What percentage of homeless are addicts?
In 2019, I was travelling with family and friends to the Pacific Northwest. We were walking through downtown Seattle, and noted that there were many homeless people on the streets.
You might think that it would be obvious, who was homeless and who was not. I was surprised to see that it was not clear at first glance which people walking down the street might be part of the homeless population.
While walking along a particular street, I would come to the conclusion that someone walking nearby might be homeless when they said or did something unusual, maybe because of mental illness or intoxication. Then, I would note that they appeared unkept, wearing rumpled clothing and their hair in disarray.
One member of our party, a family friend, was shocked to see, looking down an alley, someone sitting against the wall of a building, injecting themselves with a needle. “He’s shooting up heroin right there in public!” she exclaimed.
I explained to her that the man’s actions are not as unusual or uncommon as she might think. She may not be aware that coworkers, friends, family, and other people in her life could be using opioid drugs such as heroin.
Opioid addiction can affect people from all walks of life. From the homeless to business men and women, to movie stars, shooting up heroin in an alley, or a locked bathroom is too common an activity these days. Everyone who struggles with addiction deserves help, regardless of whether they spend their time living on a park bench or in a penthouse apartment.
Does addiction cause homelessness?
Is there a connection between drug addiction and homelessness? How does a person end up living on the streets or in another type of homeless situation? People are rarely born homeless. Homelessness typically occurs during adulthood as a result of a particular life situation.
Does homelessness always mean living out on the streets, sleeping in a tent, against a building, under a tree, or on a park bench? It turns out that there are other forms of being homeless.
If you are living with friends or family in a temporary arrangement, also known as being doubled up, you may consider yourself to be homeless. Or, if you are living in a homeless shelter, or temporary transitional housing in a sheltered arrangement, you may also be considered to be homeless. Of course, the unsheltered, people living in their cars, outdoors, or in abandoned buildings, are also homeless.
Stories of substance abuse and homelessness.
I am certain that addiction can lead to homelessness after hearing the stories of many people struggling to overcome active addiction who ended up losing their homes. The pathway to homeless may be unique for every individual, but drug use is often a common part of the experience, along with domestic violence and other causes.
One woman who ended up as a sex worker, living in an apartment with her boyfriend told me how she ended up in her situation. While she did have a roof over her head, she had been living on the streets before, and she believed that she might end up there again. Their power had been shut off for months after not paying the bill.
However, this woman was not always homeless, doubling up with a boyfriend briefly after a long stretch of living outdoors. She was once an elementary school teacher, married and living in a home with her husband.
What happened to lead to her homeless situation? The story, according to her, is that her husband came back from a business trip and told her that he had found a weight loss program that involved smoking a particular product that helped to curb appetite. Unfortunately the product he was referring to was crack cocaine.
Another homeless person I remember speaking with told me that he had worked for the local post office, living in a town far from where he lived on the streets. He had a home and a loving family. So, why was he living under a tree in an empty lot by a busy downtown street?
Why did he not go to his family for help? According to his story, he had burnt all bridges with his family, stealing, selling family possessions, and spending all the family money. Also, he was not ready to give up drugs. He was ashamed to stay in his hometown, so he ended up in a city far from where his family lived.
Is it possible for addiction to be a consequence of homelessness?
There are unpleasant situations in life that many people can not face without being medicated. For example, there are people who ask their doctors for a sedative before getting on a plane or before going for an MRI.
Being homeless is unpleasant in a way that most people are unable to fully understand. Living outside or in the backseat of a car is terrifying. Homeless people get robbed and beaten, sometimes murdered. When you are homeless the nights are long, seemingly lasting forever, while you try to get comfortable and forget about where you are and how you got there.
It is not hard to imagine a homeless person finding comfort in the mind and mood altering effects of street drugs. Whether it is alcohol, crack cocaine, meth, heroin, or fentanyl, there is the end result of euphoria and escape from the reality of the cold, hard nature of street life.
Studies have revealed that homelessness does lead to drug and alcohol addiction, even for people who were not addicted to drugs or alcohol before. You can well imagine the path of a person who loses their job and gets evicted from their home. How many nights can they tolerate the terror of living in a parked car under the lights of a store parking lot? While drugs or alcohol are never the solution to any problem, we can at least understand how such a person might end up addicted.
Or, imagine a homeless man living in an alley or on a sidewalk in front of a building, wrapped in dirty blankets, shivering in the cold. A gang comes by and beats him up, causing serious injuries, possibly broken bones.
The homeless man ends up in a nearby hospital ER. As part of the treatment plan, the doctor prescribes painkillers. When he takes the pills, he realizes that they take away not only the physical pain, but some psychological and emotional pain caused by post-traumatic stress disorder and living homeless day after day. This scenario can be the start of a drug addiction that will likely lead to heroin and fentanyl use.
Does mental illness lead to homelessness?
You are probably aware that mental illness is one of the major causes of homelessness. In order to save money, hospitals and institutions discharge mentally ill people who are not prepared to live on their own.
Mental illness, homelessness, and addiction all go hand-in-hand. Drug use is often an attempt to self-medicate the mental illness. Drugs such as crack and heroin are not in any way safe or appropriate to treat conditions such as severe depression or schizophrenia, but they can temporarily help a mentally ill, homeless person to suffer less from the pain and suffering caused by untreated mental illness.
