Substance Abuse BLOG

It is a common belief that substance abuse and homelessness are interlinked, but the nature of this linkage is something that is debated quite often. Does substance abuse lead to homelessness or does homelessness form the basis for substance abuse?   A typical stereotype associated with the homeless population is that they are substance abusers and alcoholics. While it is certainly true that a decent percentage of the homeless population has drug and alcohol issues, it will be wrong to assume that it is always so. A large number of substance and drug addicts are not homeless and similarly, a large number of homeless are not substance abusers. Prior to studying the association between the two issues, it is important to understand them in isolation.

Understanding the term ‘Homelessness’   While the meaning of the term ‘homelessness’ seems to be pretty obvious, in reality, it may be quite complex. The reason for this complexity is the vagueness associated with what constitutes a home. While each and every country has a separate definition for homelessness, in general, it refers to the condition where a person does not possess a regular dwelling. It is the inability of a person to acquire and maintain a safe, secure and regular nighttime residence. It, therefore, includes all the people living literally on the street, as well as those who live in temporary arrangements such as cardboard boxes, tents, warming centers, and shelters.

By 2005, there were more than 100 million homeless across the globe [1]; in the United States, by 2009, approximately 0.6 million people were homeless, with another 1.5 million people have used emergency shelters during the past year [2]. Apart from substance abuse, main causes of homelessness include poverty, mental illness, familial and relationship issues, unemployment and financial problems. In addition to the extremely low quality of life, homeless people are vulnerable to a number of problems. Living in unhygienic conditions exposes them to a host of diseases; lack of proper food leads to nutritional deficiencies which later translate into full-blown diseases. The absence of any kind of personal security exposes the homeless to acts of violence which are quite common. The homeless are also the first people to suffer from adverse weather conditions and natural disasters. Lack of education and employment opportunities makes it impossible for the homeless to improve their current living conditions.  Substance abuse is the consumption of a particular drug or substance for mood-altering purposes.

Commonly abused substances include alcohol, and drugs such as marijuana, cocaine, and heroin. Regular consumption leads to psychological dependency also called addiction. Even though these substances provide a temporary ‘high’ or ‘kick’ or mood elevation, eventually they adversely alter judgment, attention, perception and physical control. In most cases, consumption starts as a casual or recreational activity, but sooner or later, it leads to addiction. The person then needs to increase frequency and dosage to maintain the effectiveness of the substance, and thus begins the downward spiraling loop that destroys the life of the substance abuser.

Social Adaptation and Social Selection –  Numerous studies have been conducted to analyze the relationship between substance abuse and homelessness, some based on the idea of social adaptation while others following the idea of social selection. According to the social adaptation model, people adapt themselves to their existing situation. The adaptation may also be in the form of coping mechanisms, therefore, this model emphasizes homelessness as the cause of drug use.

On the other hand, the social selection model views substance abuse as one of the primary reasons for homelessness. According to this model, addiction to substances leads to depletion of financial as well as social resources, and ultimately to homelessness. In one particular research study (samples included homeless people with substance abuse issues) that looked at both angles, 34% of the people sampled had substance abuse issues prior to becoming homeless; while the remaining 66% got involved in substance abuse after becoming homeless [3].  

Substance abuse as the cause of homelessness   While it is difficult to obtain accurate numbers, considering the nature of the issue; a study conducted by a government agency in 2003, estimated that around 26% of the homeless were involved in some form of drug abuse, while 38% had alcohol dependency problems [4]. These figures were verified by Substance Abuse and Mental Health Service Administration (SAMHSA); according to their estimates, 34.7% of adults who were sheltered or homeless, had chronic drug and other substance abuse issues [5]. Alcohol dependency was found to be common with the older population, while drug abuse was more prevalent in the younger segment. These are expensive habits that eat into the financial reserves of an individual. The consequent personal debts and rent arrears then lead to eviction. In case of dependents, substance abuse has a significant detrimental effect on personal, familial and social life. The relationship breakdowns that occur may lead to the individual being evicted from the family. In a number of cases, right guidance is not available at the right time, which leads to homelessness and complete destruction of the person’s life.  

Homelessness as the cause of substance abuse   While these statistics make people believe that substance abuse leads to homelessness, it may not necessarily be always true. In numerous cases, substance abuse is actually the result of homelessness. According to a survey conducted by US Conference of Mayors in 2008, 68% of the cities in the survey, reported drug abuse as the largest reason for homelessness among single adults [6].

This percentage dropped to 12% for homeless families. People, who are homeless and leading an extremely low quality of life, are easy prey to alcohol and drugs, which are consumed as coping mechanisms. They are unaware, or simply fail to recognize, that these addictive substances will only exacerbate the problems they are facing. Even though these substances may provide temporary mental relief, in the long run, they reduce the chances of employment and hence, the possibility of improving quality of life. Further, people in this segment, seldom get exposed to the right kind of environment that may help them get out the situation. It develops into a vicious cycle, breaking which becomes close to impossible for the individual.    

Conclusion   As can be observed, both these models are equally relevant. To tackle the problem of homelessness linked with substance abuse, it is of utmost importance to diagnose the true nature of the problem. For some individuals, homelessness may be the cause leading to substance abuse, while for others it may be the other way round. It is a complex problem that does not have a generic solution that will be applicable at all times. Therefore, understanding the views of the homeless person is the first step in devising a solution that will help improve their quality of life.