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therapy and payment and insurance options.
Treatment for addiction takes many forms and depends on the needs of the
individual. In accordance with the American Society of Addiction Medicine, we offer
information on outcome-oriented treatment that adheres to an established continuum of
care. In this section, you will find information and resources related to evidence-based
treatment models, counseling and therapy and payment and insurance options.
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life outside of rehab is fraught with the potential for relapse. Aftercare resources such as
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community understands the struggle and provides guidance born of personal experience.
Each day, homeless individuals grapple with a myriad of difficulties, such as lack of employment, housing and food. For many, substance abuse is one bullet on a growing list of problems, exacerbating their situation, leading to incarceration, mental disorders and even death.
Homelessness in the United States has become harder and harder to ignore. At least 800,000 homeless people — including 200,000 children — roam streets or frequent shelters on a given evening. Many have problems in addition to where to rest their head at night or find their next meal.
A rising number of the population turn to drugs or alcohol to cope with their situation, often leading to full-fledged addiction. Substance abuse can lead to poor physical and mental health, which makes obtaining employment or residential stability difficult.
Grappling With Addiction
For some, drugs lead to homelessness. For others, homelessness leads to drugs. Either way, substance abuse among this population has proven problematic.
Homelessness and Addiction by the Numbers
Drug and alcohol abuse constitutes the most pressing public health problem among the homeless.
Varying reports exist on the percentage of homeless individuals with a substance abuse problem. Some studies estimate that about 40 percent of the population is dependent on drugs or alcohol. Others say the figure is more than 50 percent. Several accounts even suggest drug use is twice as common among the homeless, per capita, than among the general population.
At least 800,000 homeless people — including 200,000 children — roam streets or frequent shelters on a given evening.
The 100,000 Homes Campaign, a movement of communities working to find permanent homes for 100,000 homeless individuals, conducted a survey of more than 30,100 homeless people across the country. Close to 60 percent of participants had a substance abuse problem. Nearly 14 percent engaged in drugs intravenously, and roughly 20 percent had a drug problem without knowing or admitting it.
Alcohol is more common among older generations, whereas drug abuse is more prevalent with young adults. Polydrug use — using two or more drugs in combination — has become more popular among all adults.
More specifically, opioid addiction, a major problem among the homeless, is also widespread. Other street drugs, such as cocaine and methamphetamine, are also popular among the vagrant.
More and more displaced youth are engaging in substance abuse, too. A 2013 study indicated homeless children are 60 percent more likely to use drugs.
Another study, published in the American Journal of Public Health, made a number of eye-opening findings with regard to vagrant youth:
Alcohol
67% of vagrant youth in shelters were using alcohol.
Youth with homes
64% Among youths with homes, 64 percent used alcohol, 25 percent marijuana and two percent crack cocaine.
Marijuana
75% of street youths and 52 percent of sheltered youths were using marijuana.
Cocaine
26% of street youths and eight percent of sheltered youths were using crack cocaine.
How Addiction Leads to Homelessness
Substance abuse is often the cause of homelessness.
Addiction can rupture relationships, lead to termination of employment and cause people to lose a handle on their finances. Subsequently, they may fail to pay their rent or mortgage and lose their homes. With nowhere else to go and nobody with whom to communicate, their options are limited.
Enter, homelessness.
The studies speak for themselves. In 2015, the United States Conference of Mayors, a nonpartisan organization for cities with populations exceeding 30,000 people, asked 22 cities to investigate and determine their top three causes for homelessness.
Thirty-five percent of unaccompanied adults cited substance abuse as a main cause of their homelessness. Ten percent of homeless families cited drugs or alcohol.
A life on the streets rarely cures a drug habit. The need to seek help for addiction is routinely put on the backburner for other priorities, such as finding shelter and food.
Additional Causes of Homelessness
Many factors cause homelessness — not just substance abuse. The 2015 Hunger and Homelessness Survey identified lack of affordable housing as the leading cause of homelessness among unaccompanied individuals and families with children.
Poverty, unemployment and low-paying jobs were also major factors. Economic insecurity, violence at home, mental illness and lack of social support also led to homelessness, the survey found.
