Homelessness and Addiction: How Do They Relate?

Homelessness and Addiction

On any given night in January 2019, 567,715 people didn’t have a place to call home. According to HUD’s Annual Point-in-Time Count, that means 17 out of every 10,000 Americans are homeless. Unfortunately, homelessness and addiction often go together. 

For example, some studies show around 40% of the homeless population struggle with alcohol misuse. Furthermore, over 26% struggle with homelessness and drug misuse. Mental illness also affects homelessness and addiction more than the average American. 

While there are resources for the homeless population, it can be challenging to connect an individual with the right program. However, for people struggling with homelessness and addiction, it’s even more difficult. 

What are the Causes of Homelessness?

The country’s economy directly affects the rates of homelessness. However, individual factors such as lifestyle, physical, and mental health play a significant role in being homeless. According to the National Alliance to End Homelessness, critical factors in homelessness in the U.S. include the following.

Housing is Out of Reach

Substance Use Disorder

In the 1970s, there was plenty of affordable housing. So, if an emergency or crisis caused the need for new housing, it was easy to find. However, in the 1980s, affordable housing became harder to find. 

Now, rent prices keep rising, but the minimum wage is not. As a result, over 8 million households pay over half their income toward housing. Without more affordable options and assistance, many people face evictions and homelessness. 

Health Problems and Homelessness

There are inextricable links between health issues and homelessness. While health problems can lead to homelessness, homelessness can exacerbate health issues. According to HUD, those living in shelters are twice as likely to have a disability than the general public. 

When a person’s health becomes disabling, it can be difficult to maintain housing. This results in homelessness and a deeper struggle for assistance. Furthermore, diabetes, heart disease, and HIV/AIDS can be up to six times higher in the homeless population. 

Domestic Violence

In America, domestic violence is, unfortunately, a prevalent problem. As many as 1 in 4 women and 1 in 9 men are survivors of domestic violence. That equals about 10 million people every year living in abusive situations. 

Many of these survivors lack the financial support to escape their situation. Therefore they turn to homeless programs to find safety. In 2019, homeless shelters and programs provided over 48,000 beds each night to survivors of domestic violence.

What Challenges Do Homeless People Face?

The challenges people face when they are homeless include food insecurity, lack of sleep, and an unkempt appearance. But, they also may face violence, ridicule, and legal issues. Frequently these challenges become overwhelming, and people turn to drugs or alcohol to cope. 

Combining homelessness and addiction further complicates the problem. Getting off the streets often starts with stable housing. And, homeless shelters are typically the first step in stable housing. 

However, many homeless shelters and programs have a no-drug policy. So for people who struggle with homelessness and drug misuse often have nowhere to turn. But, if treatment for substance use disorder was easily attainable, then many homeless people could gain access to these programs.

Does Substance Misuse Cause Homelessness?

Homelessness and Addiction

There is a stigma surrounding the homeless population that they all struggle with drug and alcohol misuse. While substance misuse often leads to homelessness, it’s a chronic disease that requires support and treatment. 

Yes, substance misuse is often a cause of homelessness. Drug and alcohol misuse often leads to job loss and relationship issues. And people already struggling to pay bills may turn to using more alcohol or drugs. This typically results in becoming homeless. 

A survey by the United States Conference of Mayors asked mayors in 25 cities the top three reasons for homelessness. Sixty-eight percent of mayors said substance misuse is the number one cause of homelessness. Furthermore, two-thirds of homeless individuals say drugs and alcohol are the cause of being homeless.

Do the Causes of Homelessness Lead to Substance Use Disorder? 

Although misusing drugs and alcohol can lead to being homeless, homelessness often leads to substance use disorder. Homelessness and drug misuse are common as people seek to escape their situation. But, using drugs and alcohol only worsens their situation by making it harder to find a job and get off the streets.

Mental Illness, Homelessness, and Drug Misuse

Tragically, 25% or 140,000 homeless people have a serious mental illness. Additionally, 45% or 250,000 struggle with a mental illness. In comparison, only 4.2% of U.S. adults are diagnosed with a serious mental illness. 

Like addiction, mental illness is another cause of homelessness. Homelessness and drug misuse often occur in people struggling with:

A mental illness may cause cognitive and behavioral issues, making it difficult to maintain employment and stable housing. Many people struggling with mental illness and homelessness are at an increased risk of developing substance use disorder. 

