For example, young adults who sold self-made items were more likely to use drugs infrequently, while those who reported dealing drugs as their primary source of income were more likely to be drug dependent. Previous research has suggested that economically disadvantaged groups who are also socially isolated, may experience physical threats and victimization 48. The living conditions of this group, compounded with the need for monetary and material resources, may lead to not only illegal activities such as selling drugs, but to violent actions as well 49. As a drug dependent lifestyle requires a constant infusion of money, heavy involvement in property crime and drug distribution is common.
The Benefits of Group Therapy for Addiction Recovery
For example, unsheltered women in Los Angeles with recent substance use had much greater odds of poor mental health than sheltered women. The authors found a consistent and strong association between unsheltered homelessness and high rates of chronic disease. For example, one study in Los Angeles found that unsheltered women had greater odds of being in fair or poor physical health and of having experienced pain in the last six months than sheltered homeless women. Another study conducted in Wales found that unsheltered individuals suffered from chronic conditions such as oral health diseases, orthopedic problems and arthritis, and vision impairment. As participants were interviewed face-to-face at the drop-in center where they received services, it is possible they answered questions in a manner they perceived as most desirable to the interviewer. In addition, the possibility of cultural bias may also be a factor as homeless young people have a unique culture which identifies with a street “language” and expressing themselves counter to traditional authority 38.
The role of journaling in addiction treatment
Chi-square and ANOVA tests were conducted to compare participants across the three groups in relation to demographic and independent predictor variables. Multinomial logistic regression (MLR) models were calculated to examine the impact of homeless drug use statistics social networks, economic resources and future expectancies in relation to youths’ use, abuse or dependency on alcohol or drugs. Multinomial logistic regression is an extension of binary logistic regression that allows the simultaneous comparison of more than one contrast 36, such as comparisons of street youth in three substance use categories (use, abuse and dependency). Analyses compared multiple groups through a combination of binary logistic regression using maximum-likelihood ratio estimation to predict the likelihood of being in specific categories (use or abuse) relative to the reference group (dependency). Effective intervention strategies often emphasize harm reduction, such as providing safe consumption settings and accessible treatment options, along with person-centered care that builds trust.
The headline of this story has been updated to reflect that Portland decriminalized fentanyl — meaning the drug remained illegal but the criminal justice system did not prosecute those who used it — but did not legalize it. Back at the coffee van in Old Town, a gaunt addict named Travis walks up and asks for detox. “I’m just done,” says the 43-year-old, “I can’t live like this anymore.” Tommy Richmond, a volunteer who credits a jail term with helping him get clean, starts making calls. The first two places are booked, but Recovery Works Northwest has a single bed available, and Mejia comes to drive them over. On the way, Richmond stays on the phone trying to arrange housing for the day Travis exits detox, so he doesn’t slip through the cracks. If he commits to outpatient treatment, he could be eligible for county funds that would cover his rent while he gets back on his feet.
What Are the Barriers to Treatment?
- Homelessness disproportionately impacts LGBTQ+ youth, who face discrimination and increased risks for mental and substance use disorders.
- “There are humans behind those numbers, and their experience is not a statistic for them,” Holt said.
- Today, there are just 785 on staff, with some entering retirement; another 150 officers are in training but it will take months before they are in service.
- 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.
Substance use disorder, along with PTSD, are two of the five most common mental health disorders impacting homeless veterans today, according to the U.S. Without the proper support, they are much more likely to end up on the street, which can worsen their substance abuse and other mental health conditions. Detox programs provide medical stabilization for individuals undergoing withdrawal from drugs or alcohol.
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Previous research has estimated that 39% to 70% of homeless youth abuse drugs or alcohol 2, 3. Substance use in this population has been reported as two to three times higher than that found among non-homeless young adults. In nationally representative samples, marijuana has been identified as the drug of choice for homeless youth 4, 5.
For example, the Los Angeles study found that unsheltered women were more likely to have used alcohol or non-injecting drugs in the past six months than their sheltered counterparts. Along the same lines, a study in Harris County, Texas, found that sheltered young adults were less likely than their unsheltered counterparts to have used alcohol, marijuana, or synthetic marijuana in the previous month. In conclusion, homeless status poses higher risks of substance use hospitalized patients than that of other hospitalized patients across all substance types, opioid, cocaine, marijuana, and heroin. The continuous trends of increase in substance use in all type of substances except cocaine are observed regardless of homeless status among hospitalized patients. Old homeless patients are more vulnerable to hard drugs including cocaine and heroin, compared to their younger counterparts.
As with housed individuals, certain demographics of homeless people suffer from addiction at a higher rate than others. The research on SDoH mirrors what I see clinically, in the inner-city clinic where I practice as a primary care clinician. A patient can be stable for years on buprenorphine or methadone (medications to manage cravings and help with recovery), but if they abruptly lose their housing due to no fault of their own, they can lose access to the organization and security in their lives. It becomes far more difficult for them to care for their families, to attend medical appointments or support groups, to fill prescriptions, or to practice any of the self-care that is so integral to maintaining oneself in recovery.
