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Substance Abuse and Homelessness

Updated: Feb 24, 2022

Published by the National Coalition for the Homeless June 2017


Many people stereotype the homeless population as all alcoholics or drug

abusers. Although a high percentage of homeless people do struggle with

substance abuse, addictions should be viewed as illnesses and require

treatment, counseling and support to overcome. Substance abuse can

cause homelessness, but it often arises after people lose their housing.


Stare at Narrowing down accurate and recent numbers on the prevalence

of substance abuse is extremely difficult. Yet, most statistics prove that

substance abuse is much more common among homeless people than in

the general population.

• HUD’s 2013 Annual Homelessness Assessment Report states

approximately 257,000 homeless people have a severe mental

illness or a chronic substance abuse issue

• The Substance Abuse and Mental Health Services Administration

(2003) estimates, 38% of homeless people were dependent on

alcohol and 26% abused other drugs.

• According to the 2015 National Household Survey on Drug Use and

Health (NSDUH), only 10.1% of people above the age of 12 reported

using drugs within the past month.

• The Substance Abuse and Mental Health Services Administration (SAMSA) found that 8.4% of adults had a substance abuse issue within the last year. • Alcohol abuse is more common in older generations, while drug abuse is more common in homeless youth and young adults (Didenko and Pankratz, 2007). Relation to Homelessness

Substance abuse often leads to homelessness. Addictive disorders disrupt

relationships with family and friends and can cause job loss. For people struggling

to pay their bills, the onset or exacerbation of an addiction may cause them to lose

their housing.

• A 2014 survey by the United States Conference of Mayors asked 25 cities for their top three causes of homelessness and substance abuse and the lack of needed services was cited by 43% of cities, making it tied for the third leading cause.


Millions of Americans with substance abuse dependences, both housed and homeless, do not receive the treatment they need. Since many homeless people do not have health insurance, substance abuse treatment may be especially unattainable. Other barriers to services include long waiting lists, lack of transportation and lack of documentation. Furthermore, few federal substance abuse treatment and prevention programs target funds

specifically to the homeless population. In order for those with substance abuse issues and mental illness to live independently in their communities, they often require a variety of services and support (Kleinman et. al). Those programs that already exist need to be

strengthened. Finally, much of public policy has favored a punitive approach to substance abuse, even though medical and public health experts agree that treatment and prevention are more effective. Since substance abuse is both a cause and result of homelessness, both issues need to be addressed simultaneously. Aaccording to Didenko and Pankratz

(2007),stable housing during and after treatment decreased the risk of relapse. Substance abuse treatment on its own is inadequate and needs to be combined with supporting housing opportunities. A report from the Office of the Assistant Secretary for Planning

and Evaluation used data from four states to show the benefits of coordinating housing services with behavioral health services: overall, this approach is more likely to garner

progress (Kleinman et. al). In addition to housing, supported housing programs offer services such as mental health treatment, physical healthcare, education and employment opportunities, peer support, and daily living and money management skills training. Supportive housing programs that include substance abuse services would help

homeless people treat their addiction and re-establish residential stability.

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