1/great piece by @CarlynZwaren addresses how we misconstrue associations between substance use and homelessness. The stories we tell, often enough, are “my addiction made me homeless”
filtermag.org/drugs-homeless…
filtermag.org/drugs-homeless…
2/I have talked with patients who say, “I’m homeless because of cocaine”. Yes. Okay. When I ask when they last used, it was 4 months earlier. One bad day triggered a catastrophe. Quoting @KellyMDoran there is every reason to think these relationships go both ways.
3/Just to be clear, a some bad days of drug use can cause homelessness if, wait for it, you’re poor, and your family is poor, and no one has any space left in their overpriced apartments and your community has not invested in light-touch assistance like temporary cash support.
4/But we do overestimate how many lacking homes are using substances. @CarlynZwaren cites 1/3. In our survey of homeless & formerly homeless, 10% met criteria for “high risk” use. In older adults, 15% had high-severity drug use ncbi.nlm.nih.gov/pmc/articles/P…
ncbi.nlm.nih.gov/pmc/articles/P…
ncbi.nlm.nih.gov/pmc/articles/P…
5/But even this doesn’t quite get the point. In modeling studies, substance use doesn’t “cause homelessness”. It weakens connections to those who might protect one against homelessness. Those connections weaken in part because of how we react to a person who does use
6/In 1934, Sutherland sent researchers into Chicago’s shelters. They said that historical processes explain “why there were 20,000 men in shelters in 1934 and practically none in 1924”, but not why some wound up alone and outdoors and others not. trove.nla.gov.au/work/19725524?… 
7/Addiction recovery still can be a key step to regaining a job and housing. Except when it’s not! In our work, for individuals who attended NIDA-funded abstinence contingent treatment for 6 months, <50% achieved stable work & housing 6 months later ncbi.nlm.nih.gov/pmc/articles/P…
8/Ultimately —we must recognize that our social arrangements – including zoning, labor markets, federal incentives for homeownership, interest rates & disability policies fix “how much” homelessness there is. It's up to us.Get the facts @naehomelessness endhomelessness.org/homelessness-i…