Substance Abuse in Homeless Youth
Initiatives like distributing Narcan (Naloxone), which can reverse opioid overdoses, and providing overdose education save lives and serve as entry points into treatment. These approaches recognize that harm reduction does not solely focus on abstinence but on minimizing health risks and engaging individuals in care. 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. Idle time, difficulty obtaining legal documents or employment, and social networks rooted in street culture contribute significantly to increased drug and alcohol use among the homeless. Research indicates that a large percentage of homeless youth misuse drugs or alcohol to numb emotional pain and daily stress.
But in another, critical sense, addiction does discriminate among people, in a way that is unjust and deadly, and in a way that shines a spotlight on tears in the socioeconomic web that is holding our society together. It has long been observed by clinicians that social determinants of health (SDoH) can tip the scales against people, in their already daunting quest to recover from any type of addiction. According to the World Health Organization, SDoH are defined as “the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels.” A common saying is that “addiction doesn’t discriminate,” which means that it can affect anyone from any sphere of life, ranging from coal miners and truck drivers to executives, doctors, and lawyers. I have personal experience with what an equal-opportunity destroyer of well-being and happiness addiction can be, as I am 14 years into recovery from a vicious addiction to prescription painkillers.
Homelessness is not the only risk factor for overdose mortality, nor is it likely among the largest contextual influences on state overdose rates. Nonetheless, the present study documented a positive association between state-level homelessness prevalence and drug overdose mortality rates in the US, 2007–2020, even after accounting for levels of unemployment and other differences between states and years. 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. Due to the disruption of family relationships and separation from social institutions (such as schools), homeless peers often become the primary social support network for homeless young adults 19, 20. Homeless young adults draw upon peer relationships to fulfill multiple needs including love, companionship and safety 7, 15.These peer relationships often provide an educational function to newly homeless youth regarding street survival 19.
Now, people living near the park say drugs are being sold there, while pedestrians are also being mugged. A panel of experts attempted to dispel these persistent myths about homelessness to an audience of 200 people during a recent Key to Home event in Oklahoma City’s northeast side. Discover the risks of mixing Latuda and alcohol addiction, and learn how to seek professional help. Discover how to overcome burnout after you’ve burnt out, from recognizing symptoms to strategies for recovery. Explore the connection between sleep and addiction, and how better sleep can support recovery. Discover how to transform your life by embracing healthy addiction habits and leading a healthier lifestyle.
What mechanisms or models explain the link between substance abuse and homelessness?
- As peers form “street families” that provide consistent relationship support over extended periods of time and geographic distances 38, they are highly influential.
- Agencies providing care to these youth must assess alcohol and drug use and develop referral mechanisms and brief interventions that target alcohol/drug issues.
- In a live-and-let-live city that likes to signal its virtues, can empathy and stricter law enforcement go hand in hand?
- Homeless persons engaging in drug or alcohol use are at a higher risk of being victims of violence or assault.
- Albert Park and Warwick Junction are among the areas that have been occupied following a raid by authorities under a flyover to the M4 next to the port in October last year.
- We also recognize that grey literature searches have limitations, including the possibility that existing evidence is missed.
This may have impacted the variety of studies found and excluded the most recent primary studies in the field. We also recognize that grey literature searches have limitations, including the possibility that existing evidence is missed. While many homeless individuals were included in certain primary studies of pharmacological programs, homeless-specific results may have been omitted from the original reviews as a result of selective reporting. In addition, many of our included reviews are of low quality, since we did not exclude any reviews on the basis of methodological quality. The low scoring quality of these reviews indicates that they have one or more critical flaws in their methodology, as defined by AMSTAR 2 38, and should not be relied on to provide an accurate and comprehensive summary of the available studies. For the majority of the included reviews these critical weaknesses were due to a lack of explicit reference to a review protocol and/or omission of a list of excluded studies.
Understanding the Connection Between Addiction and Mental Health
Population estimates for each state each year were obtained from the National Center for Health Statistics’ intercensal estimates of the July 1st resident population, accessed via the WONDER online platform (CDC, 2023). Population estimates for Black, White, American Indian/Alaska Native, non-elderly adult (ages 18–64), and metropolitan populations were also used to calculate the demographic composition of each state each year (e.g., percent Black, percent ages 18–64; see Table S1). 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).
In one study, 71% of a sample of homeless youth met criteria for an alcohol and/or illicit drug use disorder NCBI. Additionally, another study reported that 48% of homeless youth met criteria for alcohol abuse or dependence, while 39% met criteria for drug abuse or dependence NCBI. Homeless youth often turn to drugs and alcohol as a coping mechanism to deal with the challenges of street life and the emotional effects of traumatic experiences NCBI. By breaking down the barriers of cost and accessibility, we can empower homeless individuals to seek treatment and support their journey towards recovery. However, it’s important to recognize that these barriers are just a part of the complex issue of substance use and homelessness.
According to the Treatment Advocacy Center, nearly one-third of the homeless suffer from a serious mental illness. Often, these people were released from mental institutions and found themselves back on the streets shortly after being discharged. The National Alliance to End Homelessness reports that the nation’s overall rate of homelessness was approximately 18 out of every 10,000 people in 2020. When it comes to Black, Indigenous, and People of Color (BIPOC), those rates are much higher.