Ending Addiction for Good

Addiction Among the Homeless Begins in Childhood

Bellevue Hospital study shows most homeless alcoholics became dependent as kids

Most homeless alcoholics began drinking while they were still children and became alcohol dependent soon after. This is a profound conclusion based on findings from a quantitative study at Bellevue Hospital in New York City. The detailed insights into chronically homeless, alcohol-dependent patients, helps give a better understanding to a tragic social problem.

Twenty patients were included in the study. The researchers found these individuals are often incapable of escaping the circumstances that have contributed to and perpetuated their problems, including multiple co-occurring disorders. The patients were recruited after repeated emergency department treatment for intoxication. Researchers found the following results:

  • that all began drinking in childhood or adolescence
  • thirteen reported having alcoholic parents
  • thirteen patients reported abuse in their childhood homes
  • nineteen were forced to leave or chose to leave home by age 18
  • only one was married
  • all 20 reported having entered detoxification programs at some point in the past
  • eleven suffered psychiatric diagnoses in the psychotic, mood or anxiety spectrums
  • three were veterans

Study author Ryan McCormack, MD, of New York University School of Medicine in New York, N.Y. said,

"One hundred percent of patients enrolled in the study began drinking alcohol as children, becoming alcohol-dependent shortly thereafter.  It is difficult to imagine the level of despair these people experience day in and day out, or the all-consuming focus on getting the next drink that overrides even the most basic human survival instinct. Most do not come to my ER voluntarily, but end up there because of public intoxication. The majority of patients in this study consistently left the hospital prior to the completion of medical care."

Homeless alcoholics have few goals for their future other than finding the next drink. Detox  and treatment programs are usually not long enough to address most problems due to high costs and few available beds. This is a growing concern in healthcare for substance abuse and can discourage patients, preventing effective treatment.

"As their capacity to envision a future diminishes, they increasingly lose motivation for personal recovery," said McCormack. "An alcoholic is first a human being. We hypothesize that more accessible, lower-barrier, patient-centered interventions that support alcohol harm reduction and quality of life improvement can be translated into the emergency department setting and this population."

The homeless alcoholics is criticized and stigmatized by the public in general. These individuals need understanding and mental health treatment in a long-term residential facility that can specifically address their myriad issues.        

Constance Scharff, Ph.D. is the Senior Addiction Research Fellow and Director of Addiction Research at Cliffside Malibu Treatment Center.

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