Student Homelessness
Homelessness disrupts many aspects of a child’s life, including education. It interrupts their ability to attend class, achieve or maintain good grades and graduate. Problems outside of the classroom affect concentration and the ability to socialize and learn.
K-12 Students
Homeless families frequently relocate, affecting a child’s development. Young students have difficulties forming bonds with their peers. Transiency could also set students back academically, affect their ability to learn and increase their chances of repeating a grade or dropping out.
More than 1.3 million homeless students were enrolled in public schools during the 2013–2014 school year.
Two of every three homeless individuals have not received a high school diploma, according to the National Association for the Education of Homeless Children and Youth. A lack of education could result in drug use.
College Students
Homelessness threatens students who struggle to pay for college expenses. Public university tuition has quadrupled over the last three decades. The average student loan debt rose by more than $10,000 from 2004 to 2014.
More than 58,000 college applicants in the United States indicated they were homeless on their Free Application for Federal Student Aid forms, according to Barbara Duffield, policy director of the National Association for the Education of Homeless Children and Youth.
This number does not take into account students who handle housing insecurities on their own or do not identify as homeless. Also, those who couch surf or sleep in cars may not inform officials of their status.
“Most [homeless students] are reluctant to talk about their situation,” Dr. Amy Donley, assistant professor of sociology at the University of Central Florida and co-author of “Poor and Homeless in the Sunshine State: Down and Out in Theme Park Nation,” told DrugRehab.com.
“They hide it well and only tell people if they have to,” she said.
Why Do College Students Experience Homelessness?
Donley says student homelessness is problematic in Florida. Nearly 25 UCF students suffer from homelessness.
Students live on the streets for various reasons — and not all of them relate to drug use. Many people age out of the foster system and have no family to lean on for support. This means they have nowhere to live between semesters and no guarantor to co-sign an apartment lease for them.
James Wright, a research professor in UCF’s Department of Sociology, told DrugRehab.com how a student’s plans for living arrangements could fall through and lead to homelessness. Their roommates may fail to show up, or a job may fail to materialize. They then have no income stream and cannot afford housing.
Unemployment or a low-paying job contributes to this problem.
Where Do Homeless Students Stay?
Many of these individuals couch surf or sleep at a friend or co-worker’s house. It is common among homeless UCF students, according to Donley.
However, these types of living arrangements can cause anxiety. Many students who couch surf do not want to encroach on their friends or overstay their welcome, but they don’t have money to pay for a hotel room. They have no idea where to sleep the next night.
Because most college campuses have restaurants and a gymnasium for showering, some students live in their vehicles. They attend class during the day, blending with the rest of the student body, and sleep in their cars in a parking garage at night.
“One girl was living in a storage unit,” said Donley. “She moved out of her family’s home, put stuff in a storage unit and realized she could live there.”
How Drugs and Alcohol Influence College Student Homelessness?
Not all homeless people experience addiction. In fact, neither Wright nor Donley recognized substance abuse as a major factor in homelessness among UCF students.
Substance abuse can give way to numerous issues, including:
Poor academic performance
Loss of scholarships
Loss of housing
Suspension or expulsion
These outcomes can cause or prolong homelessness.
Drug or alcohol abuse has indirectly resulted in homelessness. Donley encountered a student whose mother was battling addiction. Strangers would engage in drugs in their house. Feeling unsafe, the student moved out and lived in her car.
“There have been three or four women who have left their homes because they feel safer in their cars,” said Donley.
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For the country’s homeless population, lack of shelter and addiction are not problems that exist in a vacuum. The consequences of homelessness and substance abuse can be fatal.
Everyday Issues of Homelessness and Addiction
Homeless people face numerous challenges each day, such as hunger, lack of sleep and untidy appearances. Substance abuse worsens these problems and creates a new set of issues.
Drug or alcohol use affects a homeless person in several ways:
Their overall health declines.
They have difficulties obtaining shelter, food or clothing.
They have trouble finding employment.
Additionally, many shelters turn away homeless people with addictions. This means these individuals must fend for themselves, a particularly difficult task during winter.
Vagrant people with substance use disorders need treatment. However, addiction is a disease that causes cravings. Therefore, many prefer continued drug use to rehab.
