n = 58). Results The CHDP group had 4.13 (3.86, 4.39) detoxification unit admissions per year, 18.1 (95% CI 12.5–23.7) and 33 (95% CI 21–46) times higher than the GH and LIH groups respectively. Admission rates were 43.8 % (95% CI 32.7–54.9%) higher in the winter than summer months for the CHDP group. The proportions of stays that involved police, leaving without discharge, and staying two days or less were 74%, 75%, and 89% among CHDP, GH, and LIH subjects. Conclusions and Scientific Significance Rather than being a resource for achieving abstinence, frequent short visits, treatment non‐compliance, higher winter visit rates suggest that detoxification units are more likely used by individuals as shelter; high rates of admission related police involvement suggest that they continue to be used as an alternative to judicial intervention into public inebriation. (Am J Addict 2013; 22:226–232)