Homeless Women and Hazardous Drinking: Screening Results in a Primary Health Care Setting

Authors

  • Carole C. Upshur EdD,

    Corresponding author
    1. Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts
    • Address correspondence to Dr. Upshur, University of Massachusetts Medical School, Department of Family Medicine and Community Health, 55 Lake Ave. North, Worcester, MA 01655. E-mail: carole.upshur@umassmed.edu.

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  • Linda Weinreb MD,

    1. Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Monica Bharel MD, MPH

    1. Departments of Medicine, Boston University Medical Center and Massachusetts General Hospital, Boston Health Care for the Homeless Program, Boston, Massachusetts
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Abstract

Background and Objectives

Screening for alcohol use in primary care is underutilized, especially for women. The current study implemented systematic women's alcohol use screening in a health care for the homeless primary care program.

Methods

All women (n = 541) seeking care over 12 months were screened.

Results

Of the 541 screening forms returned, 80 women refused to answer the alcohol use questions. Of 461 completed screens, over 40% reported no alcohol use, while 43.8% reported hazardous drinking. Hazardous drinking was significantly associated with younger age, African American race, and living on the street or in a shelter.

Discussion and Conclusions

High rates of drinking were identified among women in different housing situations and use of systematic screening was beneficial to providers.

Scientific Significance and Future Directions

Health care settings are important sites to identify hazardous drinking as well as alcohol disorders among women with unstable housing histories. The growing integration of behavioral health care into primary care, and the medical home concept, both provide opportunities for brief interventions for at-risk drinkers, as well as treatment options for those with alcohol use disorders that may be particularly appealing to women. Findings support further investigation of the relationship of housing stability to drinking, and suggest African American women may need special attention. (Am J Addict 2014;23:117–122)

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