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Homelessness and Substance Use Disorder

homeless boy holding a cardboard house

On a single night in 2018, approximately 552,830 people were identified as homeless in the United States, according to the U.S. Conference of Mayors’ Report on Hunger and Homelessness. A large percentage of these individuals also struggled with drug or alcohol use.

The U.S Conference of Mayors asked 25 mayors to name the main reason for homelessness in their city, and 68 percent said it was due to substance use. When the homeless themselves were interviewed, two-thirds responded that a problem with drugs, alcohol, or both was the reason for their homelessness. Surveys of homeless veterans report similar findings.

Experts agree that the homeless experience much higher rates of alcohol and substance use disorders than those with housing stability. Sometimes homelessness precedes a substance use problem, and sometimes the substance use disorder occurs first. Having both issues makes it difficult for the homeless to find stable housing or to seek treatment and recovery.

According to the National Coalition for the Homeless, mental illness is often an underlying cause of addiction and frequently contributes to homelessness.

What Does it Mean to be Homeless?

For many, homelessness is a temporary situation. The U.S. Department of Housing and Urban Development (HUD) defines a homeless person as one who “lacks a fixed, regular, and adequate night-time residence.”

Homelessness may mean:

  • Living on the streets, in cars or in an abandoned building
  • Staying in an emergency shelter or transitional housing
  • Living temporarily with friends or family

Why are the Homeless at Risk for Substance Use Disorder?

Trauma and Violence

Multiple studies have confirmed the relationship between trauma and substance use disorders. A study by the National Center on Family Homelessness also identified a strong correlation between homelessness and the trauma resulting from childhood sexual or physical abuse, domestic violence, and other traumatic events, especially for women.

Trauma and violence can also result from living on the streets, as the homeless try to find food, feel safe, find protection from the elements, fight physical or mental issues and experience the stigma often attached to homelessness. These issues may trigger the use of drugs or alcohol in an attempt to self-medicate.

Mental Illness

“Half of the mentally ill homeless population in the United States also suffers from substance abuse and dependence,” according to the National Coalition for the Homeless. Of that number, about 25 percent suffer from schizophrenia.

Not only do the mentally ill homeless have an increased risk for a substance use disorder, but they are also more likely to have adverse physical health conditions. Physical illnesses can result from a lack of hygiene, lack of proper nutrition, exposure to communicable diseases and exposure to blood-borne pathogens like Hepatitis B and C, and HIV.

The mentally ill homeless are less likely to be able to care for themselves or others, to obtain or keep a job, and to maintain healthy relationships. Mental illness, coupled with the stress of homelessness, makes it extremely difficult for those with a substance use disorder to achieve recovery.

Only about 25 percent of the homeless who have a substance use disorder receive treatment. To recover, this population needs a stable living environment, treatment of co-occurring disorders, a way to meet survival and social needs, supervised detox, counseling, and support. Providing these services can be far less expensive, and more compassionate, than paying for incarceration, emergency department visits, psychiatric hospitalization and other costs incurred when the homeless are left to fend for themselves.

Turning Point of Tampa has been offering Licensed Residential Treatment for Addiction, Eating Disorders and Dual Diagnosis in Tampa since 1987. If you need help or know someone who does, please contact our admissions department at 813-882-3003, 800-397-3006 or admissions@tpoftampa.com.