The Prevalence of Cocaine Use in Homeless Populations: A Systematic Review

Recent findings Cocaine use plays a large role in initiating and maintaining homelessness. Purpose of review The present review systematically studied the existing literature on prevalence of cocaine use, cocaine use problems, and cocaine use disorders in the lives of homeless populations. Summary A total of 57 articles with 55 unique studies were included in the review. Cocaine use was quite prevalent in these homeless samples, with around one-third of samples endorsing lifetime use and one-fourth endorsing past year use. Further, prevalence rates for cocaine use problems ranged from around one-fourth to more than one-third across different measurement periods. The median prevalence rate for lifetime cocaine use disorder across studies was 30%. Comparatively, cocaine and cannabis had similar popularity for use, but cocaine was the dominant drug in studies assessing problematic use and disorders. In general, cocaine appeared to be more prevalent in the USA than internationally. Although this literature had methodological inconsistencies limiting comparisons across studies, the findings suggest a major role of cocaine in the initiation and maintenance of homelessness. Further research is needed, especially studies providing prevalence data in multiple time frames, studies comparing prevalence across specific subgroups, and prospective studies.