1. Coping Mechanism for Trauma and Stress
Trauma History
Past Trauma: Many individuals who experience homelessness have a history of trauma, such as childhood abuse, domestic violence, or severe loss. Substance use can become a coping mechanism to deal with the emotional and psychological pain.
Daily Stressors
Living Conditions: The harsh realities of living on the streets – including exposure to violence, lack of safety, and extreme weather conditions – create a high-stress environment. Substances may be used to temporarily escape or numb these stressors.
2. Mental Health Issues
Prevalence of Mental Illness
Dual Diagnosis: A significant number of homeless individuals suffer from mental health disorders such as depression, anxiety, PTSD, and schizophrenia. These conditions can lead to or exacerbate substance use as individuals attempt to self-medicate.
3. Lack of Access to Healthcare
Limited Mental Health Services
Barriers to Treatment: Homeless individuals often face barriers in accessing mental health and addiction treatment services. This is due to a lack of trust in institutions caused by, among other things, perceptions of being ‘let down’ in the past, inconsistencies and perceived judgement in receiving care, and lack of culturally appropriate/conducive care. Additional barriers include lack of transportation or availability of services. This lack of access makes it harder to address SUDs effectively.
Treatment Type: Therapeutic interventions to address trauma history and daily stressors are often not readily available or accessible. Cost is a barrier and the transient nature of homelessness can disrupt therapy.
4. Social and Environmental Factors
Peer Influence
Community Norms: In some homeless communities, substance use can become normalised or even a social activity, reinforcing and perpetuating its use.
Drug Availability: Easy access to drugs in certain areas can increase the likelihood of substance use among homeless individuals.
Drug Quality: Drugs laced with unknown compounds can lead to unpredictable behaviour, and social and health consequences, often exacerbating issues.
5. Economic Instability
Financial Constraints
Poverty and Hopelessness: The financial instability that accompanies homelessness can lead to feelings of hopelessness and despair, making substance use a more appealing escape.
6. Self-Medication for Physical Pain
Untreated Health Issues
Chronic Pain: Homeless individuals often suffer from untreated chronic pain due to lack of healthcare. Substances may be used to self-medicate physical ailments.
7. Barriers to Recovery
Lack of Support Systems
Social Isolation: Many homeless individuals lack supportive social networks, making recovery from substance use disorders more challenging without encouragement and assistance from family or friends.
Inconsistent Care: The transient nature of homelessness can disrupt continuous care and support for those seeking to recover from substance use disorders.
Lack of support for family or friends: Limited support is available to family and friends of homeless individuals where capacity for care could be built if support existed.