The Dasis Report (Drug and Alcohol Information System)
August 8, 2003

Characteristics of Homeless Admissions to Substance Abuse Treatment: 2000
In Brief
  • Homeless admissions were older than admissions who were not homeless
  • Alcohol was the primary substance of abuse for a majority of homeless admissions (51 percent), followed by opiates (18 percent) and smoked cocaine (17 percent)

  • Homeless admissions were more likely than admissions who were not homeless to refer themselves for treatment (43 vs. 30 percent)

In 2000, more than 120,000 admissions to substance abuse treatment facilities were homeless at time of admission. These admissions comprised 10 percent of admissions for whom living arrangements were recorded, a proportion which has remained consistent since 1997.

Admissions to substance abuse treatment facilities are tracked in the Treatment Episode Data Set (TEDS). TEDS is an annual compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once.

TEDS includes a Minimum Data Set collected by all States and a Supplemental Data Set collected by some States. Living arrangement is a Supplemental Data Set item. Only data on admissions for the 41 States with a response rate of 75 percent or higher on this data element in 2000 were used for this report. 1

Demographic Characteristics
Homeless admissions were older than admissions who were not homeless (Figure 1). The average age of homeless admissions was 38 compared with 33 for those admissions not homeless. The proportion of homeless admissions over age 45 was 23 percent compared with 15 percent of those not homeless.

Three-quarters (76 percent) of homeless admissions were male, a larger proportion than among admissions who were not homeless (70 percent). Homeless admissions were also more likely to be veterans than those who were not homeless (10 vs. 6 percent) in the 27 States reporting both living arrangement and veteran status.2

Homeless admissions were 53 percent White and 30 percent Black, whereas admissions who were not homeless were 59 percent White and 24 percent Black. There were no differences among other racial/ethnic groups.

Figure 1. Age at Admission, by Homeless Status: 2000
Figure 1. Age at Admission, by Homeless Status: 2000
Source: 2000 SAMHSA Treatment Episode Data Set (TEDS).



Primary Substance
Alcohol was the primary substance of abuse for more than half (51 percent) of homeless admissions, compared with 47 percent of admissions who were not homeless (Figure 2). Homeless admissions were also more likely to be admitted for smoked cocaine abuse than those who were not homeless (17 vs. 10 percent), but, being an older population, were less likely to be admitted for marijuana abuse (5 vs. 17 percent).

However, there were large differences in the distribution of primary substance of abuse by race/ethnicity among homeless admissions (Table 1). Alcohol was most frequently reported as the primary substance of abuse for homeless admissions in all racial/ethnic groups except Blacks. Alcohol, in fact, accounted for 80 percent of American Indian/Alaska Native admissions. For homeless Black admissions, however, smoked cocaine and alcohol were equal, at 37 percent, as primary substance. Homeless Hispanic admissions exceeded other racial/ethnic groups in the abuse of opiates at 33 percent, while homeless Asian and Pacific Islander admissions exceeded other racial/ethnic groups in the abuse of stimulants, at 21 percent.

The largest differences between homeless admissions and admissions who were not homeless in regard to primary substance of abuse were found among Blacks and among American Indians/Alaska Natives. More than one-third (37 percent) of homeless Blacks abused smoked cocaine compared with less than one-quarter (23 percent) of Blacks who were not homeless. Four-fifths of homeless American Indians/Alaska Natives (80 percent) abused alcohol compared with two-thirds (67 percent) of those not homeless.

Figure 2. Primary Substance of Abuse, by Homeless Status: 2000
Figure 2. Primary Substance of Abuse, by Homeless Status: 2000
Source: 2000 SAMHSA Treatment Episode Data Set (TEDS).



Table 1. Homeless Admissions, by Race/Ethnicity and Primary Substance of Abuse: 2000
  White Black Hispanic AI/AN* API** Other
Percent of Homeless Admissions
Alcohol 61 37 48 80 45 41
Smoked Cocaine 8 37 9 4 9 27
Marijuana 4 6 4 4 9 6
Opiates 17 15 33 7 13 17
Stimulants 6 0 1 3 21 17
Other 4 5 5 2 3 5
Total 100 100 100 100 100 100
Source: 2000 SAMHSA Treatment Episode Data Set (TEDS).



Co-Occurring Disorders
 Co-occurring disorders refer to the co-occurrence of a substance abuse problem and a psychiatric disorder. In States reporting on both living arrangements and psychiatric problems, almost one-quarter (23 percent) of homeless admissions had co-occurring disorders compared with one-fifth (20 percent) of admissions who were not homeless.3

Source of Referral
 Homeless admissions were more likely to seek treatment themselves than those who were not homeless (43 vs. 30 percent), while they were much less likely to be referred by the criminal justice system (15 vs. 40 percent) (Figure 3).
Figure 3. Sources of Referral for Admissions, by Homeless Status: 2000
Figure 3. Sources of Referral for Admissions, by Homeless Status: 2000
Source: 2000 SAMHSA Treatment Episode Data Set (TEDS).



Treatment Setting
 Homeless admissions were more likely than admissions who were not homeless to receive detoxification (45 vs. 14 percent) or residential rehabilitation (27 vs. 16 percent) services (Table 2). They were less likely to receive outpatient services (28 vs. 70 percent).

Table 2. Treatment Setting, by Homeless Status: 2000
  Homeless Not Homeless
 
Percent of Admissions
Detoxification (24-hour service) 45 14
Residential Rehabilitation 27 16
Outpatient 28 70
Source: 2000 SAMHSA Treatment Episode Data Set (TEDS).

Prior Treatment
Homeless admissions were more likely than admissions who were not homeless to have been in treatment previously (72 vs. 54 percent).

End Notes
1The "living arrangements" data element in the TEDS Supplemental Data Set encompasses "dependent living" and "independent living" in addition to "homeless." The 41 States reporting on this data element in 2000 were: AL, AK, AZ, CO, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, NE, NV, NH, NJ, NY, NC, ND, OH, OK, OR, RI, SC, SD, TN, TX, UT, VT, VA, and WA.
2The "veteran status" data element is in the TEDS Supplemental Data Set. These 27 States reported both the "living arrangements" and the "veteran status" data elements at a 75 percent response level: AL, AK, CO, DE, GA, HI, ID, IN, IA, KS, KY, LA, ME, MA, MI, MN, MS, MO, NV, NY, ND, OH, OK, SC, SD, TN, and WA.
3The "psychiatric problem" data element is in the TEDS Supplemental Data Set. These 26 States reported both the "living arrangements" and "psychiatric problem" data elements at a 75 percent response level: AL, CO, DE, GA, ID, IA, KS, KY, LA, ME, MD, MA, MI, MS, MO, NV, NH, NJ, NY, NC, ND, OH, OK, RI, SC, and TN.

Table Notes
*AI/AN = American Indian Alaska Native;
**API = Asian and Pacific Islander
The Drug and Alcohol Services Information System (DASIS) is an integrated data system maintained by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment Episode Data Set (TEDS). TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. Information on treatment admissions is routinely collected by State administrative systems and then submitted to SAMHSA in a standard format. Approximately 1.6 million records are included in TEDS each year. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once.

The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and RTI, Research Triangle Park, North Carolina.

Information and data for this issue are based on data reported to TEDS through April 1, 2002.

Access the latest TEDS reports at:
www.oas.samhsa.gov/dasis.htm

Access the latest TEDS public use files at:
http://www.oas.samhsa.gov/SAMHDA.htm

Other substance abuse reports are available at:
http://www.oas.samhsa.gov
The DASIS Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available on-line: http://www.oas.samhsa.gov. Citation of the source is appreciated.

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