This process is closely monitored by healthcare professionals to ensure safety and comfort. Detoxification is often the critical first step in a comprehensive treatment plan, preparing individuals for long-term recovery by addressing the immediate physical effects of substance use. Unsheltered homeless populations are more likely to use substances than their sheltered peers, often a combination of alcohol, crack cocaine, heroin, and/or cannabis.

MAP clients experienced significantly fewer social, health, safety, and legal harms related to alcohol consumption 70. Individuals participating in MAPs demonstrated fewer hospital admissions and a 93% reduction in emergency service contacts 69. MAPs also promoted improved or stabilized mental health 69 and medication adherence 70. Relative to the general population, drug overdose mortality rates are more than ten times as high in samples of individuals experiencing homelessness across different US communities (Baggett et al., 2015; Fliss et al., 2022; Fine et al., 2022; Rowe et al., 2019; Scott et al., 2022).

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. “I think the municipality must give us an alternative place because we are all human beings and we have rights. And people must stop painting us with one brush that we are all criminals of which we are not.

To learn more about SAMHSA’s Center for Substance Abuse Treatment and their initiatives for individuals experiencing homelessness, visit the SAMHSA website. The transient nature of homelessness also makes it difficult to track and gather data on substance use patterns among this population. Homeless individuals may move between different locations or reside in temporary shelters, making it challenging to conduct comprehensive research and surveys. Despite these challenges, ongoing efforts are being made to better understand the correlation between substance use and homelessness through research and outreach programs. To learn more about the research conducted in this field, please refer to our article on substance use and homelessness research. According to the Research Triangle Institute in North Carolina, teens and young adults between the ages of 12 and 21 are at a far greater risk of drug abuse than those who are not homeless.

Selecting the Best Opiate Addiction Treatment Program

• MAT helps reduce withdrawal symptoms and cravings, enabling individuals to engage more fully in recovery activities and decrease their risk of relapse.
• The explanation included information about who was conducting the study, the voluntary nature of participation, the confidentiality of the data collected, and the option of stopping the interview at any time.
• Despite the substantial unmet care needs of this population, people struggling with both substance use and homelessness experience overlapping barriers to accessing care, including stigma related to care itself 9, and abstinence-based treatment first housing services 10,11.
• These include systemic poverty, economic inequality, and lack of affordable housing, which increase vulnerability to both homelessness and substance abuse.
• For example, unsheltered women in Los Angeles with recent substance use had much greater odds of poor mental health than sheltered women.
• Unemployment rates for each state each year were drawn from the US Bureau of Labor Statistics Local Area Unemployment Statistics program (US Bureau of Labor Statistics, 2023).

Public venues like libraries can serve as accessible places for outreach and intervention. By understanding and supporting these vulnerable groups with tailored interventions, communities can help break the cycle of homelessness and substance abuse. The goal is to provide safer pathways out of homelessness, emphasizing stability, health, and resilience. Substance abuse can significantly hinder their ability to escape homelessness, as addiction may interfere with their efforts to find stable housing, employment, and education.

• Childhood traumatic experiences, posttraumatic stress disorder and adult exposure to other traumatic experiences can also influence substance use 8.
• Through their initiatives, SAMHSA strives to improve access to vital services and supports, ultimately helping individuals experiencing homelessness to achieve better outcomes in their journey toward stability and recovery.
• Study findings add to literature at the individual level concluding that not only is preventing and addressing homelessness a priority in and of itself, but also a priority relevant in efforts to address overdose mortality.
• Additionally, mental health issues frequently co-occur with substance use and homelessness, further complicating recovery efforts.
• Finally, it is important to note limitations in the generalizability of our findings from the range of social and geographical settings reviewed.

Substance Abuse in Homeless Youth

This included three reviews on supervised consumption facilities, 24 on pharmacological interventions, and three on managed alcohol programs. Supervised consumption facilities decreased lethal overdoses and other high risk behaviours without any significant harm, and improved access to homeless drug use statistics care. Pharmaceutical interventions reduced mortality, morbidity, and substance use, but the impact on retention in treatment, mental illness and access to care was variable.

As a society, and as clinicians, we have to go far beyond simply viewing the drugs as the problem. By strengthening society’s safety net, so that we all have access to the basic human rights of food, shelter, and healthcare, we not only help those suffering from addiction, we help everyone else too. 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. Medication-Assisted Treatment (MAT) is a highly effective approach for managing opioid and alcohol addiction.

How to Develop Healthy Coping Mechanisms in Recovery

“There are humans behind those numbers, and their experience is not a statistic for them,” Holt said. “Every year, between 80 to 90% of people experiencing homelessness tell us that they became homeless right here in Oklahoma City or in the state of Oklahoma,” Holt said. Half of the event was devoted to a panel of Key to Home board members answering questions from the audience and offering their perspectives on the issues, while also addressing various misconceptions the public might have about Oklahoma City’s homeless population. Expectations concerning the future have been described as the extent to which the future is perceived as predictable, structured, and controllable 27. An individual’s perspective on the future reflects both long-term and immediate experiences, thoughts and feelings.

