Substance use affects nearly 3 in 4 people sleeping rough.
With such an alarming number, The Connection explores why this is the case and how we can make a difference.
Why do so many people experiencing homelessness rely on substance use?
Many people experiencing homelessness, or sleeping rough, often turn to substances. This can be for a variety of reasons.
Firstly, it is important to note that most people aren’t addicted to substances before becoming homeless. Living on the streets is extremely stressful, which drives people to seek escapism.
Drugs or alcohol can provide temporary relief from the physical and emotional pain endured by people sleeping rough.
Additionally, many people sleeping rough (around 50%) suffer from mental health issues like depression, anxiety, or PTSD, and using substances might seem like the only coping mechanism they can access.
This is especially true for people who have been sleeping rough for years, as they have often been let down by support services. This means they are less likely to trust mental health support services and will seek relief for their health issues elsewhere (including unsafe substances).
There are few ways to stay busy on the streets, so once a person starts using substances, it can be difficult to stop and move on. Many people simply have nothing else to do and no support system.
When you have lost all hope, taking drugs or drinking alcohol might start to seem like a good way to pass the time.
To make matters worse, drugs and alcohol are easy to access, with drug dealers often targeting the rough sleeping population. At the same time, support services can be hard to navigate and inflexible, making it tough for those in need to get help.
Understanding these reasons highlights the need for compassionate and comprehensive support systems to address both homelessness and substance use issues.
Ultimately, it is hard to know how any of us would respond in the same situation.
What treatment options are in place?
At The Connection, we run a methadone prescribing clinic with Turning Point, the Homeless Health Service, and a local GP surgery.
This is a flexible, walk-in support centre with no formal appointments, and provides wraparound healthcare. The clinic also supports people sleeping rough with complex needs who are more likely to struggle with change and often get left behind. This means we meet people where they’re at and take the time to build trust. This person-centred and trauma-informed approach is essential when supporting people experiencing addiction.
The success of this approach has shown that once a substance dependency has been stabilised, people are then in a position to prioritise other needs they have, like finding accommodation. We have been pleased to see a significant number of the people we work with settle into accommodation after attending the clinic.
While clinics like this are important, they are only part of the solution, and we are looking into other types of accessible support that are needed. One of the big challenges people face is getting the right help into detox support.
Unfortunately, traditional addiction support services often do not adequately meet the needs of people experiencing rough sleeping.
These services typically require appointments, which can be challenging for those without stable communication or living arrangements. Structured programmes and fixed schedules often don’t align with the unpredictable nature of life on the streets.
Access barriers, including physical distance and stigma, can make it even harder to seek help. Often, support is the hardest to reach for the most vulnerable. This makes relapse more common and reduces trust in support services, allowing the addiction cycle to continue.
What changes do we want to see in treatment options?
To overcome these issues, we believe policy change is key. This includes: