Substance Misuse and Related Infectious Diseases in a Soup Kitchen Population

Representative samples of female (N = 119) and male (N = 100) guests were selected at two inner city soup kitchens. In the preceding month, 75% used cocaine/crack and 25% used heroin/opiates as determined by hair analysis. Relatively few guests (25%) were in substance dependency treatment. Infectious disease rates were: HIV (16%), hepatitis B exposure (21%), hepatitis B carrier (6%), syphilis exposure (15%). Years of injecting drug use and homelessness/marginal housing were associated with HIV infection and hepatitis B exposure. Soup kitchens should be prime locations for outreach to cocaine/crack and heroin users in need of treatment, medical care, and interventions to prevent infectious disease transmission.

[1]  R. Beasley Hepatitis B virus. The major etiology of hepatocellular carcinoma , 1988, Cancer.

[2]  Guidelines for prevention of transmission of human immunodeficiency virus and hepatitis B virus to health-care and public-safety workers. , 1989, MMWR supplements.

[3]  D. Lipton,et al.  The validity of hair analysis for detecting cocaine and heroin use among addicts. , 1992, The International journal of the addictions.

[4]  O Suzuki,et al.  Detection of methamphetamine and amphetamine in a single human hair by gas chromatography/chemical ionization mass spectrometry. , 1984, Journal of forensic sciences.

[5]  S. Friedman,et al.  HIV infection among intravenous drug users: epidemiology and risk reduction. , 1987, AIDS.

[6]  K. Püschel,et al.  Opiate levels in hair. , 1983, Forensic science international.

[7]  S. Acorn Mental and physical health of homeless persons who use emergency shelters in Vancouver. , 1993, Hospital & community psychiatry.

[8]  D. Chatel,et al.  Substance misuse, emotional disturbance, and dual diagnosis in a meal-line population of mixed ethnicity. , 1992, The International journal of the addictions.

[9]  A. Detsky,et al.  Costs and cost-effectiveness of a universal, school-based hepatitis B vaccination program. , 1998, American journal of public health.

[10]  M Beardsley,et al.  Declining seroprevalence in a very large HIV epidemic: injecting drug users in New York City, 1991 to 1996. , 1998, American journal of public health.

[11]  E. Dunlap Women and Crack-Cocaine , 1993 .

[12]  S. Deren,et al.  HIV serostatus and risk behaviors in a multisite sample of drug users. , 1998, Journal of psychoactive drugs.

[13]  R. Iachan,et al.  Drug Use and Homelessness , 1999 .

[14]  P. Leaf,et al.  Homelessness and drug abuse in New Haven. , 1992, Hospital & community psychiatry.

[15]  R. Fullilove,et al.  Risk of sexually transmitted disease among black adolescent crack users in Oakland and San Francisco, Calif. , 1990, JAMA.

[16]  P. Selwyn,et al.  Risk factors for human immunodeficiency virus infection in intravenous drug users. , 1989, The New England journal of medicine.

[17]  H. Lamb A Nation in Denial: The Truth about Homelessness , 1994 .

[18]  H. Klee,et al.  Factors associated with risk behaviour among injecting drug users. , 1990, AIDS care.

[19]  C. Word,et al.  Crack cocaine smoking and oral sores in three inner-city neighborhoods. , 1996, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[20]  J. Emparanza,et al.  Heterosexual transmission of hepatitis C virus and the possible role of coexistent human immunodeficiency virus infection in the index case: A multicentre study of 423 pairings , 1994, Journal of internal medicine.

[21]  E. Susser,et al.  Prevalence of HIV infection among psychiatric patients in a New York City men's shelter. , 1993, American journal of public health.

[22]  S. Read,et al.  Hepatitis B and human immunodeficiency virus infection in street youths in Toronto, Canada , 1991, The Pediatric infectious disease journal.

[23]  M. Alter,et al.  Hepatitis C, hepatitis B, and human immunodeficiency virus infections among non-intravenous drug-using patients attending clinics for sexually transmitted diseases. , 1994, The Journal of infectious diseases.

[24]  E. Susser,et al.  Sexual behavior of homeless mentally ill men at risk for HIV. , 1995, The American journal of psychiatry.

[25]  W. Compton,et al.  Effectiveness of HIV risk reduction initiatives among out-of-treatment non-injection drug users. , 1998, Journal of psychoactive drugs.

[26]  E. Nardell,et al.  Exogenous reinfection with tuberculosis in a shelter for the homeless. , 1986, The New England journal of medicine.

[27]  T. Johnson Alcohol and drug use among displaced persons: an overview. , 1996, Substance use & misuse.

[28]  C. Antunes,et al.  HIV risk behavior and medical status of underprivileged youths in Belo Horizonte, Brazil. , 1994, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[29]  N. El-Bassel,et al.  Drug use and AIDS risks in a soup kitchen population. , 1992, Social work.

[30]  D. Schnell,et al.  Behaviors of Crack Cocaine Users and Their Impact on Early Syphilis Intervention , 1992, Sexually transmitted diseases.

[31]  R. H. Liu,et al.  Detection of cocaine metabolite in perspiration stain, menstrual bloodstain, and hair. , 1986, Journal of forensic sciences.

[32]  S. Magura,et al.  HIV risk among women injecting drug users who are in jail. , 1993, Addiction.

[33]  S. Semaan,et al.  At risk for HIV infection: incarcerated women in a county jail in Philadelphia. , 1997, Women & health.

[34]  J. Feldman,et al.  Sexually transmitted diseases, sexual behavior, and cocaine use in inner-city women. , 1994, American journal of epidemiology.

