Emmalee Laing and John Slack, a couple who began receiving buprenorphine injections through the new protocol about six months ago, say their fentanyl use is about a quarter of what it used to be. On a recent Wednesday, Martinez-Perez was at Fred Hutchinson Cancer Center to receive her first radiation treatment for carcinoma, a diagnosis she received in 2018 that has since metastasized into stage four cancer. The nonprofit helped more than 120 people start the medication using the new technique during a pilot period last year. In 2023, the Food and Drug Administration approved a low-dose version of injectable buprenorphine; Washington state made it available to publicly insured residents in 2024. But in practice, it wasn’t much easier to get on than the higher dose injection; the medication’s instructions still suggested patients transition to the drug by using oral buprenorphine first. Martinez-Perez was told to take oral medication four times a day in gradually larger doses for several days.
But each agreed that homelessness and addiction aren’t as directly linked as Wells suggested. I reviewed several studies and surveys, most of them national, and talked with national experts on homelessness to dig into Wells’ claim. When we look at studies examining why people become homeless the data once again points to different causes than you might’ve read on NextDoor or Facebook. Laing started delivering takeout for Uber Eats using a scooter, which is a big deal, she said, since it’s the first time she’s cared about getting a job.
Project 25, a program led by Father Joe’s Villages, housed about three dozen homeless people who were frequent users of emergency services. Living on the street or in precarious housing can also make someone susceptible to turning are most homeless drug addicts to drugs or alcohol to cope with the stress or self-medicate a health problem. But in many cases, drug abuse or addiction happens before a person becomes homeless. Unfortunately, substance abusers who are also homeless may not know where to turn for help.
- MAT helps reduce withdrawal symptoms and cravings, enabling individuals to engage more fully in recovery activities and decrease their risk of relapse.
- That’s why the mobile triage center was placed on 6th Street–with the intention of processing drug users and offering treatment.
- The county’s 2017 point-in-time count of homelessness included a survey of homeless people, and about 36 percent acknowledged a substance-abuse problem.
- Interventions that integrate housing stability with addiction treatment are effective in disrupting this cycle.
- Multiple studies and surveys consistently show a strong correlation between homelessness and substance use disorders (SUDs).
- When drugs are much easier to obtain on the street than mental health services, the result is a chronically homeless population with addiction and mental health issues.
How to Manage Stress Without Relying on Substances
It’s disheartening to think of the women who survived domestic violence, who are now fighting to survive on our streets. These are tough truths to digest, but once we do we’re able to see just how critical housing is in solving people’s homelessness. Withdrawals — the body’s painful, “worst-flu-of-your-life” response to quitting opioids — were for years part of the reason Martinez-Perez, Slack and Laing stayed addicted to fentanyl while they were living outside or in homeless shelters.
More than 770,000 people in the U.S. were experiencing homelessness on a single night in January 2024, an 18% increase from 2023, according to a report from the U.S. The report uses data from the 2023 California Statewide Study of People Experiencing Homelessness (CASPEH), which is a representative study of homeless adults conducted by BHHI. While Martinez-Perez was addicted to fentanyl, she was scared to show up to appointments with withdrawal symptoms and went nearly a year without visiting the doctor. Since she started receiving buprenorphine injections, she says, she hasn’t missed an appointment.
During January’s homelessness census, 14 percent of those surveyed reported struggling with substance abuse, and another 10 percent with alcohol addiction. The lion’s share of research and the experts I spoke with instead suggested somewhere between 25 percent and 40 percent of the nation’s homeless population is struggling with alcohol or drug addiction, or both. About 20% experienced a non-fatal overdose at least once in their lifetime, with 10% of people experiencing an overdose while they were homeless. The researchers suggested that targeted distribution strategies could improve access to the medication naloxone, which can reverse an opioid overdose. The method involves a three-day ramp-up, but it’s not as complicated as the current standard. Downtown Emergency Service Center providers use the smallest available dose of injectable buprenorphine on the first day, use a slightly larger dose on the second day and on day three, patients receive a full, monthly dose of the shot.
How Drugs and Alcohol Lead to Homelessness
Fourth, it is unknown how generalizable these findings are to veterans not enrolled in VA healthcare or other homeless adults who are not veterans, so further study with other samples is needed. However, these estimates were based on a sample collected over a decade ago and there is evidence that the psychiatric epidemiology of homeless adults has not remained static. One study that examined three different samples of homeless adults in St. Louis, Missouri in 1980, 1990, and 2000 reported that the prevalence of mood and substance use disorders among homeless adults has dramatically increased16.
Many individuals experiencing substance use disorders are at increased risk of losing their housing. Substance abuse, particularly involving alcohol and drugs like methamphetamine, cocaine, and opioids, can impair an individual’s ability to maintain employment and relationships. These challenges often result in job loss and strained personal connections, which diminish financial stability and housing security. Homeless people suffer from alcohol and drug addiction at a higher rate than those who have permanent residences.
- “That would be a nonstarter,” said Charissa Fotinos, Washington State Health Care Authority’s Medicaid and behavioral health medical director.
- “It’s not fair to mix these drug addicts who refuse service in with everyone else who is paying a ton of money to live here, who is raising their kids here, who’s driving around just trying not to live a stressed out life,” said Andres Wiken.
