The Opioid Epidemic In Veterans Who Were Homeless Or Unstably Housed

Health Aff (Millwood). 2019 Aug;38(8):1289-1297. doi: 10.1377/hlthaff.2019.00281.


Veterans who are homeless or unstably housed are at increased risk for opioid-related morbidity and mortality. However, there is a limited understanding of the scope of the opioid epidemic and gaps in care for these populations. We conducted a retrospective observational study to examine opioid use disorder (OUD) in a national sample of veterans who accessed specialized homeless programs in the Veterans Health Administration. Additionally, in a subgroup of veterans with a history of OUD, we examined several opioid-related measures: opioid dose, concomitant opioid-benzodiazepine prescribing, and receipt of medication for addiction treatment (MAT) and overdose prevention medication (naloxone). Rates of OUD history varied significantly across age, gender, and program type. Among the subgroup of homeless veterans with an OUD history, prescribing practices and rates of MAT and naloxone receipt varied significantly by age and specialized homeless program. Rates of receipt of MAT and naloxone were moderate and low, respectively, indicating opportunities for program-specific interventions.

Keywords: Veterans; homelessness; opioids.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Female
  • Housing
  • Humans
  • Ill-Housed Persons / psychology
  • Ill-Housed Persons / statistics & numerical data*
  • Male
  • Middle Aged
  • Opioid Epidemic* / statistics & numerical data
  • Opioid-Related Disorders / epidemiology
  • Retrospective Studies
  • United States / epidemiology
  • Veterans / psychology
  • Veterans / statistics & numerical data*
  • Veterans Health Services / statistics & numerical data