Female-specific trends and treatment needs for substance use disorder among homeless and at-risk females

Background: Homelessness is a multifaceted issue often complicated by high rates of substance use disorder (SUD). While the prevalence of SUD among homeless individuals is well-established, research specifically addressing female-specific trends and treatment needs within this population remains limited. This study seeks to bridge this gap by analysing national-level data on SUD treatment admissions for females experiencing homelessness or at risk of homelessness in Ireland between 2004 and 2022.

Methods: Annual data from Ireland's National Drug Treatment Reporting System (NDTRS) were used to assess the characteristics and treatment patterns of female cases seeking SUD treatment among the homeless and at-risk population. Temporal changes along with socioeconomic and clinical factors were comprehensively described.

Results: Of the 302,896 SUD treatment cases recorded over the nineteen-year period, 2.9% [n=8,756] were females who met the inclusion criteria.  The findings revealed a significant increase in female admissions. Over the period, the proportion of females who were homeless increased by 288.1%; the proportion of females at risk increased by 164.3%.   Lower educational attainment and unemployment were common. Younger age (mean=33 years) and history of previous addiction treatment were prevalent. Overall, opioids were the most common primary substance (46.7%), followed by alcohol (31.8%), although there were differences by homeless status, with higher rates of opioids among homeless females and higher rates of alcohol among females at-risk of homelessness. 

Conclusion: This study provides valuable insights into the female-specific trends and treatment needs for SUD among homeless and at-risk individuals in Ireland. The findings underscore the importance of addressing the underlying socioeconomic factors associated with SUD and developing tailored treatment interventions that consider the unique needs of female homeless populations.