Homelessness and Addiction: Causes, Consequences and Interventions

Abstract

Homeless individuals suffer from poverty, disaffiliation, personal vulnerability and often poor health. The main concerns from a public health point of view are poor health and barriers to health care. Reviews have identified substance use disorders as a priority among these disorders. Substance use disorders are under-treated and can constitute a barrier to treatment. The current review summarizes recent findings and up-to-date evidence on substance use disorders in this marginalized population. Focusing on treatment-relevant factors, the review will summarize the current evidence for substance use as a risk factor for homelessness, and on homelessness as a risk factor for substance use. The review will further focus on the impact of these findings have on interventions and the current best practices to treat homeless individuals with substance use disorders. Motivation to initiate and retention are major issues in addiction treatment and are they are even more of an issue for the treatment of homeless individuals. Similarly, the level of comorbidities in homelessness seems to be higher than in the general population increasing the need for an interdisciplinary approach. Research focused on this marginalized and stigmatized population, while still limited, has produced a number of findings which are helpful to developed more efficient interventions.