School of Social Policy & Practice, D17 Caster, University of Pennsylvania, Philadelphia, PA 19130, United States.
Drug Alcohol Depend. 2013 Sep 1;132(1-2):202-6. doi: 10.1016/j.drugalcdep.2013.02.004. Epub 2013 Mar 7.
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.
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.
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).
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.
尽管关于饮酒和无家可归的学术研究集中在酒精滥用和依赖的影响上，但对于低水平的误用（如危险饮酒）的影响知之甚少。在退伍军人事务部医疗保健系统（VA）接受治疗的退伍军人构成了一个容易受到酒精滥用和无家可归影响的群体。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的影响，该研究样本包括 2898 名年龄较大的退伍军人（平均年龄=50.2 岁），他们在全国 8 个 VA 接受治疗。
逻辑回归模型检验了以下三个方面之间的关联：（1）基线时的危险饮酒与 1 年后的无家可归之间的关联；（2）从基线到随访期间进入和退出危险饮酒状态与无家可归之间的关联；（3）从基线到随访期间过渡到危险饮酒状态和过渡到无家可归状态之间的关联。
在控制了其他相关因素（包括酒精依赖）后，基线时的危险饮酒增加了随访时无家可归的风险（调整后的优势比[OR]=1.39，95%置信区间[CI]=1.02，1.88）。从基线时的有房状态过渡到随访时的无家可归状态的风险增加了两倍多（OR=2.42，95% CI=1.41，4.15），而从基线时的有房状态过渡到随访时的无家可归状态的风险增加了两倍多（OR=2.49，95% CI=1.30，4.79）。
旨在防止过渡到危险饮酒的早期干预措施可以提高退伍军人的住房稳定性。已经证明在较低水平的饮酒行为中有效的简短干预措施应该在接受 VA 护理的退伍军人中实施。
