Department of Psychiatry, Yale School of Medicine.
APT Foundation Services.
Med Care. 2020 Nov;58(11):1030-1034. doi: 10.1097/MLR.0000000000001414.
Although homelessness and opioid use disorder (OUD) are important public health issues, few studies have examined their cooccurrence.
The aim of this study was to evaluate the correlates of homelessness among patients enrolled in low-barrier-to-treatment-access methadone maintenance treatment (MMT) programs for OUD.
Demographic, diagnosis-related, and treatment-related correlates were assessed by self-report for 164 patients in MMT. Correlates of past-month homelessness were investigated with logistic regression.
Twenty-four percent of patients reported homelessness in the past month. Bivariate analyses initially identified 7 statistically significant (P<0.05) correlates of homelessness: gender; Latinx ethnicity; symptoms of depression, anxiety, and somatization; self-criticism; and duration of MMT. In the final logistic regression model, which included significant independent variables from the bivariate logistic regressions, patients in MMT who were homeless (vs. domiciled) were more likely to be male (odds ratio 2.54; confidence interval, 1.01-6.36) and report higher symptoms of depression (odds ratio 1.07; confidence interval, 1.01-1.15).
Low-barrier-to-treatment-access programs can attract people who are homeless with OUD into MMT. These programs also have an important public health role in addressing both depression and OUD among people who are homeless.
尽管无家可归和阿片类药物使用障碍（OUD）是重要的公共卫生问题，但很少有研究探讨它们的同时存在。
本研究旨在评估接受低治疗障碍阿片类药物维持治疗（MMT）治疗 OUD 的患者中无家可归的相关因素。
通过自我报告评估了 164 名 MMT 患者的人口统计学、诊断相关和治疗相关因素。采用逻辑回归分析过去一个月无家可归的相关因素。
24%的患者报告过去一个月无家可归。双变量分析最初确定了 7 个与无家可归相关的统计学显著（P<0.05）因素：性别；拉丁裔族裔；抑郁、焦虑和躯体化症状；自我批评；以及 MMT 持续时间。在最终的逻辑回归模型中，包括双变量逻辑回归中具有统计学意义的独立变量，无家可归（与有住所）的 MMT 患者更有可能是男性（比值比 2.54；置信区间，1.01-6.36），并报告更高的抑郁症状（比值比 1.07；置信区间，1.01-1.15）。
低治疗障碍治疗方案可以吸引患有 OUD 的无家可归者进入 MMT。这些方案在解决无家可归者的抑郁和 OUD 方面也具有重要的公共卫生作用。
