The homeless population faces a variety of issues that make traditional drug and alcohol rehab programs less effective for long-lasting recovery. Programs must go beyond standard health and behavioral care services and treat the whole person, including providing care which will improve their personal environment.
For example, effective rehab programs should not only use integrated care to address addiction and mental illness, but also provide additional services such as life-skills development, housing, and employment assistance to reduce homelessness and other issues.
The Relationship Between Homelessness And Substance Abuse
While every person is different, substance abuse often leads to or causes homelessness. Substance use disorders, the medical term for addiction, tend to cause problems in relationships, with family and friends, and within professional careers. These problems, along with someone already struggling to make payments or pay the bills, can worsen addiction and lead to homelessness.
In one survey, 25 city mayors cited substance abuse as the leading cause of homelessness for single adults. When homeless people were asked about what led to their circumstances, around two-thirds reported drugs or alcohol as a major factor for becoming homeless.
However, substance abuse can also be the result of homelessness, not the cause. Homeless people often turn to drugs or alcohol to help manage or cope with their situation. They may believe drugs or alcohol can relieve them of their problems and provide escape or comfort.
Some homeless persons also believe drug and alcohol use as necessary for acceptance among the homeless community, prioritizing things like food and shelter over counseling, therapy, and managing addiction.
The Prevalence Of Homelessness And Addiction
Researchers estimate around 35 percent of homeless individuals suffer from substance abuse and addiction. Other research puts that estimate closer to 50 percent. It’s difficult to track or obtain accurate information regarding homelessness and substance abuse, but it’s understood the older generation of homeless people struggle more with alcohol abuse while the younger generation has more problems with drug use.
In general, substance abuse is more prevalent in homeless people than the rest of the general population. Among homeless people who struggle with substance abuse, an estimated 10 to 20 percent also struggle with mental illness. Homeless people have a high need for treatment but experience multiple barriers and difficulties when it comes to accessing help and care.
Co-Occurring Disorders And Homelessness
Many homeless people suffer from both substance abuse and mental illness, which is called co-occurring disorders or dual diagnosis. People suffering from co-occurring disorders, especially among the homeless population, often use drugs and alcohol to self-medicate unpleasant symptoms caused by mental health conditions.
A homeless person suffering from a co-occurring disorder is presented with multiple obstacles to recovery and treatment, which may include:
- being in and out of jail or the criminal justice system
- frequent cycling of the streets and emergency rooms
- lack of access to health and behavioral services
- lack of social support
- problems with payment or lack of insurance
- risk for violence or victimization
Unfortunately, homeless people are often unable to find facilities or rehab programs that will help them overcome addiction. While many programs exist for homeless people with mental illness, several may not accept people with substance use disorders. Effective rehab programs for homeless individuals should address both substance abuse and mental illness, as well as provide additional services to help improve their situation.
Drug And Alcohol Rehab Programs For Homeless Individuals
To effectively serve the homeless population, rehab programs must do at least three things: provide services that address the needs for employment, income, and housing; offer access to low-demand, flexible, and affordable interventions; and provide continuous and long-term care, treatment, and support.
The best rehab programs for homeless persons understand substance abuse and addiction cannot be effectively treated without addressing the needs of the whole person, or in the context of their environment.
For example, effective programs should include assistance with:
- employment services and job training
- financial assistance or entitlements
- housing or shelter
- identification papers
- legal assistance
- medical and dental care
- psychiatric care
Programs should offer comprehensive services that address a homeless person’s safety and material, social, and health needs. To help address all the challenges homelessness presents, effective rehab programs must coordinate multiple services to link people with community-based resources.
Themes Of Effective Rehab Programs For Homeless Individuals
Effective drug and alcohol rehab programs for homeless individuals should provide client-centered services that are comprehensive and multidisciplinary, meaning they’re capable of treating various conditions and coordinating additional services.
The following are some common themes of successful rehab programs geared toward the homeless:
Comprehensive Services: Programs must offer multiple services that address all aspects of an individual’s condition and circumstances. This includes building relationships with other service organizations that can help with the person’s various needs, like having appropriate materials and resources to stay healthy and safe.
Integrated Services: An array of clinical professionals should collaborate or make a coordinated effort to provide treatment for both mental health and substance use disorders at the same time. This should ideally take place in one environment or treatment center that emphasizes the need for housing and promotes healthy living.
Client-Centered Care: Treatment plans should be individualized and based on the unique needs of the homeless individual. Plans also take into account their wishes, capacities, and readiness to participate in treatment. There is no need to implement predetermined goals for treatment outcomes, as plans should instead focus on the individual’s pace and circumstances.
Uniquely Qualified Staff: Staff should approach people with kindness, compassion, empathy, patience, and flexibility. Dealing with homeless people can be difficult, and difficult situations may arise. Staff should be trained to handle these situations and react in ways that show understanding and care for the diversity of the population.
Access to housing: For treatment to effective, homeless people must have a stable living situation. Appropriate housing can help individuals achieve a sense of stability and safety. Once basic needs are met, they can focus on increasing control over their lives, environment, and problems with addiction. Stable housing, however, is not a substitute for addiction treatment.
Inpatient Rehab Programs For The Homeless
Inpatient rehab programs, or residential treatment, for homeless people can be effective when programs are modified to address the needs of the population. Therapeutic communities (TCs) are offered within several long-term rehab programs, and not only focus on addressing substance abuse issues, but also focus on the whole person to help inspire overall lifestyle changes.
Research of TCs has shown they are effective for lessening drug and alcohol use, promoting healthy behaviors, increasing psychological functioning, reducing criminality, and helping with employment. Modified TCs for homeless people may incorporate additional resources to involve educational, legal, vocational, and housing services. Plus, staff is more likely to be less confrontational, more supportive, and integrate mental health treatment along with substance abuse counseling.
Inpatient rehab programs can also provide a network of support many homeless individuals lack. Homeless persons have a difficult time remaining sober on the streets, where substance abuse is prevalent. Building relationships in a supportive environment can help homeless individuals connect with resources and services that encourage long-lasting recovery and improve quality of life.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- National Coalition for the Homeless—Substance Abuse and Homelessness
- National Health Care for the Homeless Council
- National Health Care for the Homeless Council
- Substance Abuse and Mental Health Services Administration