It can sometimes be difficult to diagnose a patient’s mental status accurately when they are actively using drugs. A person living on the streets, addicted to drugs or alcohol, might appear to have one or more mental illnesses. After the drugs are removed from their system, and they go through a detox process, the symptoms of mental illness may dissipate.
Do cities help the addicted homeless to recover and improve their lives?
Different cities have different ways to address their homeless issues. Some cities build modern shelters and encourage rehabilitation. Other cities provide areas where the homeless can live in tents and have some police protection.
Unfortunately, there are cities that choose to ignore their homeless population. While the homeless exist and live in alleys and parks, they are not helped by their city at all. They are victims of crimes, and then they are treated as if they are criminals themselves.
Providing shelters and programs to rehabilitate the homeless are often well-intentioned, but not always successful. Just like a person who uses drugs may not be ready to give up drugs, a homeless person may not be prepared to accept help to work towards improving their living situation.
Sometimes the best answer is to meet the person where they are at and provide harm reduction. For example, in some cities around the world, they have supervised consumption sites where the homeless who use street drugs can go to use drugs in a safe environment.
In a supervised consumption site, sterile drug paraphernalia, such as clean needles and syringes are provided. Visitors have a safe, clean place to use drugs they bring in with them. The staff is prepared to prevent overdoses, and they can test the drugs for toxic contaminants.
Additionally, the staff will form ongoing relationships with visitors, making them feel safe and providing a personal connection. When a homeless person is ready to make a change in their life, they have people whom they trust that they can ask for guidance.
How do cities hurt the homeless population?
One of the most common ways that cities hurt the homeless is to criminalize them. Is it a crime to not have a home?
When I lived in Des Moines, Iowa, I remember listening to a radio show where they described an experiment done by a team of reporters to test homeless people asking for money. They would approach a homeless person asking for money and ask what they were planning to use the money for.
Of course, the answer nearly all the time was that they needed the money for food. The reporter would then give the person money and secretly follow them to see where they went with the money. The result of this very unscientific study was that many of the homeless people followed went to buy alcohol.
The purpose of this report was clearly to motivate people to not help the homeless because they are a group of lying alcoholics and addicts. Not only was the study very flawed, it was unethical. It is unfortunate that there are influential people who use their position of power to misinform the public about the homeless population.
Some people might argue that every citizen must pull their own weight in society, having a job and making a living so that they can afford housing and food. They see a homeless person on the roadside and make the assumption that the person looks strong and healthy and able to work.
Should being homeless be a crime? Often, the homeless are put in situations where criminal activity is unavoidable. When a person does not have access to a bathroom or food, what options do they have? Is it helpful to a city to have police arresting the homeless, repeatedly charging them with crimes and putting them in jail?
Clearly, criminalizing the homeless is a waste of taxpayer money and is morally wrong. Finding ways to coexist and provide assistance to the homeless is the best civic policy.
A more ominous trend has been law enforcement authorities stating that they will not administer narcan to all people who overdose on opioids on the streets. Local sheriffs proclaim that they will not waste resources providing the life-saving drug to save the lives of overdosing people on their streets.
We know that withholding narcan is wrong. There are people who have rehabilitated their lives and are now productive, working members of society who required many narcan doses to reverse many overdoses.
I know of one man who was “narcanned” at least 28 times before he finally made the decision to get help for his addiction. He went from being homeless and addicted to heroin to having a job working with other addicted people to help them recover.
How can we do better to help the homeless?
Homelessness is a hard problem. Like addiction, there are no easy answers. Fortunately, there are many local programs that do their part to help the homeless to survive. And, they are prepared to help people who are ready to take the next step in improving their situation.
Soup kitchens, also known as food banks, meal centers, community kitchens and food pantries, are places where the homeless can get a healthy hot meal. I had the opportunity to spend some time observing what happens in a local soup kitchen, and the environment was uplifting.
First, the kitchen and dining area were kept very clean. It is very likely that the visitors to the facility were getting better meals than what they might get in a typical diner. The food was healthy and delicious.
The team that ran the facility worked closely with individuals to help them get assistance whenever possible. They allowed visitors to use their address if needed. They provided healthy food to many homeless people, and they provided hope.
Interestingly, I met some people who were not homeless that ate at the soup kitchen. I met one elderly couple who had a home, but they could not afford groceries. With fixed incomes and the high cost of living, they had to make choices between medical care, medications, and food.
Local soup kitchens and shelters are excellent, but they are not enough to address the larger problem.
In my community, we have several such meal centers. Often, they are hosted by local churches. We also have shelters, but probably not nearly enough beds to serve a significant portion of the local homeless population.
If a homeless person is addicted to drugs and ready to quit using drugs, they might find help by going to a local recovery meeting. 12-step meetings, such as Alcoholics Anonymous and Narcotics Anonymous, are a good place to start for a person who wants to quit drugs or alcohol. Often, by attending meetings regularly, if you are homeless, you will likely meet people who can help you find the help you need.
As you can see, there are often solutions that can be put together to help some members of the homeless population who are motivated to get help to survive. Yet, these solutions are often too small to help more than a handful of homeless people.
While local efforts to feed and house the homeless are admirable, large-scale, government funded programs have the potential to assist many more people. If cities are serious about helping the homeless, leaders must organize efforts to build the foundations for programs that can reach and assist all the homeless population to make their lives better and give them hope for a better future.