Homelessness and substance abuse
At Frederick Place, one of the missions is to change the perception of the homeless and hopefully in doing so, enlighten the public so positive, long-term solutions for ending homelessness can be found. The purpose of this article is to teach a little about substance abuse and its impact on an individual becoming homeless, and what we at Frederick Place are doing for our residents who have issues with addiction/alcoholism.
Society has a tendency to stereotype classes of people, and a common belief about the homeless population is that the majority of those without homes are alcoholics or drug abusers. Addicts and alcoholics in the larger cities, and as portrayed by the media, are often viewed as people with poor hygiene who wear dirty clothes. They are seen on the streets drinking from brown paper bags or hiding in an alley to do their drug of choice. The homeless addict/alcoholic is a person who is unemployable or unable to keep a job for a long period of time because they put their drug of choice before a job and a “normal” life. The alcoholic/addict is a person with no ambition who prefers to hold up signs begging for money or “will work for…” and is most likely drunk or high all day long. To sum up, a stereotypical alcoholic/addict is seen as a loser, a failure…a person who created the mess they now live in.
In our small community, we don’t often see the type of homeless addict/alcoholic that fits this “big city” stereotype. However, that does not mean we do not have our share of alcoholics and addicts who, unable to beat their addictions alone, find themselves homeless.
While this stereotype may be unfair to the homeless population, the truth is that a high percentage of homeless people are addicts/alcoholics. A 2008 survey by the United States Conference of Mayors asked 25 cities for their top three causes of homelessness. Substance abuse was the largest cause of homelessness among single adults (reported by 68 percent of cities). Even in our small community, addictive disorders are a cause of homelessness. The stress of being unable to pay bills or keep a job can result in the exacerbation or onset of an addiction causing them to lose their housing. Addiction can destroy relationships with family and friends. Family and friends who have tried in vain to help their loved one often reach a point where they just can’t live with the addict’s/alcoholic’s broken promises, lies and relapse any longer and refuse to shelter them even for a night. On the flip side, homelessness can also be the cause of substance abuse. People begin to use substances to get some temporary relief from their problems, and this more often than not results in increasing their problems, and decreases their ability to achieve employment stability and get off the streets. In urban homeless communities, people can actually view drug and alcohol use as necessary to be accepted amongst other homeless people.
Addiction had for years been viewed as a moral issue, the result of a lack of will power and/or the presence of emotional or psychiatric problems. In other words…the addict/alcoholic could help themselves if they really wanted to; they just don’t want to sober up.
On April 12, 2011, the American Society of Addiction Medicine adopted a new definition of addiction after a four-year process involving more than 80 experts. Addiction is now defined as a chronic brain disorder and not simply a behavior problem involving drugs, alcohol, gambling or sex.
“At its core, addiction isn’t just a social problem or a moral problem or a criminal problem. It’s a brain problem whose behaviors manifest in all these other areas,” said Dr. Michael Miller, past president of ASAM, who oversaw the development of the new definition. The new definition also describes addiction as a primary disease, meaning that it’s not the result of other causes, such as emotional or psychiatric problems. So, like cardiovascular disease and diabetes, addiction is recognized as a chronic disease; it must be treated, managed and monitored over a person’s lifetime, the researchers say. Dr. Miller also added, “So, we have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction, and start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment.”
With all this in mind, is it any wonder breaking addiction is difficult for anyone let alone someone who is homeless? The homeless addict must view survival and finding food and shelter as a higher priority than personal growth and development or drug counseling. And if they are motivated to put their sobriety first and foremost, how difficult it must be to remain sober while living in a community where substances are so widely used. One has to keep in mind that by this point, many addicts/alcoholics have become estranged from their families and friends and have nowhere to go but the streets. Other barriers for a homeless addict/alcoholic to getting the necessary treatment are lack of, or the high cost of, health insurance, long waiting lists, lack of transportation and lack of documentation.
Since substance abuse is both a cause and a result of homelessness, both issues need to be addressed simultaneously. It has been shown that stable housing during and after treatment decreases the risk of relapse. Substance abuse treatment on its own is inadequate and needs to be combined with supported housing opportunities. In addition to housing, supported housing programs offer services such as mental health treatment, physical health care, education and employment opportunities, peer support, and daily living and money management skills training. Successful supported housing programs include outreach and engagement workers, a variety of flexible treatment options to choose from and services to help people reintegrate into their communities (National Mental Health Association, 2006). Supported housing programs that include substance abuse services would help homeless people treat their addictions and re-establish residential stability.
One third of the individuals that Frederick Place has sheltered since opening in January of 2011 have struggled with substance abuse. Rhinelander is home to Koinonia, an inpatient treatment facility, to help those who struggle with substance abuse. Koinonia is the place from which many addict/alcoholic residents have come to our doorstep. They arrive at Frederick Place because they are not welcome in a family member or friend’s home for reasons previously mentioned. Some of our residents arrive on our doorstep after being released from jail or prison, having nowhere to go. We’ve had individuals arrive here upon the recommendation of their probation officer.
A significant amount of our addicts/alcoholics come to Frederick Place because of our “zero tolerance” policy. These individuals do not have homes of their own but could go to a friend’s or family member’s if absolutely necessary after leaving treatment. However, for someone serious about recovery, these places are often not “safe” places to be because there may be substance use/abuse of some sort going on in the residence. It is a fact that stable housing during and after treatment decreases an individual’s chance of relapse.
Regardless of how or why our addict/alcoholic residents arrive at Frederick Place, they are welcomed with open arms and viewed as courageous individuals who are self-aware enough to know they need to be in a safe place a little longer to help them achieve long term sobriety. While they live at Frederick Place, they take part in the same programs as our non-addicted residents. This includes applying for housing programs, help with job searches, physical and mental health care and educational opportunities such as GED, HSED or enrollment in college courses. The difference between the two groups of residents is that an individual with substance abuse issues will have sobriety as one of their goals set forth by their case manager. To help these individuals succeed in this area, Frederick Place has AA and NA meeting lists posted and we do what we can to get people to meetings if they are unable to walk or ride a bike to the meeting site. We have several recovery and mediation books as well as a caring staff available to the residents 24/7. One staff member, who calls herself the “token alcoholic,” applied for this job for the simple reason that she is sober today because when she was struggling, there were people who believed in her, listened to her and offered advice or a hug. It made all the difference in the world. She wanted to share her experiences, strength and hope to help others like her, as well as be a resource for other staff members.
Fighting an addiction is hard enough when you have a home and/or the support of friends and family. To be homeless and struggling with addiction is difficult, to say the least, and our mission at Frederick Place is to offer these individuals all the support and understanding we can once they arrive, because in our book “It takes more courage to ask for help than to act alone.”