Rates of alcohol and other drug (AOD) related problems among homeless populations are high. Several studies that have assessed the prevalence of drug disorders among homeless people have found that these disorders are significantly higher in this population compared with the general population, with ‘alcohol use disorders’ more prevalent than ‘drug use disorders’, particularly among men (Hodder et al., 1998; Ministerial Advisory Committee, 2000; Teesson et al., 2000).
This means that service providers are likely to come across AOD related problems in various ways. Outreach workers might encounter intoxicated people on the street or intoxicated clients might come into the service, creating challenges as well as an opportunity to help. Services for homeless people can also reduce a number of chronic problems that are associated with AOD use, such as access to safe and secure environments and improved nutrition and can play an important role in recovery.
The evidence about how people successfully ‘give up’ harmful drug use illustrates the important role of services for homeless people. The evidence consistently tells us that experiencing adverse consequences of drug use can prompt someone to think about changing or ‘giving up’, but they also need to believe that they can make changes and that, if they do, the quality of their life will improve. Influential factors include improved health, new and supportive relationships, improved living conditions, employment opportunities, and support from a ‘helper’ (e.g. a friend, a priest, a counsellor, a family member). Obviously, what has influence is likely to vary from person to person, and cultural factors will have impact (some people will find religion is helpful, others will not; employment is important to some people, less important to others).
Services for the homeless can help their clients realise that they can make changes, even small ones, and they are frequently engaged in helping them access a better quality of life, both in the short- and the long-term.