Lawless and Corr1 at Merchants Quay Ireland assessed the nature, extent and experience of alcohol and drug use among people who were homeless in four cities in Ireland, namely: Cork, Dublin, Galway and Limerick.  The report was prepared for the National Advisory Committee on Drugs and launched in April 2005.  Homelessness was defined as living in a hostel or shelter, a bed and breakfast, or a squat, or living temporarily with family or relatives.  In Cork, Galway and Limerick, the definition was extended to include transitional housing or long-term supported housing. 

In Dublin, the sample was selected using a quota sampling based on gender, age and primary accommodation type, while in Cork, Galway and Limerick the quota sample was based on primary accommodation.  The majority (247, 70%) of the sample was recruited in Dublin and the remainder (108, 30%) in the other three cities.  The 355 participants were recruited from among those in contact with homeless services in the four cities.  Drug treatment centres and needle exchange facilities were excluded from the list of services so as to avoid over-estimating the prevalence of drug use. 

Between June and October 2003, nine field workers interviewed the participants using a semi-structured questionnaire, which: 

• Elicited information regarding basic identifiers, personal characteristics, accommodation types, experiences of homelessness, income, health, alcohol and drug use, risk behaviours, contact with services and current needs; 
• Measured problem alcohol use using a validated tool known as the Alcohol Use Disorders Identification Test Screening Instrument (AUDIT); 
• Assessed drug use through three approaches, which included:
• • European Monitoring Committees Drug and Drug Addiction (EMCDDA) standard questions on lifetime, recent and current use of various drug classifications;
  • A 10-point version of the Drug Abuse Screening Test to identify problematic drug use;
  • Severity of Dependence Scale to measure the degree of dependence on a variety of drugs.

Each person interviewed was allocated a unique identifier (initials, gender and date of birth) and these identifiers were shared between the fieldworkers so as to avoid respondents participating more than once. 

This article presents the prevalence of alcohol and drug use among the homeless.  The main findings are as follows:

• Of the 355 participants:
• • 101 (28%) were less than 24 years old, while 161 (35%) were more than 34 years old;
  • 244 (69%) were male.
• Of the 352 participants for whom location and type of accommodation were known:
• • Half (176) were living in a hostel, just under one-fifth (69) were staying in bed and breakfast accommodation, 56 (16%) were sleeping rough and the remaining 15 were staying in other accommodation;
  • 245 (70%) lived in Dublin while 36 (10%) lived in each of the other cities, Cork, Galway and Limerick;
• Of note, 19 per cent of respondents reported that drug use was the main reason for their becoming homeless, while 13 per cent reported that alcohol was the main reason; 
• Of the 352 for whom frequency of alcohol use was known, 105 (30%) were not drinking alcohol at the time of the survey, while 83 (23%) consumed alcohol on four or more days per week;
• 247 participants reported alcohol use at the time of the survey and were screened for problem alcohol use, 73 per cent had an alcohol problem and 49 per cent of these had a high-level alcohol problem.
• Of the 355 participants,
• • 74 per cent reported illicit drug use at some point in their life, 64 per cent reported illicit drug use in the year preceding the study and 52 per cent had reported illicit drug use in the month preceding the study (Table 1); 
  • • Gender was not associated with current drug use;
    • A lower proportion of hostel dwellers (43%) reported current drug use than did those sleeping rough (73%) or staying in bed and breakfast accommodation (67%);
    • A higher proportion of homeless living in Dublin were current drug users than the proportions living in each of the other cities;
  • Cannabis was the most common illicit drug used, with 69 per cent using it at some point in their life, followed by heroin (42%), ecstasy (42%), cocaine powder (41%), amphetamines (35%), hallucinogens (28%), crack cocaine (19%) and solvents (16%);
  • Cannabis was the most common (43%) illicit drug used in the last month, followed by heroin (22%), cocaine powder (17%), ecstasy (12%), crack cocaine (3%) amphetamines (2%), hallucinogens (1%), and solvents (1%);
  • 45 per cent were using more than one drug at the time of the study and this represents 72 per cent of current drug users;
• Using the DAST screening instrument, 36 per cent of the 355 participants were classified as problem drug users and 65 per cent of the 183 current drug users were problem drug users;
• Using the Severity of Dependence Scale, 43 per cent of the scores of the 183 current drug users indicated a high level of psychological dependence. 

Table 1   Prevalence of illicit drug* use in the homeless population in Ireland in 2003

*Illicit drugs are cannabis, ecstasy, amphetamines, cocaine powder, crack cocaine, heroin, hallucinogens, and solvents

As expected, drug use is much more common among the homeless population than among the general population.1,2  The profile of drug use reported by the homeless population in 2003 is similar to that reported by the prison population in 1999,3 indicating the high-risk substance use among these two populationsand, possibly, considerable overlap between the prison and the homeless population.

1. Lawless M and Corr C (2005) Drug use among the homeless in Ireland. Dublin: Stationery Office.  

2. National Advisory Committee on Drugs and Drug and Alcohol Information and Research Unit (2003) Drug use in Ireland and Northern Ireland: First results from the 2002 and 2003 drug prevalence study. 

3. Centre for Health Promotion Studies, National University of Ireland, Galway (2000) General health care study of the Irish prison population. Dublin: Stationery Office