The presence of a co-occurring disorder increases a person’s chances of losing control of their circumstances, leading to a life on the streets.
Homelessness is a traumatic experience which deteriorates one’s mental health, leading to co-occurring disorders. Studies indicate as many as one-third of destitute adults have co-occurring substance use and mental health problems. Nearly 35 percent of participants in the 100,000 Homes study had reported having co-occurring disorders.
Some common mental health problems among the homeless include:
These disorders can also be the cause of vagrancy. Many homeless persons are severely paranoid and mistrustful of those around them. Many believe they are under surveillance. They also experience heavy bouts of anxiety and routine panic attacks.
Co-occurring disorders can further complicate their respective situations. Researchers say these individuals have a harder time obtaining shelter, food, clothing and medications to treat their disorder. Over time, when combined with poor hygiene, these deficiencies can lead to physical ailments, such as respiratory infections, skin diseases and HIV.
Yet, often, self-care is not a priority. For many, behavioral needs take a backseat to more immediate desires, such as finding work or shelter.
Only one in four homeless adults did not report any mental health or substance abuse problems in the last year, per the Urban Institute.
Incarceration
Not only can shelters turn away individuals who are intoxicated or high, law enforcement officers can lock them up.
The National Healthcare for the Homeless Council estimated that between 25 to 50 percent of destitute persons has experienced incarceration. In contrast, 15 percent of the jailed population has experienced homelessness. Many are locked up because of minor drug crimes.
Upon their release, these individuals face an additional barrier: stigmatization. In the past, federal housing agencies and potential employers have turned people away because of criminal records. This can lead to increased criminal activity, which can result in continued substance abuse.
Death
Large chunks of the population engage in illicit drug use, from stimulants to opioids, yielding higher death tolls across the board. According to a study by JAMA Internal Medicine, drug overdoses led to nearly 17 percent of deaths among 28,000 current or former displaced adults from 2003-2008; opioids contributed to 81 percent of those mortalities.
In 2015, the National Health Care for the Homeless Council reported drugs and alcohol caused 29 percent of all homeless mortalities in Sacramento, California over a 12 year period.
Self-medication is also a problem. Many of these individuals, who lack insurance or money to see a physician, self-diagnose. Many of those who do so, in an attempt to remedy a drug problem or co-occurring disorder, have overdosed.
Homeless Assistance Resources
Seeking substance abuse treatment is paramount in the battle against addiction, but few individuals experiencing homelessness have access to it. Many within the population lack access to health and behavioral services, which exacerbates their physical and mental health conditions. This can cause chronic homelessness.
Numerous government and community organizations have launched programs to support homeless people struggling with housing, mental health problems and substance use disorders.
The National Coalition for the Homeless is an organization that strives to prevent and end homelessness in the United States through public education and advocacy. Its network includes activists, advocates, service providers, and current and former homeless people.
The National Alliance to End Homelessness evaluates and develops policies that impact homeless people. The alliance collaborates with the public, private and nonprofit sectors in creating strategies to end homelessness.
The National Coalition for Homeless Veterans is a resource center for a network of local, state and federal agencies that provide assistance to homeless veterans. The nonprofit has strengthened funding for nearly every federal homeless veteran assistance program today.
SAMHSA offers grant programs that support homeless people. The Projects for Assistance in Transition from Homelessness program provides funding to support services for homeless individuals with mental illnesses or substance use disorders.
Members of the U.S. Interagency Council on Homelessness aim to identify and implement strategies to end chronic homelessness. The council looks to end this epidemic by improving access to permanent supportive housing, an intervention combining low-cost housing with health care and support services.
NAEHCY is a national membership association dedicated to helping homeless youths achieve academic success. The organization provides professional resources and training for those interested in helping these children excel at school.
Government officials have made a more concerted effort to provide assistance. Dozens of municipalities are launching Law Enforcement Assisted Diversion programs. These innovative programs aim to address low-level drug and prostitution crimes by shifting addicts away from jails and toward supportive services.
Considering the high percentage of incarcerated persons transitioning to homelessness, these programs could prove beneficial.
