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Is There a Connection Between Addiction and Homelessness?

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Addiction can be both a cause and an outcome of homelessness and result in a cycle that is challenging to break. For example, people who struggle with substance use often find it difficult to maintain stable employment, housing, and relationships. As a consequence, they may end up being unable to retain their homes or living arrangements and end up becoming homeless. Conversely, homelessness can worsen addiction problems due to the associated stress and trauma, as individuals turn to substance use to cope with the difficulties they face due to their bleak situation.

People who experience homelessness often feel hopeless and desperate and don’t know where to turn to get the assistance they need. People with addiction often feel this way as well, even if they have stable housing. Those without, however, face even greater obstacles and can get trapped in a downward spiral, believing there’s no way out. If you or a loved one is struggling with substance use, you are encouraged to contact Guardian Recovery to learn more about how we can help.

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What Is the Prevalence of Addiction Among the Homeless?

Per the Annual Homeless Assessment Report to Congress, published by the Department of Housing and Urban Development (HUD), in January, 2002, an estimated 580,466 people experienced homelessness on a single night. (1) According to the National Institutes of Health, estimates suggest that alcohol misuse affects 30% to 40% of homeless people, and drug misuse affects 10% to 15%. (2)

The Substance Abuse and Mental Health Services Administration (SAMHSA) reported in 2011 that data from research conducted in the previous five years indicated that: (3)

  • Approximately 30% of chronically homeless people have mental health disorders.
  • Approximately 50% have co-occurring substance use issues.

Also, an analysis of data from the 1996 National Survey of Homeless Assistance Providers and Clients (NSHAPC) revealed that: (4)

  • More than 60% of people who were chronically homeless also experienced lifetime mental health issues.
  • More than 80% have experienced lifetime alcohol or drug problems.

Economic, Social, & Psychological Risk Factors for Substance Use & Homelessness

There are many economic, social, and psychological risk factors that can contribute to both substance use and homelessness.

Economic Risk Factors Include:

  • Poverty and an inability to find affordable housing.
  • Unemployment and underemployment.
  • Insufficient income or financial instability.
  • High amounts of debt and financial burden.
  • Inaccessibility to quality healthcare and substance use treatment.
  • Limited education or job training options.

Social Risk Factors Include:

  • Alienation or disconnection from family or other support systems.
  • Having a criminal history.
  • Discrimination based on race, gender, sexual orientation, etc.
  • Loneliness or social isolation.
  • Lack of social skills or healthy relationships.

Psychological Risk Factors Include:

  • Mental health conditions, such as depression, anxiety, or PTSD.
  • Experiencing trauma, neglect, violence, especially in childhood.
  • A history of substance misuse.
  • Lack of coping skills.
  • Poor impulse control.
  • Lack of self-esteem or self-worth.
  • Poor emotional regulation or stress management.

It is important to note that these risk factors can interact with one another in complex ways. Addressing these risk factors often requires a comprehensive approach to treatment that addresses all of these issues concurrently.

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What Are Common Substances Used by Homeless Individuals?

Those who find themselves homeless may use a variety of drugs and alcohol. Although obtaining accurate data is difficult, the National Coalition for the Homeless cites the Substance Abuse and Mental Health Services Administration, which estimates that in 2003, 38% of homeless people were dependent on alcohol and 26% misused other drugs. (5)

Common Substances Include:

  • Alcohol.
  • Cannabis.
  • Methamphetamine.
  • Heroin.
  • Cocaine or crack.
  • Prescription drugs, especially opioids.

The substances used by homeless individuals, like all drug and alcohol users, depend on their personal preferences. However, these are also largely based on what is accessible to them.

Can Homelessness Be a Cause of Substance Use & Addiction?

Homelessness is a public health issue associated with a wide range of risk factors that can increase the likelihood of misusing substances and developing an addiction. For example, living on the streets and in poverty can expose individuals to severe health problems, social isolation, violence, and trauma. All of these can lead to physical and emotional suffering and the use of unhealthy coping mechanisms like substances.

In addition to these risk factors, homelessness can make it challenging for individuals to access mental and medical healthcare and addiction treatment, all of which can further contribute to and compound upon substance use. Without stable housing, those who are homeless will likely struggle to maintain a regular medication schedule or attend therapy or counseling appointments, and may be more likely to depend on alcohol or drugs as a dysfunctional form of self-medication.

In general, homelessness and substance misuse have a complex cause-and-effect connection, and addressing both issues often requires a comprehensive approach that considers the underlying causes and risk factors of each. (6) This may include access to healthcare, substance use treatment, and support for mental health and emotional well-being.

The Barriers to Addiction & Mental Health Treatment

There are many barriers homeless individuals commonly encounter when trying to access addiction and mental health treatment.

Common Barriers Include:

  • Lack of financial resources, insurance, and social programs.
  • Difficulty finding transportation to treatment locations.
  • Limited availability of services, including long waitlists and inconvenient locations.
  • Co-occurring disorders and multiple health issues, making treatment more complex and difficult to manage.
  • Trust issues, as those who are homeless may have had negative experiences in the past and be reluctant to trust the healthcare system.
  • Difficulty adhering to treatment, due to challenges such as an inability to access stable housing, nutritious food, and maintain regular sleep patterns.

How Trauma & Mental Health Issues Are Connected to Homelessness

Many people who are homeless have been exposed to traumatic events, such as sexual abuse, physical abuse, domestic violence, natural disasters, or military service. (7) These experiences can lead to a wide variety of mental health disorders, such as depression, anxiety, post-traumatic stress disorder (PTSD), and substance misuse. Moreover, homelessness itself can be a traumatic experience, as individuals are forced to navigate poor or dangerous living conditions and endless uncertainty.

The ongoing stress associated with these conditions can worsen existing mental health conditions and lead to the development of new ones. Psychological issues can also contribute to homelessness, as individuals may struggle to manage symptoms such as depression and anxiety. These issues tend to make it exceedingly difficult to maintain employment or secure housing, and may lead to social isolation and estrangement from family and friends.

Vocational & Life Skills Training Programs for Employment

Vocational and life skills training programs can be a valuable resource for homeless individuals who are seeking employment. These programs provide job training, career counseling, and other resources that can help individuals develop the skills they need to succeed in the workforce.

Vocational & Life Skills Training Programs Include:

  • Job training programs, including specific job skills and on-the-job training opportunities and apprenticeships.
  • Career counseling, to help individuals identify their strengths and interests, and explore career options that might be suitable for their skills and experience.
  • Financial literacy programs, to help individuals learn basic money management skills, such as budgeting, saving, and managing debt.
  • Soft (interpersonal) skills training, such as communication, teamwork, and problem-solving, which can help homeless individuals develop the confidence and competence they need to succeed on the job.
  • GED and literacy programs, to help individuals gain the skills they need to pursue further education or job opportunities.

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Addressing the psychological and social needs of those who are homeless is vital to helping them overcome some of their many challenges. By providing dual diagnosis treatment and addressing the causes of homelessness, it is possible to help these individuals restabilize their lives and improve their well-being.

At Guardian Recovery, we offer comprehensive, individualized addiction treatment and multiple levels of care of varying intensity and flexibility. To learn more, contact us today to speak to a skilled Treatment Advisor and receive a free, no-obligation health benefits check. We are dedicated to helping every person we can overcome substance use and providing them with the tools they need to achieve a successful and sustainable recovery.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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