- Jessica graduated from the University of South Florida (USF) with an English degree and combines her writing expertise and passion for helping others to deliver reliable information to those impacted by addiction.
- Depending on the type of SUD, reviews of studies have reported that homeless adults can benefit from supervised consumption facilities, pharmaceutical interventions, or managed alcohol programs11.
- To prevent that, prescribers typically had patients take small doses, available in oral forms like pills, strips or films, to ramp up to the full shot.
The Connection Between Homelessness and Addiction
“It’s not fair to mix these drug addicts who refuse service in with everyone else who is paying a ton of money to live here, who is raising their kids here, who’s driving around just trying not to live a stressed out life,” said Andres Wiken. Two years after her arrest, starting in 2016, she became an addiction recovery coach where she’d been treated. Post-treatment, Marsh encouraged Mertz to apply to have drug felonies expunged from her record – then granted the request. Addiction Services Council, under Mertz, now manages the jail’s pod recovery program for both men and women who are inmates. McGuffey wrote letters to help Mertz regain her nursing license, and later, get into law school. Mertz has been successful, the sheriff said, because she is a tireless advocate for people in recovery, with a combination of “empathy but hard love.”
The study reported 60% of veterans in the supportive housing program had SUDs, and 54% of those with SUDs had both alcohol and drug use disorders. Veterans in the HUD-VASH program with both alcohol and drug use disorders had more extensive homeless histories and had more recent use of transitional housing or residential treatment than those with either alcohol or drug use disorder alone. Because of these challenges, there is little understanding of the different types of MHDs and SUDs among homeless populations. For example, SUDs encompass addiction to a broad array of different types of substances and different SUDs may be differentially predictive of outcomes. Greater understanding of specific disorders may inform development and deployment of appropriate interventions. Depending on the type of SUD, reviews of studies have reported that homeless adults can benefit from supervised consumption facilities, pharmaceutical interventions, or managed alcohol programs11.
Family Support as a Protective and Recovery Factor
If that person loses his job, he can easily run through his life savings in a matter of weeks. Among those who are homeless, substance abuse occurs in a large portion of the population. This is not making excuses for people—illicit drug use is notsomething we condone. And more than 12,000 people in King County areexperiencing their own personal crisis every night when they don’t have a placeto call home. Whether you’re ready to start treatment or just need additional information about accessing effective addiction care, our navigators can help you or you can click on any of the links below. The symptoms of severe mental illness can make it difficult or impossible to perform the activities that most of us take for granted, such as working, developing relationships, or maintaining a home.
By definition, anyone who does not have “a regular, adequate, and stable night-time residence” can be considered homeless. According to the National Alliance to End Homelessness, in 2020, more than 500,000 people in the U.S. were considered homeless on a nightly basis. Homeless individuals experience higher rates of substance abuse than those with homes. SAMHSA estimates about 38% of the homeless are alcohol dependent, while 26% abuse drugs.
Alcohol Use Disorder
Until policy changes are made and the depth of the problem is addressed, experts warn that very little will change. Multiple studies and surveys consistently show a strong correlation between homelessness and substance use disorders (SUDs). People lacking stable shelter often turn to drugs or alcohol as a coping mechanism for stress, trauma, or mental illness. At the same time, addiction can erode finances, relationships, and employment, pushing individuals closer to the brink of homelessness. This article explores key statistics, demographics, and treatment outcomes to provide a detailed picture of how substance abuse and homelessness overlap and reinforce each other. What was somewhat surprising was our finding that there were higher rates of SUD diagnoses among HUD-VASH veterans than homeless veterans.
Many programs for the homeless won’t accept people with a substance use disorder, and many treatment programs for addiction don’t treat co-occurring disorders. But treating both the addiction and the mental illness at the same time, each in the context of the other, is essential for successful recovery. A lack of insurance and transportation, along with long waiting lists, precludes many individuals from getting the help they need. These limitations notwithstanding, this study examines the rates of MHDs and SUDs of nearly 200,000 homeless veterans and 30,000 veterans in supported housing. Comorbid MHDs and SUDs were examined in detail by diagnosis type, and healthcare use by addiction to CNS stimulants and depressants.
Dozens of new patients are requesting it each month, the nonprofit’s officials say. Surprisingly, when they tried medication for opioid addiction, it was even worse. Taking it would shoot their bodies into a supercharged version of withdrawals as they adjusted off fentanyl. He recently posted video of his three-year-old daughter riding a scooter on her block in the Mission as she navigates her way past several drug users who are openly using drugs – likely fentanyl or meth. By March 2021 – after working in home health care for a few years and earning a second UC degree, this one in criminal justice and corrections – she’d landed at the top jobs at Addiction Services Council.
Stable housing combined with accessible, tailored treatment services creates a foundation for healthier, more stable lives. Studies across various regions highlight that substance use disorders are both a cause and a consequence of homelessness. For example, 38% of homeless individuals depend on alcohol, and 26% abuse other substances, while many began substance use before or after losing their homes. Inpatient rehabilitation provides a structured and supportive environment where individuals can focus exclusively on recovery. These programs typically include 24/7 medical care, individual and group therapy sessions, and holistic activities designed to promote physical, emotional, and mental well-being. Inpatient rehab is particularly beneficial for those with severe addictions or co-occurring disorders who require an intensive level of care.