The Complex Association between Homelessness and Addiction That Will Make You Think
A prevalent belief by people thinking about why individuals experience homelessness is that many individuals are battling addiction. In reality, numerous factors contribute to individuals becoming homeless. However, many people experiencing homelessness do also have problems with substance abuse.
Substance abuse is often a result of homelessness rather than a cause of it, but addiction can contribute to someone becoming homeless. When considering the connection between addiction and homelessness, it is important to view addiction as an illness requiring treatment and support to overcome. Addiction treatment should be a central component of programs designed to reduce homelessness.
Understanding the Relationship between Homelessness and Addiction
Because of obstacles in accurately surveying people experiencing homelessness, the prevalence of addiction in this population is only an estimate. Approximately two in five individuals experiencing homelessness have a dependence on alcohol, and about one in four abuse other drugs. Researchers have found substance abuse is more common among people experiencing homelessness than in the general population. Studies indicate alcohol abuse is more common among older generations, while drug use more frequently affects young people experiencing homelessness.
Many factors can lead to homelessness, but addiction often strains relationships with family members and friends. This can restrict the safety net for individuals to rely on when challenges arise. Substance abuse can also lead to job instability, which makes it impossible to cover the costs of housing. Historically, substance abuse has been listed among the top three causes of homelessness in cities across the country.
Conversely, the stress of homelessness can lead to substance abuse. Substances become a crutch for dealing with stress, and the ultimate dependence makes it more difficult to overcome homelessness and reestablish stability. Breaking an addiction is difficult even under the best circumstances, but can be nearly impossible for people experiencing homelessness, many of whom prioritize finding shelter and food above seeking counseling.
Creating Programs to Effectively Address Substance Abuse
Many programs designed to reduce homelessness do not provide appropriate or effective strategies for dealing with addiction. Program developers need to understand the environment in which people experiencing homelessness live. These individuals have often become estranged from friends and family. As a result, their primary social support comes from other people experiencing homelessness.
Substance abuse can be widespread in homeless communities, making it difficult to maintain sobriety, especially when recovery programs do not emphasize the development of coping skills. Frequently, treatment programs designed as part of a larger strategy to reduce homelessness focus on abstinence only. This leaves individuals ill-equipped to deal with relapse.
A more realistic approach to addiction treatment focuses on harm-reduction strategies. Such strategies help individuals develop a wide range of skills to deal with the stress of homelessness. In addition, this approach provides tools for individuals to use in the event of relapse.
Treatment programs also need to address the overlap between substance use and mental illness. People with untreated or undiagnosed mental illnesses may use drugs or alcohol as a form of self-medication. These individuals need help addressing their mental illness before they can address their substance abuse. Often, programs for mental illness or addiction are not designed for people who have both issues. This makes it difficult for these people to find help.
Thinking about Homelessness and Addiction from a Policy Perspective
The largest issue concerning the link between addiction and homelessness from a policy perspective is access. Each year, millions of people who need addiction treatment services do not connect with programs to help them. Some of the major barriers preventing people from connecting to care are lack of financial resources and lack of insurance.
Both of these barriers are relevant to people experiencing homelessness since many of them do not have health insurance or the ability to pay. Programs that do not require insurance can have long wait lists. Furthermore, individuals often need transportation and documentation to make use of these services.
Many federal substance abuse treatment programs are not designed to treat people experiencing homelessness, who become enmeshed in the justice system due to their substance use. However, research shows treatment and prevention are more effective uses of resources than punishment. For that reason, policy needs to be reshaped to connect people to services when they have minor infractions rather than placing them in correctional facilities.
In the case of people experiencing homelessness, these programs should focus on the unique needs of the population, such as access to housing and healthcare, as well as education and employment. Supportive housing programs often integrate peer support, life skills training and intensive casework.
