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Cause or Effect? - Substance Misuse.

Substance misuse within the homeless community is a huge and prevalent problem. Whether it be misuse of alcohol or drugs, both have devastating effects on health and well-being. However, it is often questioned whether substance misuse is a cause or an effect of homelessness, with many accounts supporting both theories. The short answer is that it can be both cause and effect, as no data has ever supported one theory significantly over the other. This post will look to explore how both theories are valid.


As much as 70% of those on the street suffer from a substance addiction, with two thirds citing substance misuse as a cause for first becoming homeless. Addiction often occurs from use as a coping mechanism. Some may find it hard to deal with the hardships thrown up by life and so find a way to escape them, like through alcoholism or drug use. Misuse, as a cause, can be the result of a mental or physical health problem, unresolved past trauma, family bereavement, housing problems, or even financial difficulties. Addiction can happen at such a rate that many are already in trouble before even truly knowing it and develop a heavy reliance on a substance. Consequently, this changes the person’s ability to think clearly, as they’re forced to consider when next they will be able to get a fix. Rent may be missed, employment lost, and debts increased, because of this, which most often leads to the individual becoming homeless, as a result. Substance misuse can cost someone everything and it can affect anyone. As a drug user, you are seven times more likely to become homeless than the general population. Substance misuse can be an almighty contributor to someone becoming homeless, but not all have become homeless this way. Some fall into substance misuse after becoming homeless.


Being a rough sleeper is an incredibly difficult life to live. Not only do the stresses of daily life on the street occupy your thoughts, but the thoughts of how one came to be in this position make for an upsetting experience to face. If someone has not become homeless as a result of substance misuse, this can easily occur on the streets. As mentioned before, a mental illness can increase the likelihood of an addiction developing. Feeling vulnerable, threatened, hungry, and stressed all lead to one misusing substances as a coping mechanism. Women and LGBT+ people on the streets can be particularly vulnerable to this happening to them as gender or sexuality-based trauma, either past or present, encourages this unhealthy behaviour. Moreover, finding a trusting community on the streets is not a guarantee of not misusing substances. If others around you are taking drugs or drinking, you, too, are at risk of developing these behaviours. The ease with which it’s possible to get these substances only makes it more likely and the addiction stronger. During the height of the legal high crisis in 2017, it was estimated that 90-95% of those on the streets of Manchester were using synthetic highs. A mixture of accessibility, stress, desperation, and past trauma, make substance misuse an easy behaviour to acquire.

Housing First is one way to help rough sleepers with substance abuse recover, putting people into permanent residence with treatment. Rehabilitation centres, too, are there to support those with addictions, but the sheer increase in rough sleeping and lack of funds mean those who most need help, cannot access it easily.

Of course those who are homeless do not all misuse substances and those who misuse substances are not all homeless, but the risk is present nonetheless. A cycle of dependency can be easily picked up and hard to control, without even noticing it’s happening; leading to it either being a cause or effect of homelessness.

Read more about the Housing First scheme here and drug addiction in the homeless community here.

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