Adolescent Alcohol Use a Common Thread among Homeless Alcoholics

A staggering portion of the homeless who are alcohol dependent began drinking as children, according to the findings of a recent study in the Annals of Emergency Medicine.

New York University School of Medicine researchers conducted detailed, semi-structured, and qualitative interviews with 20 homeless alcoholic participants who had 4 or more emergency department (ED) annual visits to Bellevue Hospital. Investigators claimed the 20 subjects were of diverse backgrounds.

From their conversations, the researchers categorized their responses into themes such as alcoholism, homelessness, healthcare, and the future.

Alarmingly, every subject reported their alcohol use began during childhood, which progressed into alcoholism shortly after. Eleven believed their alcoholism was genetic, as they witnessed excessive drinking by their parents.

Furthermore, alcoholism was cited as the main cause of their homelessness. All 20 patients claimed they underwent a detoxification program prior to the study. However, 14 participants reported they were stuck in a cycle of sobriety and drunkenness, with loneliness, commitment, and hopelessness being common themes.

“Medical records confirmed they needed care for myriad comorbidities associated with alcoholism, such as cirrhosis, chronic obstructive pulmonary disease, cardiovascular diseases, gastrointestinal ailments, and brain injuries,” the authors wrote.

Within a year of the interview, a quarter of the patients died of liver and lung cancers; vehicular trauma, assault, and hypothermia; or intoxication, the researchers also reported.

Another compounding issue highlighted in the study was mental illness, with 11 of the participants being diagnosed with a psychotic, mood, or anxiety disorder.

The study’s author, Ryan McCormack, MD, explained why alcohol misuse is a common ailment that plagues many homeless individuals.

"For people who have homes and jobs, 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,” McCormack said in a statement. “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."

Based on the investigators’ discoveries, McCormack recommended alcohol abuse interventions become more accessible to the homeless and focus on damage control and improving their quality of life.