A new study at Bellevue Hospital in New York City has shed light on the life of a homeless alcoholic and found that they typically begin drinking as children. 100% of the patients enrolled in the study began drinking at a young age, becoming alcohol-dependent soon after.

“For people who have homes and jobs, it is difficult to imagine the level of despair these people experience day in and day out, or the all-consuming focus on getting the next drink that overrides even the most basic human survival instinct,” said study author Dr. Ryan McCormack of New York University School of Medicine.

McCormack, along with his team, interviewed 20 alcohol-dependent, homeless patients who had four or more annual visits to Bellevue Hospital’s emergency department for two consecutive years. Most end up in the ER because of public intoxication.

Of the 20 patients, 13 reported abuse in their childhood homes, 13 had alcoholic parents, 19 left home by age 18, one was married, and none of the patients had jobs. The three interviewees who were military veterans said that military life amplified their alcohol use.

All 20 patients cited their alcoholism as the primary reason for living on the street. According to the report, 11 had definitive psychiatric diagnoses in the mood, psychotic, or anxiety spectrums. Every patient had entered detoxification programs in the past.

The researchers added that within a year of being interviewed for the study, one quarter of the patients had died as a direct result of their alcoholism. Alcohol-attributed causes of death included liver or lung cancer, vehicular trauma, assault, and hypothermia, noted the report.

“As their capacity to envision a future diminishes, they increasingly lose motivation for personal recovery,” said McCormack. “An alcoholic is first a human being. We hypothesize that more accessible, lower-barrier, patient-centered interventions that support alcohol harm reduction and quality of life improvement can be translated into the emergency department setting and this population.”