Illegal drug use is deeply intertwined with homelessness, both increasing the risk of losing housing and arising or worsening when people find themselves on the streets, a new study reports. It also found that a large majority of people living on the streets are not drug users. The study, published in the medical journal JAMA by the Benioff Homeless and Housing Initiative at UC San Francisco, gives a complex statistical picture of a topic that has been fraught by conflicting narratives. Against a public perception that drug use is endemic to homeless camps, service providers and advocates see an exaggerated reaction to open drug use on the street that stigmatizes the majority of homeless people who do not use drugs, reports the Los Angeles Times. The Benioff study supports some elements of both viewpoints. Contrary to common perception, only about 37% of homeless people were using illicit drugs regularly, and 25% said they had never used drugs. Drug use is far more prevalent among homeless people than in the general population. Just over 65% reported having regularly used at some point in their lives, and 27% had started after becoming homeless.
Some 35% said their drug use had decreased after they became homeless. Some were parents worried about losing custody of their children. Others had “just reached that point,” said lead author and Benioff director Margot Kushel. That finding highlighted the need for better treatment options, Kushel said. Many told interviewers that had already cut back and would like help to cut back more. “One of the most poignant findings was that 1 in 5 told us they are actively seeking treatment and couldn’t get it,” Kushel said. Housing is the solution, Kushel said, but until enough of it is available, there is a need to bring more resources to the street, such as methadone or other medications that treat opioid addiction. Kushel also urged increased access to residential treatment as long as it could lead to housing and that those who relapse in treatment — “very common and part of the natural history of substance use disorders” — would not be returned to homelessness. The report, Illicit Substance Use and Treatment Access Among Adults Experiencing Homelessness, is one of a series of reports based on Benioff’s 2023 Statewide Study of People experiencing homelessness. The largest representative sample of homelessness since 1990s, it consisted of 3,200 questionnaires and 365 in-depth interviews.
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