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> Homelessness != Substance Use Disorder

True. But the Venn diagram overlaps a _lot_. If we magically solved homelessness for everyone with a substance-abuse problem, the people still left homeless would be the ones cities are already able to help.



The majority of homelessness is caused by economic issues like the loss of a job, lack of sufficient income, lack of affordable housing and domestic violence. I did some work for an Australian charity that works with the homeless, so I have this graphic[1] on hand.

Here's a relevant graphic for the US[4].

The top three obstacles to obtaining permanent housing in SF are lack of affordability, unemployment and lack of housing availability[2].

The figures I've seen put substance abuse and alcoholism between ~10% and ~20% of the reasons for homelessness[3].

[1] https://probonoaustralia.com.au/wp-content/uploads/2016/08/w...

[2] http://www.socketsite.com/archives/2016/02/san-franciscos-ho...

[3] https://www.spur.org/sites/default/files/wysiwyg/Figure%206_...

[4] http://www.homelesshouston.org/wp-content/uploads/2012/09/lo...


Thanks for taking the time to provide background data. This is all really great.

I'm skeptical of the percentages you shared, not because I think people are liars, but that rooting out causative effects is complex, especially in self-reported cases.

I have an aunt who was homeless for the better part of a decade. If you had spoken to her during this period of time about why she was homeless, she would have said many things such as (1) she lost her job (2) she got evicted (3) her family kicked her out. In reality she is a paranoid schizophrenic, who does not understand when she's not on her medication that she has schizophrenia. So, was she homeless because she lost her job? Yes. Did she lose her job because she was scaring customers due to her mental disorder? Yes.

When my father was in the hospital and detoxing from his alcohol abuse, he was asked repeatedly "Russ, do you have an alcohol problem?" He uniformly responded "No I do not." He only changed his tune when he believed answering in the affirmative would get his release.

My general point is that homelessness and substance abuse are deeply intertwined, and that if we pull on the thread long enough in someone's backstory, we'll often find that substance abuse was a catalyst in the chain reaction that resulted in their homelessness, but they aren't willing to, or aren't self aware enough, to recognize it.


Research that goes beyond self-reports echoes the sentiment that homelessness is overwhelmingly an economic issue. That's not to understate the impact that health, substance abuse and domestic violence play, either.

This is important to recognize, because families are falling victim to homelessness due to loss of jobs, insufficient income and the rising cost of living.

You could probably shake a few alcoholics out of that population, just like you could with the general population, but the overwhelming majority of them became homeless because of economic reasons. Those reasons, from here[1], include lack of affordable housing, unemployment, poverty, and low wages, in that order.

I have an uncle that became homeless after his divorce. It's a hole anyone can fall into if just the right bad things happen.

There's plenty of research available. I implore anyone who is reading this to Google "causes of homelessness", or start here[2] and continue researching by checking out the citations.

[1] https://www.nlchp.org/documents/Homeless_Stats_Fact_Sheet

[2] https://en.wikipedia.org/wiki/Homelessness_in_the_United_Sta...


Reading more on what you shared, and a more contemporary study [1], I think the issue is that when I say "homeless", I'm talking about the chronic homeless in unsheltered situations in Los Angeles. Many of those who are also commenting here live in LA & SF, where we have the largest number of unsheltered homeless in the US, per capita.

All that being said, this survey seems to be absolute junk (the mayor survey, which is cited elsewhere). The survey instrument is at the bottom of the page and is remarkably subjective / at the whims of the reviewer. The word "alcohol" shows up once in that whole report. As does the word "drug[s]".

[1] https://endhomelessness.atavist.com/mayorsreport2016


This is what I mean. There are plenty of people experiencing homelessness because, say, they lost their job and they were already behind on their rent, so now they're couchsurfing or living in their car. That is not a complicated problem for cities to solve, if they have enough money and the political will to spend it. Housing vouchers, job placement counseling, domestic violence programs: there are lots of successful ways to help people without substance abuse issues.

But my uncle Jim, an alcoholic whom I most recently saw panhandling on a freeway on-ramp in Seattle? His problems are not easy to solve, and nobody quite knows how to turn money and political will into solutions for people like him. His family doesn't know how, his city doesn't know how, and I certainly don't know how. I gave him a few bucks, which I'm sure he used on his alcohol of choice, and tried not to think about how my dad looked just like him.


If you solved homelessness (not with magic, but with money) for everyone with a substance use disorder, then a lot more people would seek treatment, and a lot more would be successful. Even better, you could make that housing into supportive housing, which would prevent deaths from substance use in isolation.


One of the features of addiction and many other mental health issues is a total denial of a problem. It's one of the symptoms of the disease. That's why the first step in 10-step programs is _admit you have a problem_.




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