Background: Alcohol use disorders (AUDs) are more prevalent among people who are homeless than in the general population. Thus, homeless individuals experience disproportionately high levels of alcohol-related problems and associated publicly funded criminal justice and healthcare system utilization. Available treatment services, however, are not effective at engaging and treating this population. To better tailor treatment services to their needs, it is imperative we understand this population’s perceptions of their alcohol use. Objectives: The aim of this study was to provide description and relative rankings of the advantages and disadvantages of alcohol use from this population’s perspectives. Methods: Participants were 44 individuals with lived experiences of AUDs and homelessness who received services at community-based agencies in Seattle, Washington. Open-ended prompts were used in interviews conducted in 2013–2014 to assess the perceived role of alcohol in participants’ lives, including participants’ perceptions of the advantages and disadvantages of their current drinking, and a conventional content analysis was conducted. Results: The most frequently mentioned advantages of drinking included positively and negatively reinforcing psychological reasons, perceived control over drinking, and social benefits. Physical effects, concerns about dependence on alcohol, and health problems were the most commonly mentioned disadvantages. Conclusions/importance: By documenting the perceived advantages and disadvantages of drinking among people with the lived experience of homelessness and AUDs, this study supplies information providers may use to better tailor treatment services to this multimorbid, high service-utilizing population’s needs and interests.

Susan E. Collins, Emily Taylor, Connor Jones, Laura Haelsig, Véronique S. Grazioli, Jessica L. Mackelprang, Jessica Holttum, Molly Koker, Alyssa Hatsukami, Madeline Baker & Seema L. Clifasefi
Substance Use & Misuse, Volume 53, 2018 – Issue 1