Housing First is the most effective approach to ending homelessness. Housing First is a bipartisan, evidence-based strategy that provides people experiencing homelessness with stable, affordable housing quickly and without prerequisites. In one study, people receiving the Housing First intervention experienced substantial declines in their alcohol use and likelihood of drinking to intoxication over time. Evidence indicates that, compared with people in abstinence-based programs, individuals in programs with greater fidelity to Housing First principles are more likely to remain housed and less likely to report using stimulants or opiates.
The opioid crisis has tragically compounded the struggles of those experiencing homelessness, creating a cycle that is devastating and difficult to escape. Unsafe environments, limited access to harm reduction, and the stigma around both homelessness and addiction make it incredibly hard to get help. Every life lost to an overdose is a policy failure, a stark reminder that we are not doing enough to protect those most vulnerable. We need to do better to create compassionate, effective systems that support substance users rights, harm reduction programming, recovery in any form, to prevent these tragic losses.
Of the 8,798 Canadians who died of acute toxicity in 2016, at least:
7.8% (686) were experiencing homelessness at the time of their death
8.3% (732) experienced homelessness within six months of their death
1.0% (86) experienced homelessness during their lifetime as a direct result of substance use.
Provincial and municipal reports show that some populations have been more affected than others, including people experiencing homelessness. In 2016, an estimated 235,000 people were experiencing homelessness and 22,190 people were in shelters on any given night. (Source)
The relationship between housing insecurity and substance use is complex.
People experiencing homelessness have higher rates of substance use than the general population. Substance use is both a reason for housing loss and a way of dealing with the difficulties and dangers of life without a secure home. People experiencing homelessness have added pressure to conceal or rush substance use, use alone, and use larger amounts to avoid drug possession charges. These substance use patterns are more dangerous and can lead to higher rates of acute toxicity events.
Previous research has shown that trauma and mental health conditions are possible risk factors for harmful use of substances and for homelessness. The added fear and stress of limited resources, lack of safety, and stigma associated with homelessness and substance use can also negatively impact mental health. Barriers to services and not seeking services due to social exclusion and stigma can also contribute to poor physical and mental health in this population. (Source)
By Ashley Legere
