Homelessness and substance misuse: a tale of two cities

Area of Science:

• Public Health
• Addiction Medicine
• Urban Studies

Background:

• Homelessness is a significant public health issue in urban environments.
• Substance misuse often co-occurs with homelessness, creating complex challenges.
• Understanding the prevalence of substance misuse among the homeless is vital for targeted interventions.

Purpose of the Study:

• To investigate the relationship between alcohol and drug misuse among the literally homeless population.
• To compare substance misuse rates in two comparable northeastern U.S. cities: Hartford, Connecticut, and Providence, Rhode Island.
• To identify the need for accessible substance treatment services within homeless support systems.

Main Methods:

• Conducted a point-in-time census (N=1058) and random sample (N=66) in Hartford.
• Sampled clients (N=82) from six shelters serving residents in Providence.
• Collaborated with homeless advocacy organizations in both cities for data collection.

Main Results:

• Substance misuse was identified in 47.2% of the homeless population in Hartford.
• Substance misuse was identified in 45.1% of the homeless population in Providence.
• High rates of substance misuse indicate a significant need for accessible treatment.

Conclusions:

• Substance misuse is a widespread issue among the literally homeless in both studied cities.
• There is a critical need to implement substance treatment services within shelters, soup kitchens, and day centers.
• Integrating services into the homeless milieu increases opportunities for engagement and treatment adherence.