Introduction Homeless women are at high risk of substance abuse (SA), leading to excess morbidity and mortality. Yet, few homeless women seek SA treatment programs.
Objective To determine correlates of SA treatment initiation and completion among homeless women reporting serious drug and alcohol use.
Population 1,342 homeless women were recruited from sober living or residential recovery shelters and street outreach in downtown LA. The 794 women (59%) reporting daily use of drugs or alcohol during the prior year comprise the sample.
Measures Demographics, SA, childhood sexual/physical abuse, parental SA, support, coping, distress, and medical service use were assessed.
Results 31% (246) underwent drug treatment; of these, 71% completed therapy. Women who did receive treatment were more likely to report support from both drug and non-drug-using friends, prior sexual or physical abuse, suicide attempt(s), parents who abused substances, and to display active coping behaviors. Latina women were less likely to receive treatment. Women completing SA treatment were more likely to report peer influence for initiating drug use, support from non-drug-using friends, less parental SA, and to display active coping behaviors.
Conclusions Less than one third of homeless women with serious substance use sought treatment and less than three quarters completed therapy. Greater knowledge of the women who seek and complete treatment is valuable both in triaging limited resources and in tailoring programs to users. Strategies to improve parental modeling, coping skills, positive peer influence, and to increase utilization of SA programs are warranted.