{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:10:24Z","timestamp":1789477824676,"version":"build-2803163510"},"reference-count":51,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Background<\/jats:italic>\n                    : The median age of the single adult homeless population is 50 and rising. Although the prevalence of substance use decreases as individuals age, older adults now have a higher prevalence of substance use than older adults did 10\u00a0years ago. Homeless individuals have a higher prevalence of substance use disorders than the general population. However, little is known about substance use in older homeless adults.\n                    <jats:italic toggle=\"yes\">Methods<\/jats:italic>\n                    : The objective of the study was to examine prevalence of and factors associated with substance use in a population-based sample (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 350) of homeless individuals aged 50 and older in Oakland, California. Dependent variables included moderate or greater severity illicit drug symptoms (Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) score &gt;3) and moderate or greater alcohol symptoms (Alcohol Use Disorders Identification Test (AUDIT) score &gt;7). Independent variables included demographics, mental health problems, and negative life course events such as physical and sexual abuse, school expulsion, and onset of homelessness.\n                    <jats:italic toggle=\"yes\">Results<\/jats:italic>\n                    : Almost two thirds of participants, 64.6%, had moderate or greater severity symptoms for at least 1 illicit drug; 25.8% had moderate or greater severity alcohol symptoms. History of psychiatric hospitalization was associated with moderate or greater illicit drug symptoms (adjusted odds ratio [AOR] = 1.9, 1.0\u20133.6). The presence of major depressive symptoms was associated with moderate or greater severity alcohol symptoms (AOR = 1.8, 1.1\u20133.0).\n                    <jats:italic toggle=\"yes\">Conclusions<\/jats:italic>\n                    : In this sample of older homeless adults, substance use is common. There is a need for substance use treatment programs, integrated with mental health services, which are targeted towards the needs of older homeless adults.\n                  <\/jats:p>","DOI":"10.1080\/08897077.2016.1264534","type":"journal-article","created":{"date-parts":[[2016,11,29]],"date-time":"2016-11-29T11:17:38Z","timestamp":1480418258000},"page":"88-94","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":46,"title":["Factors Associated with Substance Use in Older Homeless Adults: Results from the Hope Home Study"],"prefix":"10.1177","volume":"38","author":[{"given":"Matthew A.","family":"Spinelli","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Ponath","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Tieu","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily E.","family":"Hurstak","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Guzman","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot","family":"Kushel","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,1,1]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009","year":"2009","unstructured":"Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009. 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