Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.
RAND Corporation, Pittsburgh, Pennsylvania, USA.
Subst Use Misuse. 2024;59(2):243-253. doi: 10.1080/10826084.2023.2267124. Epub 2023 Dec 28.
To examine prospective, bidirectional associations between homelessness and substance use frequency among young adults receiving substance use treatment in the United States. We also investigated potential differences across demographic subgroups. Young adults ( = 3717, age = 20.1, 28% female, 7.3% sexual/gender minority, and 37% non-Hispanic White) receiving substance use treatment in the U.S. completed assessments at intake, 3 months, 6 months, and 12 months post-intake. Latent growth curve models with structured residuals (LGC-SR) were used to examine cross-lagged associations between homeless days and frequency of substance use and associated problems. Models were stratified by sex, race/ethnicity, and sexual and/or gender minority status. Overall, days spent homeless ( -0.19, = 0.046) and substance use frequency ( -6.19, < 0.001) significantly decreased during treatment, with no significant cross-lagged associations between homeless days and substance use frequency. However, results differed by race and ethnicity. For non-Hispanic White young adults, greater substance use at treatment entry was associated with steeper declines in homeless days between-persons ( = -0.14, = 0.04). For African Americans, homeless days at treatment entry were associated with greater increases in substance use between-persons ( = 0.29, = 0.04). No significant differences were found by sex or sexual/gender minority status. Despite overall declines in homelessness and substance use during treatment, these outcomes may unfold differently for non-Hispanic White and African American young adults. More support may be needed for African American young adults reporting homelessness at treatment entry.
为了研究在美国接受物质使用治疗的年轻人中，无家可归与物质使用频率之间是否存在前瞻性、双向关联。我们还调查了人口统计学亚组之间的潜在差异。在美国接受物质使用治疗的年轻人（ = 3717，年龄为 20.1 岁，28%为女性，7.3%为性少数群体，37%为非西班牙裔白人）在入组时、入组后 3 个月、6 个月和 12 个月进行了评估。使用带有结构残差的潜在增长曲线模型（LGC-SR）来检查无家可归天数和物质使用频率以及相关问题之间的交叉滞后关联。根据性别、种族/民族以及性少数群体或性别少数群体的身份对模型进行分层。总体而言，无家可归天数（ -0.19， = 0.046）和物质使用频率（ -6.19， < 0.001）在治疗期间显著下降，无家可归天数和物质使用频率之间没有显著的交叉滞后关联。然而，结果因种族和民族而异。对于非西班牙裔白人年轻人，治疗开始时的物质使用量越大，人与人之间无家可归天数的下降幅度越大（ = -0.14， = 0.04）。对于非裔美国人，治疗开始时的无家可归天数与人与人之间物质使用量的增加有关（ = 0.29， = 0.04）。性别或性少数群体身份没有显著差异。尽管在治疗期间无家可归和物质使用总体下降，但对于非西班牙裔白人和非裔美国年轻人，这些结果的发展可能不同。对于治疗开始时报告无家可归的非裔美国年轻人，可能需要更多的支持。
