Main Outcomes and Measures Projected outcomes included overdose mortality, serious injection–related infections and mortality related to serious injection–related infections, hospitalizations, initiations of medications for opioid use disorder, and life-years lived over a 10-year period for 2 scenarios: “no displacement” and “continual involuntary displacement.” The population-attributable fraction of continual displacement to mortality was estimated among this population. The model was populated with city-level data from the Centers for Disease Control and Prevention’s National HIV Behavioral Surveillance system and published data to make representative cohorts of people experiencing homelessness who inject drugs in those cities. Objective To estimate the long-term health effects of involuntary displacement of people experiencing homelessness who inject drugs in 23 US cities.ĭesign, Setting, and Participants A closed cohort microsimulation model that simulates the natural history of injection drug use and health outcomes among people experiencing homelessness who inject drugs in 23 US cities. Understanding the health implications of displacement (eg, “sweeps,” “clearings,” “cleanups”) is important, especially as they relate to key substance use disorder outcomes. Involuntary displacement is a common practice in responding to unsheltered people experiencing homelessness. More than 30% of people experiencing homelessness also have a substance use disorder. Importance At least 500 000 people in the US experience homelessness nightly.
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