Hazardous drinking and its association with homelessness among veterans in care
Hazardous drinking and its association with homelessness among veterans in care
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DOI：
10.1016/j.drugalcdep.2013.02.004
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发表时间：
2013-09-01
影响因子：
4.2
通讯作者：
Justice, A. C.
中科院分区：
文献类型：
--
作者：
Ghose, T.;Fiellin, D. A.;Justice, A. C.
背景：虽然关于酒精使用和无家可归的学术研究侧重于酒精滥用和酒精依赖的影响，但对较低水平的滥用（如危险使用）的影响知之甚少。在退伍军人事务部医疗保健系统（VA）接受护理的退伍军人构成了一个易受酒精滥用和无家可归影响的人群。这项研究在退伍军人老龄化队列研究中考察了危险饮酒对无家可归者的影响，该研究的样本是2898名老年退伍军人（平均年龄=50.2岁），他们在全国8个VAs接受护理。方法：Logistic回归模型检验了(1)基线时危险饮酒与1年随访期间无家可归之间的关系，(2)从基线到随访期间过渡到危险饮酒和退出危险饮酒以及随访期间无家可归之间的关系，以及(3)在同一时间段内从基线到随访期间过渡到危险饮酒和过渡到无家可归之间的关系。结果：在控制了包括酒精依赖在内的其他相关因素后，基线时的危险饮酒增加了随访时无家可归的风险（调整优势比[AOR] = 1.39, 95%可信区间[CI] = 1.02, 1.88）。过渡到危险饮酒的人在随访时无家可归的风险增加了一倍多（AOR=2.42,95% CI=1.41, 4.15），而在随访时从基线住所过渡到无家可归的风险增加了一倍多（AOR=2.49, 95% CI=1.30, 4.79）。结论：早期干预旨在防止过渡到危险饮酒可以增加退伍军人住房的稳定性。简短的干预措施已被证明对较低水平的酒精使用是有效的，应该在退伍军人管理局护理的退伍军人中实施。爱思唯尔爱尔兰有限公司出版。
Background: While scholarship on alcohol use and homelessness has focused on the impact of alcohol abuse and dependence, little is known about the effects of lower levels of misuse such as hazardous use. Veterans receiving care in the Department of Veterans Affairs Health Care System (VA) constitute a population that is vulnerable to alcohol misuse and homelessness. This research examines the effects of hazardous drinking on homelessness in the Veterans Aging Cohort Study, a sample of 2898 older veterans (mean age=50.2), receiving care in 8 VAs across the country.Methods: Logistic regression models examined the associations between (1) hazardous drinking at baseline and homelessness at 1-year follow-up, (2) transitions into and out of hazardous drinking from baseline to follow-up and homelessness at follow-up, and (3) transitioning to hazardous drinking and transitioning to homelessness from baseline to follow-up during that same time-period.Results: After controlling for other correlates including alcohol dependence, hazardous drinking at baseline increased the risk of homelessness at follow-up (adjusted odds ratio [AOR] = 1.39, 95% confidence interval [CI] = 1.02, 1.88). Transitioning to hazardous drinking more than doubled the risk of homelessness at follow-up (AOR=2.42,95% CI=1.41, 4.15), while more than doubling the risk of transitioning from being housed at baseline to being homeless at follow-up (AOR=2.49, 95% CI=1.30, 4.79).Conclusions: Early intervention that seeks to prevent transitioning into hazardous drinking could increase housing stability among veterans. Brief interventions which have been shown to be effective at lower levels of alcohol use should be implemented with veterans in VA care. Published by Elsevier Ireland Ltd.