What is the Drug of choice among the homeless?

By David Joel Miller

So which drug does the majority of the homeless use?

Day in the life of the homeless

Day in the life of the homeless.
Photo courtesy of Flickr

Being homeless is one problem. Most of the homeless have a whole raft of problems. It would be nice to think that if they just got a place to stay, move them into a shelter, then their problems would go away. It is more complicated than that. Drug use also plays a role. You may be surprised at the relationship between drugs and homelessness.

It is more complicated than that. Drug use also plays a role. You may be surprised at the relationship between drugs and homelessness.

Homelessness, mental illness, and drug use run in packs.

Among the homeless, there is a disproportionate number of the mentally ill. These are people with serious and persistent mental illness. By serious and persistent mentally ill, I do not mean that they are beyond hope and incapable of recovery. Many very seriously impaired people do recover. But being homeless and having a mental illness makes the road of recovery that much more difficult.

The question is “Do we as a society have the collective will to help them recover?” Can we create the path back to society that they need? I fear that as a society most of our efforts are to keep them out of sight rather than to welcome than back to society.

People who are mentally ill, homeless or not, are more likely to do certain drugs. They use them to control or manage symptoms and the use to forget and to cope. The mentally ill use one drug in particular more than the rest of society.

Beyond mental illness, there are other problems for the homeless. Drug use yes that is one. I’ll get to that in a moment. They also have a host of medical problems. The mentally ill die significantly sooner than the people who are not symptomatic. Their most preferred drug shortens their lifespan dramatically.

Note that I did not say the non-mentally ill. (Or the normal, who knows what is normal?)

We know that there are many people with less severe emotional problems who when put under enough stress can show signs of a mental illness.

As I have said before, I do not get fearful working around someone with schizophrenia. What makes me really scared is the “normal” person who is served with divorce papers or has just found out their partner is cheating and then this enraged person shows up at a workplace with a gun.

These adjustment disorders, untreated are a lot scarier than the persistently mentally ill. But I digress.

The homeless, often with a mental illness, and being homeless can cause depression and anxiety in the most stable of people, they have severe medical issues. The only source of treatment for many is long waits in hospital ER’s, at a huge effort for them and a huge cost to society. Their drug of choice makes their medical issues more acute.

By drug, I do not mean prescribed medication. Most homeless have difficulty getting a prescription and if they do have one taking it consistently is unlikely.

The homeless and the mentally ill everywhere are more likely to be the victims of crime than the perpetrators. When they do have prescribed meds they are likely to get lost or stolen during the course of life on the street. Lots of things get lost or stolen when you are homeless.

So which drug is the drug of choice among the homeless?

Tobacco, nicotine is the drug of choice among the homeless, followed arguably by alcohol. They pick these drugs because they are cheap and readily available.

The numbers with respect to smoking are staggering.

Three of every four homeless smoke, you heard that right, 75% of the homeless smoke. Rates of smoking among those with a psychosis are very high.

A homeless person is FOUR times more likely to smoke than someone who is not homeless. The homeless are dying from smoking related illness at rates far above the rest of the population.

Helping the homeless with smoking cessation, alcohol abuse treatment and treating the health related problems these two legal drugs are creating might go a significant way towards helping the homeless on their path to recovery.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books


4 thoughts on “What is the Drug of choice among the homeless?

  1. Hello David!

    When I think of the homeless it always makes me feel sad. We don’t know how lucky we are. I love that you said, “What’s normal anyway.” Never a truer words spoken!

    Great article. Hugs to you. Paula xx


  2. Pingback: What do you do if you are allergic to smoke? | counselorssoapbox

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