The Relationship Between Homelessness and Addiction

relationship between homelessness and addictionHomelessness continues to be a significant problem in the US. Although the numbers had been trending down, in recent years they have been increasing again. A number of factors could contribute to a person becoming homeless. One of those factors is substance use. In addition, many people who find themselves homeless turn to drugs or alcohol as a result. So, the relationship between homelessness and addiction runs two ways.

Homelessness in the US

Over 500,000 people in the US are homeless on any given night. Approximately 65 percent are in homeless shelters, and the other 35 percent—just under 200,000—are unsheltered on the streets (in places such as sidewalks, parks, cars, or abandoned buildings). Homelessness almost always involves people facing desperate situations and extreme hardship. They must make choices among very limited options, often in the context of extreme duress, untreated mental illness, or substance abuse disorders.

The homeless include families and individuals. Of those individuals who are homeless, who make up about 67% of the homeless population in the US, over 260,000 are men and just over 106,000 are women.

Risk Factors

Severe mental illness, histories of incarceration, low incomes, weak social connections, as well as substance abuse problems each increase an individual’s risk of homelessness, and a higher level of occurrence in each of these factors may increase total homelessness. Of course, the vast majority of people with any of these issues is not homeless (even if all half a million homeless people faced all of these problems, there are millions of non-homeless Americans who face each problem as well).

Disproportionate Impact

The relationship between homelessness and substance abuse is complex, with studies suggesting that substance use can be both a cause and consequence of homelessness. Evidence indicates that substance abuse and overdose disproportionately impact homeless people.

A survey by the United States Conference of Mayors found that 68 percent of cities reported that substance abuse was the largest cause of homelessness for single adults. Substance abuse was also reported as one of the top three causes of family homelessness by 12 percent of cities.

In another study, 25 percent of homeless people surveyed, identified drug use as the primary reason for homelessness.

A study to determine the leading risk factors for homelessness among veterans indicated that substance abuse may have the highest impact on relative risk for homelessness in this population, even more so than bipolar disorder and schizophrenia. And a 2015 study of found that the prevalence of homelessness in veterans with opioid use disorder is 10 times more than the general veteran population.

A study in Boston showed that overdose has surpassed HIV as the leading cause of death among homeless adults and that opioids are responsible for more than 80 percent of these deaths. Homeless adults, 25-44, were nine times more likely to die from an overdose than their counterparts who were stably housed.

Homelessness and Addiction

Alcohol and drug problems can be causes and consequences of homelessness, as well as co-occurring problems that complicate efforts for individuals to find stable housing. Although studies vary, research consistently shows over a third of individuals who are homeless experience alcohol and drug problems and up to two-thirds have a lifetime history of an alcohol or drug disorder.

According to the 2018 homeless point-in-time count, 111,122 homeless people (20 percent) had a severe mental illness and 86,647 homeless people (16 percent) suffered from chronic substance abuse. In addition, mortality rates among homeless persons are more than three times that of persons with some type of housing.

The Need for Treatment

Homeless people with opioid-use disorder experience significant barriers to treatment. Obstacles include social isolation, lack of available transportation, a fragmented delivery system, and complex treatment needs including co-occurring conditions.

Research has shown that integrated treatment that incorporates housing and employment components provides better health outcomes than the usual care for people who are homeless. Studies do confirm that with increased clinical support and connections to homeless services, including housing, homeless patients are statistically as likely as stably housed patients to successfully complete treatment programs. 

Addiction Treatment for Men in Southern California

When you are ready to seek help for your addiction, we are ready to help. At PACE, we know that addiction is a serious disease that can impact your life in many ways. PACE Recovery Center is focused on helping men in southern California who struggle with addiction take that first step toward the journey of recovery. The professionals at PACE can help you find structure, purpose, and accountability as you overcome your addictive behaviors. Contact us to learn more about how we can help you.

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