Hobo, bum, tramp, vagrant – homeless people are called a variety of names. And a prevalent stereotype about them is that they are all drug addicts and alcoholics. Experts cannot agree whether addiction leads to homelessness or homeless people are at high risk of becoming addicts. One thing is clear, however. Addiction and homelessness are both critical problems that are interlinked. People living on the streets with addiction problems and co-occurring mental illness are some of the most vulnerable groups in society.
Substance use disorders disrupt relationships and lead to unemployment. With no source of income, spiraling bills, and unpaid rent or mortgage, addicts can end up losing their homes. A 2008 survey conducted in 25 American cities found that in single adults, addiction is the biggest reason for becoming homeless. A 2007 study by Didenko and Pankratz indicated that two-thirds of people living on the streets blamed alcohol and/or drugs for their homelessness. On the other hand, substance abuse is a well-known consequence of homelessness. It is not uncommon for homeless people to abuse alcohol and drugs to cope with the difficulties of life on the street.
It’s like trying to answer the age-old chicken and the egg question. It appears that drugs and alcohol are both the cause and result of homelessness. How big is the problem of addiction among the homeless? What can be done to help substance abusers who are sleeping rough? Read on to learn more.
For most people, homelessness is a temporary problem. Therefore, the size of the homeless population varies and the numbers only indicate a snapshot in time. Even the interpretation of the term homeless varies depending on the context. In general, the lack of a fixed, regular, safe, and adequate place to sleep at night is regarded as homelessness. Homeless people may find themselves in different types of sheltered and unsheltered circumstances:
Chronic homelessness is defined as being continuously without a home for more than one year or experiencing at least four episodes of rough sleeping in the preceding three years.
What are the effects of homelessness? Life on the streets is incredibly harsh. Homeless individuals are in danger of violence and abuse. They are at risk of a number of health conditions, such as cold injuries, nutritional deficiencies, skin diseases, mental illnesses, and substance abuse. The lack of social support and estrangement from friends and family makes breaking out of addictive behaviors especially difficult for homeless substance abusers.
Addiction frequently accompanies the loss of housing. Substance abuse is more common in homeless individuals compared to the general population. Surveys show that drug and alcohol abuse are major contributing factors for people becoming and remaining homeless.
The numbers are staggering. An estimated 2 million Americans experience homelessness every year. Here are some statistics that indicate the enormity of the problem:
America is the world’s richest and most powerful nation, yet homelessness continues to be a serious social problem in this country. What is the relationship between a lack of adequate housing and serious health problems such as substance abuse?
Not every homeless person becomes a drug addict. And not every substance abuser ends up on the street. So, what are the dynamics between addiction and homelessness? Is this co-dependent relationship affected by other factors?
Homeless individuals struggle with harsh living conditions, putting them at high risk of turning to alcohol and drugs as a coping mechanism. About 38 percent of individuals availing homeless services report current alcohol problems and 62 percent report problems with excessive drinking at some point in their lives. A study of homeless youth in Los Angeles found that more than 70 percent had problems with alcohol, drugs, or both.
People grappling with illicit drug abuse, prescription pill dependence, or alcoholism become entrenched in their addiction. In many cases, the resulting downward spiral of broken relationships and unemployment culminates in homelessness.
The problem is further complicated by the fact that in many homeless people, substance abuse co-occurs with mental illnesses. It is estimated that 25 to 33 percent of homeless individuals have a serious mental illness. Untreated mental health conditions can lead to inappropriate self-medication with prescription drugs. In addition, this group of people faces several obstacles in obtaining drug rehab and stable housing.
Homeless addicts frequently cycle between jails, streets, and emergency rooms with a discontinuity in medical care. Not all programs for the homeless accept individuals with substance abuse issues. And not all programs for substance abusers living on the streets are equipped to treat mental conditions.
Homelessness and addiction go hand-in-hand. For a substance abuser who is rough sleeping, it is difficult to break out of this vicious cycle. What puts drug addicts at risk of losing their homes? Why do alcoholics end up on the street?
Substance abuse and homelessness do not discriminate. Men and women of any age can fall prey to various illicit substances. This can trigger a series of events that leads to unemployment and loss of housing.
Illicit drugs and prescription pills obtained on the street do not come cheap. Depending on the severity of the addiction, the habit can cost a fortune. It is not unusual for hard-core heroin addicts to spend $200 a day feeding their habit. Many addicts begin spending a substantial portion of their income on drugs, leading to a shortage of money. Very soon, there is a mounting pile of unpaid bills and several months of skipped rent or mortgage payments.
An addiction does not go unnoticed in the workplace. As an addict sinks deeper and deeper into substance abuse, unfinished work starts to pile up and performance plummets. This becomes evident to coworkers and bosses. Addicts may also start missing work more often, and sooner or later, the excuses run out and the employer lets the person go.
The loss of a job can serve as a wake-up call to get back on track. Or the path of self-destruction can continue with the addict ending up on the streets.
It takes determination, courage, and willpower to overcome substance abuse, unemployment, and homelessness. Failures are inevitable along the way, but drug rehab for someone living in a dumpster is not an impossible dream.
Living on the streets is tough. The homeless are exposed to extreme temperatures and nonexistent sanitation. Inadequate clothing, poor nutrition, and lack of clean water take a toll on their health. Chronic diseases are common in this population. For this reason, individuals battling substance abuse while living on the streets require a number of different support services including specialized healthcare for the homeless.
Yet, there are many challenges to addiction treatment in the homeless. Families may not even be able to find a homeless person. If they do find them, it may take some convincing to get help, especially if the addiction is strong and/or complicated by mental illness.
Because the problem is so complex, a cookie-cutter approach does not work. Some of the approaches to treatment for drug addiction or alcoholism in homeless people include:
This approach offers information on 12-step meetings and other drug rehab resources at shelters in the hope that homeless addicts will get on the path to recovery.
These strict alcohol- and drug-free units are offered to individuals leaving the drug rehab system and offer shelter to recovering addicts until they get back on their feet and find a home.
Although centers offering free addiction treatment are not always the best equipped, they can help homeless addicts who have no money for drug rehabilitation.
These controversial programs try to make the best of the situation. The idea is to accept that there are no easy solutions and reduce harm as much as possible, for example, by offering sterile needles in exchange for dirty ones to reduce the risk of HIV and hepatitis.
With a little humility and a lot of hope and determination, homeless addicts can set positive goals and change the game. Taking care of their physical health and relying on peer support are important aids to recovery. Training in money management, education and employment opportunities, daily living skills, and rejoining the community are all services that can help make the process successful.
A holistic approach is the key to overcoming the problems of homelessness and addiction. Access to a stable living environment, addiction treatment from well-trained staff, integrated services to treat co-occurring mental health conditions, and a comprehensive support network to address the complex social and survival issues faced by homeless addicts can help get a substance abuser living on the streets to get on the road to recovery.