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Substance use is prevalent among people experiencing homelessness (PEH) in Germany, with 34% engaging in polysubstance use. Younger PEH, those with prior incarceration, and current tobacco users are at higher risk. Targeted support is crucial.

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Area of Science:

  • Public Health
  • Addiction Medicine
  • Sociology

Background:

  • The number of people experiencing homelessness (PEH) in Germany has doubled since 2022, reaching 440,000 in 2024.
  • Representative data on substance use among PEH is critically lacking.
  • This study addresses the data gap by estimating substance use prevalence and identifying risk factors for polysubstance use in this vulnerable population.

Purpose of the Study:

  • To estimate the prevalence of recent substance use among people experiencing homelessness (PEH) in Germany.
  • To identify specific subgroups of PEH at increased risk for polysubstance use.
  • To inform targeted interventions and public health strategies for this population.

Main Methods:

  • A cross-sectional study involving 674 PEH across four German metropolitan areas in 2021.
  • Toxicological analysis of serum samples to detect 22 substances, categorized into alcohol, CNS stimulants, narcotic analgesics, and cannabis.
  • Polysubstance use defined as the presence of substances from at least two distinct categories.

Main Results:

  • 35% of PEH reported no recent substance use; 34% exhibited polysubstance use.
  • Alcohol was the most frequently detected substance (39%), followed by CNS stimulants (30%), cannabis (28%), and narcotic analgesics (18%).
  • Polysubstance use was significantly associated with younger age, history of incarceration, current tobacco use, and geographical location.

Conclusions:

  • Substance availability and use are widespread among the growing PEH population in Germany, coinciding with rising drug-related deaths.
  • Findings highlight the urgent need for continued monitoring of substance use trends in PEH.
  • Targeted support and interventions are essential for subgroups identified as high-risk for polysubstance use.