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Homelessness and Addiction Treatment

The U.S. Department of Housing and Urban Development found that in 2020, roughly 580,466 people were homeless on a single night.2 Of those individuals reporting homelessness, 88,873 suffered from chronic substance abuse.2, 4

While homelessness and addiction do often co-occur, it’s important for people to remember that addiction is a chronic, yet treatable condition that still needs to be addressed, regardless of where one lives.1

If you or a loved one have struggled with homelessness and addiction in the past, or are currently homeless, help is available. Helping people who are homeless gain access to treatment can be challenging; however, there are programs and support for people struggling with addiction and homelessness.

The Connection Between Addiction and Homelessness

Homelessness and addiction can be difficult problems to overcome, especially if a person is struggling with both issues at the same time.1 A person’s addiction may be the cause of homelessness, but it may also be the result of homelessness.

The challenges and consequences that people with addiction encounter, like struggles at work and in relationships, may contribute to their homelessness.1 Furthermore, the combination of poverty and addiction present an increased risk factor for homelessness.3

Other potential causes of homelessness can include:3

  • Not being able to afford housing.
  • Poverty or under-employment and lack of public assistance funding.
  • No access to affordable healthcare.
  • Mental health conditions.
  • Domestic violence.

Not everyone suffers from a substance addiction prior to experiencing homelessness, though; many people turn to drugs and alcohol to cope with homelessness, which may lead to addiction or make their situation worse. Without the right type of treatment for addiction, it may be difficult to end the cycle of homelessness and addiction.

Mental Health, Addiction, and Homelessness

Many homeless people also suffer from mental health conditions. In fact, of the 580,466 people who were homeless in 2020, 120,642 were found to be severely mentally ill.4

Research has shown that about half of people who have a mental illness will also have a substance use disorder or vice versa.5 This is also known as a dual diagnosis, or a co-occurring disorder.

Studies further show that people who have co-occurring disorders were at an increased risk for misusing prescription painkillers like opioids.5

It’s suspected that those with mental health disorders may turn to substances to self-medicate. People may feel temporary relief from the symptoms of mental illness when using certain substances; however, substances can also make symptoms worse in the short- and long-term.5

Since co-occurring disorders can present additional challenges, it’s important for people to seek treatment that can address both mental health and substance misuse at the same time.

Finding Homeless Drug Rehab Centers

Alcohol and drug rehab for the homeless can be found around the country; however, it is important to note that each facility may offer slightly different amenities and a different approach to treatment. The most effective treatment will be that which meets the needs of the individual so finding a facility or program that addresses homelessness and the challenges associated with it will be helpful.6

American Addiction Centers offers a variety of options to help you cover the cost of addiction treatment. Whether or not you have health insurance, you can quickly and easily learn about your payment options.

Barriers to Addiction Treatment

For people experiencing homeless, there may also be barriers to treatment that are different than other populations, such as:7

  • Lack of financial resources or insurance.
  • Stigma related to mental health and substance use disorders.
  • Inability to get regular transportation to treatment.
  • Lack of education about resources about addiction treatment for the homeless.
  • No community support or isolation as a result of homelessness.

What to Look for in Addiction Treatment for Homeless People

To help people overcome barriers to seeking treatment for behavioral health and substance use disorders, it’s helpful to seek treatment or programs that address the following:9

  • Medication management for physical and mental health conditions, easing the detox and withdrawal process and reducing cravings. Medication may be effective at treating anxiety, depression, bipolar disorder, schizophrenia, and other types of mental health conditions.8, 11, 12 Common medications prescribed for treating withdrawal and cravings to opioids include methadone, buprenorphine, and naltrexone.8 Medications for alcohol include disulfiram (Antabuse) and acamprosate (Campral). These drugs can help with withdrawal and cravings and help prevent people from relapsing.
  • Affordable mental health services like therapy and counseling. Publicly sponsored programs may be available in some areas to specifically help support homeless people with co-occurring disorders.
  • Affordable and supportive housing that treats behavioral health issues while providing housing.10 This may be in the form of sober living or recovery housing, which may provide mutual support groups, counseling, transportation assistance, and clinical care in an environment free of substances.10
  • Case management is important to provide social, vocational, and housing support. Public health agencies will help people build a strong network and follow up with them to assess their needs and provide resources.9
  • Treatment planning to create a short- and long-term plan for how the recovery process will unfold, which is based on the person’s needs.
  • Relapse prevention is important in treating addiction, as it is a chronic condition that takes care and management to ensure abstinence and sobriety.13 Cravings and even relapses are normal parts of the recovery process.13 However, with treatment and continuing care, a person may have better success at coping with triggers and preventing relapse.14

Types of Therapy in Addiction Rehab Programs

There are many different approaches to evidence-based therapy, which may be useful in helping a person identify and cope with triggers, address family relationships and understand what may have led to substance misuse.

Many treatment facilities and recovery programs use cognitive-behavioral therapy which examines the relationship between your thoughts, feelings, behaviors, and substance use. It may be particularly helpful in developing healthy strategies to cope with stress or boredom, which don’t involve drugs or alcohol.16

Contingency management is another form of therapy that is often used, which offers people rewards to encourage positive behaviors.15

Paying for Addiction Treatment

The cost of addiction treatment or recovery programs can feel overwhelming, especially if a person is homeless or experiencing poverty. However, there are options for people needing financial assistance.

  • Medicare is a federal health insurance program for people 65 or older, certain young people with a disability, or people with end-stage renal disease (ESRD).17 Medicare has different parts, which cover specific services. Medicare Parts A and B cover services to treat substance use disorders and mental health disorders at varying levels of care.18
  • Medicaid is a state- and federally-funded program that provides low-cost or free healthcare to many people with low income, regardless of age. Eligibility is based on income and family size.19 Coverage and eligibility vary depending on the state a person lives.19 If you have Medicaid, you often don’t pay anything for medical costs, but a minimal copayment might be required.19
  • Scholarships or grants are sometimes offered by treatment facilities to cover the cost of treatment. Many rehab centers offer these to people who have a hard time affording treatment.
  • Free rehabs and low-income recovery programs can be found through the Substance Abuse and Mental Health Services Administration’s Behavioral Health Treatment Services Locator.

Addiction Treatment Aftercare

Formal addiction treatment varies in intensity and duration. Research has revealed that the longer any person with a substance addiction stays in treatment, the more likely he or she is to achieve and maintain sobriety.6

When it is time to leave formal treatment, it is important that the program provide aftercare, or continuing care planning to help a person adjust back to daily, independent living. Aftercare is any ongoing treatment or step-down care that occurs after the initial recovery program, which may improve treatment outcomes. Aftercare may include:

  • Outpatient treatment.
  • Individual therapy.
  • Group counseling.
  • Mutual support groups and 12-Step programs.
  • Social, vocational, and housing services.
  • Case management.
  • Medication management.