Association between Homelessness and Opioid Overdose and Opioid-related Hospital Admissions Emergency Department Visits PMC

Substance use disorder, along with PTSD, are two of the five most common mental health disorders impacting homeless veterans today, according to the U.S. Without the proper support, they are much more likely to end up on the street, which can worsen their substance abuse and other mental health conditions. During January’s homelessness census, 14 percent of those surveyed reported struggling with substance abuse, and another 10 percent with alcohol addiction. Drug addiction can have a major impact on people’s lives, leading to financial instability, strained relationships, and health problems. These issues can lead to homelessness, as people struggling with substance abuse may not have the financial or emotional resources to maintain stable housing. Substance abuse can lead to physical and mental health problems, financial instability, and an increased risk of violence.

Overall, our findings for both opioid outcomes were not sensitive to restricting the analysis to NY and MA (Online Appendix Table 2A), to male patients (Online Appendix Table 3A), or to patients with ED visits only (Online Appendix Table 4A). Homeless individuals, on average, had greater number of ED and inpatient visits per person compared to low-income housed individuals (Online Appendix Table 5A). The test to assess the sensitivity of our regression results to unmeasured confounders revealed that residual confounding is unlikely to explain the observed association between homeless status and the two opioid outcomes (Online Appendix Table 6A). First, we examined the association between homeless status and opioid overdose and opioid-related ED visits/hospitalizations using multivariable regression models.

  1. Our findings suggest that the homeless population, and in particular White female homeless population, is at a higher risk of opioid overdose.
  2. Wells’ perspective is a common one and shapes both local and national discussions about how cities should address homelessness, so I decided to fact check his claim.
  3. For instance, single parent families with 1 dependent (family size of 2), were more likely to report ASU as a reason for housing loss (9.4%) compared to those with 3 or more dependents (4.3%).
  4. Homeless individuals had disproportionately higher adjusted risk of opioid-related outcomes compared to low-income housed individuals treated at the same hospital.

Maybe they get kicked out of the home they shared with their family because of their behavior, or they have to leave an apartment after spending their rent money on drugs or alcohol. People often bounce around between situations where friends and family precipitated withdrawal: definition symptoms traits causes are willing to take them in before exhausting all their options and ending up on the street. Even without looking at the statistics, it’s easy to imagine the connection between people who are unhoused and those who struggle with substance use disorders.

Loss of housing attributed to addiction or substance use

In an interview with Fox 5 San Diego, Wells claimed nearly all homelessness is tied to drug or alcohol abuse. Councilmember Eunisses Hernandez, who represents District 1, said the majority of homeless deaths in her district last year were due to opioids. She said she wants to bring more services to MacArthur Park, where many of those deaths occurred.

Much of the research is dated and surveys during the annual census rely on reports from homeless people themselves. None of those sources confirmed that most homelessness is linked to drugs or alcohol, as Wells claimed. Wells’ perspective is a common one and shapes both local and national discussions about how cities should address homelessness, so I decided to fact check his claim.

These people often end up incarcerated, where they won’t get the help they need. Typically, this worsens the cycle of poverty that contributed to the situation in the first place. During the briefing, service providers stressed “harm reduction”— the use of naloxone, syringe exchange programs and sanctioned drug-use locations — as the most effective responses. Our free email newsletter offers guidance from top addiction specialists, inspiring sobriety stories, and practical recovery tips to help you or a loved one keep coming back and staying sober. While some children, teens, and young adults are homeless because the rest of their family is homeless, many more become homeless for other reasons. Kids become homeless mainly because of family problems, economic problems, and abductions.

The report did not attempt to calculate a mortality rate for last year because of the lack of current information on the number of homeless people. Though COVID-19 became the second-leading cause of death in the overall Los Angeles population, it remained a minor factor in homeless deaths, following heart disease, transportation-related virtual meeting schedule accidents and homicide — which all lagged far behind drug overdoses. The staff at 12 Keys Rehab includes professionals experienced in addiction and recovery treatment and support. These caring counselors, therapists and others offer guidance and compassion throughout your stay at 12 Keys Rehab.

If they’re also substance abusers, the need is even greater for them to receive treatment during pregnancy since both drugs and alcohol can harm an unborn child. If you or a loved one is currently experiencing homelessness and suffering from substance abuse or addiction, some people can help you and provide you with the support you need. Race, gender, and ethnicity can influence the likelihood of dealing with homelessness and addiction. As with housed individuals, certain demographics of homeless people suffer from addiction at a higher rate than others.

Report on addiction, substance use and homelessness

Conversely, respondents in large communities with populations over 500,000 were least likely to identify ASU as a reason for housing loss (24.2%). According to the report, 31% of the homeless people who died in 2023 were Black. Black people are 8% of the city’s population but 33% of the unhoused population. From illicit drugs to prescription medications, alcohol, and tobacco, the landscape of substance abuse is complex and multifaceted. Past problematic drug use (defined as having ever failed to reduce use and having others express concern about use, with no use in the past 3 months) characterized 41% of the 289 respondents classified on the ASSIST as having “moderate risk” drug use. Past problematic alcohol use characterized 22% of the 434 respondents classified on the ASSIST as having “lower risk” alcohol use.

Annexe B: 2018 Everyone counts survey

A recent study using machine-learning algorithms to predict patients with high risk of opioid overdose identified 268 potential predictors of opioid overdose, but the homelessness was not included as one of the potential predictors (27). Indeed, homelessness has not been identified as an important predictor of opioid overdose in the currently-available clinical prediction models. Our findings, indicating a higher risk of opioid-related outcomes among the homeless population, underscore the importance of including homelessness as the key predictor in the clinical tools for predicting patients at an increased risk of opioid overdose. Our final sample consists of 96,099 homeless and 2,869,230 low-income housed individuals who had at least one ED visit/hospital admission in 2014 in these four states. Our findings suggest that the homeless population, and in particular White female homeless population, is at a higher risk of opioid overdose.

Without a steady paycheck, they end up losing their homes to foreclosure or eviction. Homeless and addicted to drugs or alcohol, they find themselves living on the streets. While men as a whole experience homelessness at a greater rate, women often suffer from homelessness for unique reasons. These unique circumstances result in a higher rate of drug and alcohol use among homeless women than men. Culhane said that crisis may have increased the rate of substance abuse addiction by 20 percent – or even more.

It is possible that opioid addiction may lead individuals to lose employment and become homeless or hinder their efforts to get off the streets rather than homeless status causing higher risk of opioid overdose. Homeless people often have a lot of concurrent medical problems as well as psychiatric issues and substance abuse. Homeless people suffer from alcohol and drug addiction at a higher rate than those who have permanent residences. Due to their financial situation, they also don’t have access to the level of care needed to address their drug, alcohol, and mental health issues.

They may not be interested yet in finding help, especially if they’re deep into their addiction. Families of people who are both addicted and homeless often struggle to convince their loved one to get help. Once they do find that person on the street and are able to talk to them, then the challenge of finding a treatment program begins.