[35]  W. Loxley,et al.  The Australian Study of HIV and Injecting Drug Use. Part I: prevalence for HIV, hepatitis B and hepatitis C among injecting drug users in four Australian cities. , 1997, Drug and alcohol review.

[36]  M R Moeller,et al.  Drug detection in hair by chromatographic procedures. , 1992, Journal of chromatography.

[37]  A. Fauci,et al.  The association of syphilis with risk of human immunodeficiency virus infection in patients attending sexually transmitted disease clinics. , 1990, Archives of internal medicine.

[38]  E L Struening,et al.  Psychiatric problems in homeless men. Lifetime psychosis, substance use, and current distress in new arrivals at New York City shelters. , 1989, Archives of general psychiatry.

[39]  J. Inciardi,et al.  Drug use and street crime in Miami: an (almost) twenty-year retrospective. , 1998, Substance use & misuse.

[40]  C. Leukefeld,et al.  Treatment of cocaine abusers: issues and perspectives. , 1993, NIDA research monograph.

[41]  J. Wasserheit,et al.  Epidemiological Synergy: Interrelationships between Human Immunodeficiency Virus Infection and Other Sexually Transmitted Diseases , 1992, Sexually transmitted diseases.

[42]  P. Arnaud,et al.  Se, Zn, Mg, Ca, K, cholesterol, and creatine kinase concentrations in men during the 12 days after an acute myocardial infarction. , 1987, Clinical chemistry.

[43]  Alter Mj,et al.  The epidemiology of viral hepatitis in the United States. , 1994 .

[44]  S. Deren,et al.  Risk factors for human immunodeficiency virus seroconversion among out-of-treatment drug injectors in high and low seroprevalence cities. The National AIDS Research Consortium. , 1995, American journal of epidemiology.

[45]  G. Krueger,et al.  Codeine disposition in human hair after single and multiple doses , 1996, European Journal of Clinical Pharmacology.

[46]  D. D. Des Jarlais,et al.  Tuberculosis in drug users. , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[47]  E. Alderman,et al.  Are there risk factors for hepatitis B infection in inner-city adolescents that justify prevaccination screening? , 1996, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[48]  I. Onorato,et al.  HIV infection among non‐injecting drug users entering drug treatment, United States, 1989–1992 , 1994 .

[49]  D. D. Cardoso,et al.  Prevalence and risk factors for HBV infection among street youth in central Brazil. , 1994, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[50]  E. Cone,et al.  Testing human hair for drugs of abuse. II. Identification of unique cocaine metabolites in hair of drug abusers and evaluation of decontamination procedures. , 1991, Journal of analytical toxicology.

[51]  S Magura,et al.  Validity of self-reported drug use in high risk populations: a meta-analytical review. , 1996, Substance use & misuse.

[52]  S. Magura,et al.  Measuring Cocaine Use by Hair Analysis among Criminally-Involved Youth , 1995 .

[53]  A. Zolopa,et al.  HIV and tuberculosis infection in San Francisco's homeless adults. Prevalence and risk factors in a representative sample. , 1994, JAMA.

[54]  J. Wiley,et al.  Substance abuse and the course of welfare dependency. , 1998, American journal of public health.

[55]  I. Ishiyama,et al.  Detection of basic drugs (methamphetamine, antidepressants, and nicotine) from human hair. , 1983, Journal of forensic sciences.

[56]  M. E. Marsden,et al.  Drug Use In Metropolitan America , 1999 .

[57]  P. J. Fischer,et al.  The epidemiology of alcohol, drug, and mental disorders among homeless persons. , 1991, The American psychologist.

[58]  E. Cone,et al.  Testing human hair for drugs of abuse. I. Individual dose and time profiles of morphine and codeine in plasma, saliva, urine, and beard compared to drug-induced effects on pupils and behavior. , 1990, Journal of analytical toxicology.

[59]  W. Loxley,et al.  The Australian study of HIV and injecting Drug Use. Part II: predicting exposure to hepatitis C and hepatitis B. , 1997, Drug and alcohol review.

[60]  A. Franceschin,et al.  Detection of morphine in hair with the Abbott TDX. , 1987, Clinical chemistry.

[61]  Bruce G. Link,et al.  HIV infection risks among homeless, mentally ill, chemical misusing men. , 1998, Substance use & misuse.

[62]  M. Chiasson,et al.  Heterosexual transmission of HIV-1 associated with the use of smokable freebase cocaine (crack). , 1991, AIDS.

[63]  Karen Brudney,et al.  Resurgent Tuberculosis in New York City: Human Immunodeficiency Virus, Homelessness, and the Decline of Tuberculosis Control Programs , 1991, The American review of respiratory disease.

[64]  A. Washton,et al.  Outpatient treatment of cocaine and crack addiction: a clinical perspective. , 1993, NIDA research monograph.

[65]  J. Devine,et al.  Losing the housing game. The leveling effects of substance abuse. , 1997, American Journal of Orthopsychiatry.

[66]  J. Feldman,et al.  The Relationship of Cocaine Use and Human Immunodeficiency Virus Serostatus to Incident Sexually Transmitted Diseases Among Women , 1998, Sexually transmitted diseases.

[67]  T. Brennan,et al.  Causes of Death in Homeless Adults in Boston , 1997, Annals of Internal Medicine.

[68]  D. Chan,et al.  Hepatitis B and hepatitis C in emergency department patients. , 1992, The New England journal of medicine.

[69]  M. Alter,et al.  The epidemiology of viral hepatitis in the United States. , 1994, Gastroenterology clinics of North America.