Addiction and Homelessness
The connection between homelessness and addiction has been studied extensively. A study in 2017 showed that there were approximately 554,000 homeless people in the United States. The US homeless population is increasing yearly, particularly in younger age ranges. Tragically, addiction and homelessness go hand in hand. The end result of homelessness is often substance abuse, and substance abuse often contributes to homelessness.
The National Coalition for the Homeless has found that 38% of homeless people are alcohol dependent, and 26% are dependent on other harmful chemicals.
Often times, addiction is a result of homelessness. The difficult conditions of living on the street, having to find food, struggling with ill-health, and being constantly away from loved ones create a highly stressful state of being. Individuals suffering from homelessness may additionally develop psychiatric conditions in response to the harsh lifestyle of feeling threatened by violence, starvation, and lack of shelter and love.
Homelessness, Mental Disorders, and Addiction
Reports suggest 33% of homeless people battle mental illness. Sources cite mental illness as another major cause of homelessness, which often leads to drug and alcohol abuse. Common mental disorders the homeless struggle with include:
- Bipolar disorder
- Schizophrenia/Schizoaffective disorder
- Post-Traumatic Stress Disorder (particularly high in homeless veterans)
- Major depressive disorder
- Severe anxiety
In addition to suffering mental illness, homeless individuals suffering from mental conditions are more likely to be victims of assault, further needing the comfort they temporarily find in harmful substances. Homeless individuals suffering from difficult mental and emotional conditions may find it convenient to self-medicate with harmful substances as well. The combination of mental disorders and substance abuse is known as dual diagnosis or co-occurring disorders. While it may seem that difficult mental conditions can be suppressed by drugs and alcohol use, this actually creates a destructive cycle of dependency.
Substance abuse is often a cause of homelessness. Addictive disorders disrupt relationships with family and friends and often cause people to lose their jobs. For people who are already struggling to pay their bills, the onset or exacerbation of an addiction may cause them to lose their housing.
A 2008 survey by the United States Conference of Mayors asked 25 cities for their top three causes of homelessness. Substance abuse was the single largest cause of homelessness for single adults (reported by 68% of cities). Substance abuse was also mentioned by 12% of cities as one of the top three causes of homelessness for families.
According to Didenko and Pankratz (2007), two-thirds of homeless people report that drugs and/or alcohol were a major reason for their becoming homeless. In many situations, however, substance abuse is a result of homelessness rather than a cause.
People who are homeless often turn to drugs and alcohol to cope with their situations. They use substances in an attempt to attain temporary relief from their problems. In reality, however, substance dependence only exacerbates their problems and decreases their ability to achieve employment stability and get off the streets.
Additionally, some people may view drug and alcohol use as necessary to be accepted among the homeless community (Didenko and Pankratz, 2007). Breaking an addiction is difficult for anyone, especially for substance abusers who are homeless. To begin with, motivation to stop using substances may be poor. For many homeless people, survival is more important than personal growth and development and finding food and shelter takes a higher priority than drug counseling. Many homeless people have also become estranged from their families and friends. Without a social support network, recovering from substance addiction is very difficult.
Even if they do break their addictions, homeless people may have difficulty remaining sober while living on the streets where substances are so widely used (Fisher and Roget, 2009).
Unfortunately, many treatment programs focus on abstinence-only programming, which is less effective than harm-reduction strategies and does not address the possibility of relapse (National Health Care for the Homeless Council, 2007).
For many homeless people, substance abuse co-occurs with mental illness. Often, people with untreated mental illnesses use street drugs as an inappropriate form of self-medication.
Homeless people with both substance disorders and mental illness experience additional obstacles to recovery, such as increased risk for violence and victimization and frequent cycling between the streets, jails, and emergency rooms (Fisher and Roget, 2009). Sadly, these people are often unable to find treatment facilities that will help them.
Many programs for homeless people with mental illnesses do not accept people with substance abuse disorders, and many programs for homeless substance abusers do not treat people with mental illnesses.
Breaking the Cycle
It’s been argued that addiction leads to homelessness and it often does. Of course, homelessness can lead to addiction.
The fact is that people who are consumed by addiction reach a point where nothing else matters but their next fix. Before long, addicts are faced with job loss, personal relationship failures, financial difficulties or even legal difficulties. The longer they’re wrapped up in their addiction, the more serious the fallout.
Many of our patients have been addicts for decades. Some would say they’ve lost everything. They run the run gamut insofar as socioeconomic status – some are wealthy, some were living in poverty (or close to it), but those who come to us have reached their personal breaking point.
One thing they all have in common is that they all wish they had sought treatment long ago.
Most people realize that an addict can’t be forced to go into treatment – they must ultimately give their mind and heart to their recovery. For every person, the situation that ultimately leads them to make this choice will vary. Sometimes, even being homeless isn’t enough of a motivating factor.
The key is for the family to intervene to the best of their ability to motivate the person to seek treatment.
The consequences of addiction and homelessness can be life-threatening in many ways. It’s important to act early in a person’s addiction. The longer they’re consumed by it, the more severe the consequences and the longer the treatment will take.
Where to Start
The first step in any recovery process is contacting and selecting a suitable facility for treatment. This means calling around and examining the options, understanding the financial costs, the time commitment by both the family and recovering addict before selecting a Rehab facility.
Rehab is the next step. Rehab (or “Detox”) purges the toxins from the body and sets the stage for continuing recovery, which includes options like Outpatient treatment or other forms of “Aftercare” such as sober living homes.
In some cases, Medication-Assisted Treatment is offered as a part of Aftercare.