Open Access Open Badges Research article

Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status

Michelle N Grinman12*, Shirley Chiu1, Donald A Redelmeier23, Wendy Levinson2, Alex Kiss4, George Tolomiczenko56, Laura Cowan7 and Stephen W Hwang12

Author Affiliations

1 Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada

2 Department of Medicine, University of Toronto, Toronto, Canada

3 Sunnybrook Health Sciences Centre, Institute for Clinical Evaluative Sciences, Toronto, Canada

4 Department of Research Design and Biostatistics, Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre, Toronto, Canada

5 Crohn's and Colitis Foundation of Canada, Toronto, Canada

6 Department of Psychiatry, University of Toronto, Toronto, Canada

7 Street Health Community Nursing Foundation, Toronto, Canada

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BMC Public Health 2010, 10:94  doi:10.1186/1471-2458-10-94

Published: 24 February 2010



Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status.


Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses.


Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2) but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3)).


Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.