Data Availability Statement

According to a National Network for Youth study, nearly 1.7 million youths experience at least one night of homelessness yearly. As a result of their addiction, they might have lost their house because they could no longer pay their bills, or their partner or spouse might have thrown them out. 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.

View our editorial content guidelines to learn how we create helpful content with integrity and compassion. The SAMHSA website allows you to search for government-funded or free treatment centers offering detox, inpatient, and outpatient treatment. While some children, teens, and young adults are homeless because the rest of their family is homeless, many more become homeless for other reasons. Kids become homeless mainly because of family problems, economic problems, and abductions. Study limitations include a survey response rate of 65% and lack of information on gender identity and whether the adolescent was part of a homeless family or alone. Had 5 or more drinks (male) or 4 or more drinks (female) in a row within a couple of hours 1 or more times during the 30 days before the survey.

BHHI has been releasing a series of reports since 2023 on various aspects of homelessness, including pregnancy, aging and intimate partner violence. In recent years, cities around the world have seen extensive growth in unsheltered homelessness—or people sleeping in cars, parks, sidewalks, tents, abandoned buildings, or other makeshift shelters not meant for human habitation. In the United States, the number of people experiencing unsheltered homelessness increased by 28 percent between 2007 and 2015. Residents at the Durban CBD have started a campaign to remove homeless people and drug addicts from parks and other public areas.

Our working group deliberated the value of systematic reviews and evidence based guidelines on various addiction interventions, giving significant weight to the needs and opinions of persons with lived experience of homelessness. The working group agreed that focusing on safe consumption sites (of drugs and/or alcohol, i.e. SCFs and MAPs) and medications to manage opioid use disorder should be the priority. Research also indicates that programs offering stable housing combined with supportive services effectively reduce both homelessness and substance abuse. Approaches like Housing First, which provides permanent housing without preconditions, have shown promising results in improving health and social outcomes.

They often lack access to healthcare, mental health support, and educational opportunities, which are crucial for recovery and stability. Addressing these issues effectively involves trauma-informed care, harm reduction programs, and comprehensive services that focus on both mental health treatment and housing support. When it comes to the correlation between substance use and homelessness, the impact of substance abuse on individuals experiencing homelessness is significant. Substance abuse can exacerbate existing challenges and contribute to various health concerns, including mental health issues and chronic health conditions. To address these barriers, collaboration between government agencies, nonprofits, and healthcare providers is essential.

The positive association between state-level homelessness and drug overdose mortality suggests that policies and programs to prevent and reduce homelessness represent fundamental elements of a comprehensive response to the US overdose crisis. 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. Chronically unsheltered individuals are more likely to have lifetime mental illness—defined as either a history of psychiatric hospitalization or current mental health counseling or treatment—than individuals who are not chronically unsheltered. Chronically unsheltered adults are also more likely to have a dual diagnosis of mental illness and substance use than those who aren’t chronically unsheltered.

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These include systemic poverty, economic inequality, and lack of affordable housing, which increase vulnerability to both homelessness and substance abuse. Disparities in access to healthcare, education, and social services mean that many individuals do not receive the support needed to break free from these issues. Of the 30 included systematic reviews, 24 reviews which included 352 unique primary studies reported on pharmacological interventions for opioid use disorder 41–64. Two systematic reviews which included 90 unique observational studies and one qualitative meta-synthesis reported on supervised consumption facilities (SCFs) 65–67. One Cochrane review with no included studies 68 and two grey literature reviews reported on 51 studies of managed alcohol programs (MAPs) 69,70. Research has indicated that substance use rates among homeless youth are much higher compared to their non-homeless peers.

Clinically Reviewed By: Dana Hamilton, AMFT

Survey weights provided by the YRBS were applied to account for nonresponse and generate representative state-level estimates. Analyses were performed using Stata version 15 (StataCorp) and a 2-sided α level of .05. The US Centers for Disease Control and Prevention’s institutional review board approved the YRBS. Further institutional review board approval was not sought for the secondary analysis of these publicly available, deidentified data, as per institutional policy. Counting only those experiencing homelessness on one given day also limits the scope of the estimates (Fusaro et al., 2018), and state-level counts may be influenced by seasonal migration patterns (Almquist et al., 2020). Furthermore, although bound by HUD minimum standards, Point-in-Time counts in different jurisdictions include different methodologies (e.g., censuses, sampling strategies, and extrapolation) which may change over time (Schneider et al., 2016; Tsai and Alarcon, 2022).