Homelessness and Drug Misuse is a Public Health Issue

Unfortunately, the homeless population is often looked down upon. The stigmas about homeless people include they are lazy and misuse drugs and alcohol. Although it is not always true, the problem of homelessness and addiction is often ignored.

Being homeless is rough. People are exposed to extreme hot and cold temperatures. They also likely live in unsanitary environments. Along with lack of basic necessities, and the prevalence of substance misuse, the health effects can be severe.

When it comes to homelessness and addiction in women, the public health issue is more pronounced. Homeless women have more unexpected pregnancies than the general population due to a lack of access to contraception. Homeless women also have less access to prenatal care. And since many homeless women misuse drugs or alcohol, they are in greater need of this care. However, these women have very few avenues for help.

The Challenges of Homelessness and Addiction Treatment

Substance Misuse

It’s possible to treat homelessness and addiction successfully. Yet, the barriers to treatment need to be removed. Homeless people have a challenging enough time meeting their daily needs, let alone finding ways to seek treatment.

Finding things like shelter and food are more important than seeking treatment for drug or alcohol misuse. Furthermore, the homeless population is generally not connected to their families anymore. Without the support of loved ones, it’s harder to seek and maintain recovery.

For example, most homeless individuals lack transportation. And public transportation costs money they don’t have. So providing transportation to meetings and treatment centers or giving vouchers for public transit is one way for cities to help end homelessness and drug misuse.

Other barriers to homelessness in addiction treatment include:

  • Lack of financial resources
  • Lack of health insurance
  • The stigma around mental health and addiction treatment
  • Lack of transportation
  • Lack of awareness about resources
  • Distrust of authority
  • Social isolation

Often, when a homeless person does seek help, they struggle to comply with treatment protocols. Their actions and inactions result in poor attendance and high dropout rates. 

Addressing Housing Issues in Homelessness and Addiction Treatment

Increasing the number of homeless individuals entering treatment requires facilities to address the housing needs. These housing needs include immediate housing to long-term housing solutions. Furthermore, social and community services involvement in homelessness and drug misuse treatment increase the chances of getting people off the street. 

The Importance of Access to Resources for Homeless People

The average lifespan of a homeless individual is 42 to 52 years old. They are more likely to become ill and be hospitalized. Additionally, homeless children are typically much sicker and struggle with academic as well as behavioral issues. 

Many church groups, charitable organizations, and volunteers are out on the streets teaching people about resources that can help. As more people know about the resources to combat homelessness and addiction, the more people seek recovery and build a better life.

Access to Comprehensive Support is Key to Ending Homelessness and Addiction

There is always more to substance use disorder treatment than just stopping the misuse of drugs or alcohol. However, when treating homelessness and drug misuse, there is more to overcome than the typical person. A comprehensive approach to treating homelessness and addiction must include the following. 

Recovery Supportive Housing

A stable and healthy living environment is crucial to recovery. It’s nearly impossible for a person struggling with drug or alcohol addiction to stay clean living on the streets. 

Client-Centered Services 

Many homeless people struggling with substance use disorder also have co-occurring mental health disorders. For this reason, dual diagnosis treatment centers are the most successful because they also address the underlying causes of addiction and mental illness.

Holistic Therapies

Living on the streets and trying to survive not only takes a toll on a person mentally and physically but spiritually as well. Holistic therapies can help people build self-worth and self-love while building confidence to maintain lasting recovery.

Job Re-entry Programs 

Job re-entry programs can help build the skills needed to re-enter the workforce. These programs also work with people to find employment which will encourage lasting recovery and self-worth.

Medication Management

Medication management is important because many people struggling with homelessness and drug misuse are also struggling with co-occurring disorders. Many times medication is needed to treat these disorders. To avoid misusing or selling medications, facilities may monitor their use.

Affordable Treatment

People working 40 plus hours a week may find it hard to afford treatment. So imagine how discouraging it is for a person who can’t even buy a meal. Offering scholarships and connecting with charitable organizations can help cover the cost of addiction treatment.

Get Comprehensive Treatment at Sana Lake Recovery

Are you or someone you love struggling with homelessness and addiction? It can be extremely difficult to ask for help, especially when battling homelessness. But, our caring and compassionate peer support staff and therapists are waiting to welcome you in. Contact us today and get started on the road to recovery. 

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Article Reviewed by David Sherman, MD

David Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.