Some institutions have implemented year-long housing for homeless and at-risk students. For example, the Campus Awareness, Resource & Empowerment Center at Kennesaw State University provides personal care items and access to temporary and permanent housing.
The program also offers homeless students:
Case management
Financial assistance
Referrals to community resources
Coaching
Progress monitoring
Access to campus food pantry
UCF provides a similar campus resource. The college offers UCF Cares, a program that offers a wide range of resources that help students in distressing situations, including homelessness.
“It started after [the Virginia Tech tragedy] as a place to report concerns,” said Donley, who also works at UCF Cares. “But it has completely evolved to help students in all situations.”
UCF Cares representatives let students know about nearby food pantries, housing options and other resources. The college is working to create short-term and emergency housing on campus, according to Donley.
Many campus health centers offer free medical services to students with minor illnesses or injuries. They may even recommend low-cost clinics for more serious health situations.
Federal Programs
The federal government has passed laws that help homeless students.
The McKinney-Vento Homeless Assistance Act of 1987 provides federal funding for homeless shelter programs across the United States. It established programs that offer housing, job training, health care and education to the homeless.
In 2015, President Barack Obama signed into law the Every Student Succeeds Act of 2015, a program that aims to ensure all students have an equal opportunity to succeed at school.
The law strengthens educational programs by
Training school representatives to help identify, enroll and support homeless children and youth
Increasing access to early childhood programs
Helping homeless youth remain in the same school when appropriate
Ensuring access to counseling and financial aid
Helping youth transition from middle school to high school
Increasing funding for school districts to serve homeless children and youth
The law, which takes effect in October 2016, will assist homeless children from preschool through high school graduation.
Financial Assistance Programs and Scholarships
The College Cost Reduction and Access Act helps students avoid homelessness by making college education more affordable. Passed into law in 2007, the act features an income-based repayment program, a cut in interest rates and loan forgiveness for people employed in certain public service jobs.
It also establishes that homeless people qualify as independent students. This gives students access to more funds for basic living expenses when applying for financial aid.
Numerous scholarships dedicated to helping homeless or at-risk students exist, including:
The Dell Scholars Program
The program offers 300 scholarships annually to low-income, highly motivated students who exude grit, potential and ambition. The maximum award, $20,000, is disbursed over a six year period.
NAEHCY Scholarship Fund
Established in 1998, the program provides scholarships to homeless students who demonstrate academic achievement. A minimum of two $2,000 scholarships are awarded annually.
Project STARS Scholarship
Supported by the Stanley G. Tate Prepaid College Foundation, the Project STARS scholarship is a state-based program that awards funds to low-income and at-risk students. The program has awarded more than 25,000 scholarships since its inception.
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Many others, specifically those with co-occurring disorders, often feel they are coerced into treatment. Several steps can be taken to prompt indigent individuals to seek treatment.
Outreach
Simply communicating, educating and imploring them to seek assistance can make a difference. Outreach, which involves a provider or other individual making initial contact, has been a successful method for connecting with the homeless.
Housing Assistance
Practical, short-term housing assistance can give way to employment opportunities. This has proven useful when steering them into treatment.
Nonthreatening Environment
Distrust is common among the homeless. Engaging the individual in a safe, nonthreatening environment, such as a welfare hotel or homeless shelter, allows him or her to relax.
Motivational Interviewing
This goal-oriented style of communication has helped individuals change their behavior, influencing them to make a change in their lives.
Peer Leadership
Mentorship from someone who sought treatment can make a difference. Numerous destitute persons have responded positively to this approach.
Matt Gonzales is a writer and researcher for DrugRehab.com. He graduated with a degree in journalism from East Carolina University and began his professional writing career in 2011. Matt covers the latest drug trends and shares inspirational stories of people who have overcome addiction. Certified by the Centers for Disease Control and Prevention in health literacy, Matt leverages his experience in addiction research to provide hope to those struggling with substance use disorders.
Substance Abuse and Mental Health Services Administration. (1998, March). Implementing Interventions for Homeless Individuals with Co-Occurring Mental Health and Substance Use Disorders. Retrieved from http://www.namhpac.org/PDFs/SAMHSAcoocurring.pdf
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