Substance Abuse and Harm Reduction in the Homeless Population

Written by: Lauren Anderson

Edited by: Jacqueline Cheung & Anya Bhopa

Dear CCP readers,

According to the Without a Home survey on young people experiencing homelessness across Canada, 20% of the homeless population are young people ages 13-24, and each year, there are at least 35,000-40,000 people experiencing homelessness. In Canada, many studies have proven that youth experiencing homeless have an increased risk of poor nutrition, victimisation, substance use and abuse, and limited access to healthcare. In this article, we focus on these risks that homeless youth experience and how they are linked to a higher likelihood to addiction to illicit substances. There is an inherent link between substance abuse/addiction and mental health.

One of the goals for the Canadian Courage Project (CCP) is to promote the mental well-being and health of youth experiencing homelessness. We actively host youth shelter workshops with the goal of educating the youth on the importance of mental health and mindfulness. Hundreds of youths have participated in these workshops, and we hope to continue these efforts to educate more of our community as well. Our organisation also hosts career-oriented workshops in school classes for youth to educate them on 17 UN Sustainable Development Goals. We have had the privilege to host this workshop with 74,000 youth so far. Each of these programs instill confidence in our youth and highlight the importance of connecting within one’s community.

If you would like to learn more information regarding the current state of homelessness in Canada and the Greater Toronto and Hamilton Area (GTHA), welcome! If you are returning for more information about the particular challenges faced by youth experiencing homelessness and those with animal companions, welcome back! If you are new to our blog, welcome to the community and thank you for your interest in learning more about issues regarding the homelessness crisis in Canada and beyond - you are one step closer to becoming a changemaker in your community, and you are in great company.

Substance Abuse as Causation or Result of Homelessness in the Youth?

The factors that lead a young person to homelessness vary from those that are causations for adults experiencing homelessness. Studies have shown that 40-71% of street-involved youth abuse alcohol and/or other drugs. It has also been found that substance abuse rates are 10% higher in youth males and 17% higher in youth females who are homeless than those who do not experience homelessness. For some, substance abuse might lead to homelessness, and for others, substance abuse might have come about as a coping mechanism due to homelessness. It is a common misconception that people facing homelessness are primarily those with drug addictions. This is a harmful misconception, as there are many other reasons that someone may find themselves homelessness, and it also adds a stigma to those dealing with addiction. In a systematic review of causes of youth homelessnes in developed and developing countries, “delinquency” was the least frequent cause for homelessness (Embleton et. al, 2016). On the other hand, the most common reasons for “street involvement” in youth experiencing homelessness were poverty and family conflict (Embleton et. al, 2016). It is important that this misconception is defeated, and we learn to have compassion for those facing homelessness, and compassion for those dealing with substance abuse issues as well.

As previously mentioned, youth who are experiencing homelessness are more prone to drug exposure while living on the street. Substance use may seem attractive to these youth as it can provide a sense of community, relief, and survival. On the other hand, substance use is linked to many physical and psychological issues, including addiction, infectious diseases, criminal behaviour and violence. The table below quantifies the effect that substance use has on youth facing homelessness, and it also connects substance use to social and mental health behaviours. It is clear that risk prevention and education is needed to help youth living on the streets avoid temptation to get involved in drug use.





The Link Between Substance Abuse, Mental Health, and Homelessness

Increased substance abuse in youth comes with more drug-related harms, including issues with one’s mental health, which are two times higher in youth facing homeslessness versus non-homeless youth. There is a strong link between struggling with one’s mental health while being homeless and substance use. Homelessness and substance use are separately individual risk factors for worsening mental health, but some people experience the overlapping disadvantages of dealing with both of these issues. The CCP is working towards the goal of improving the mental health of youth facing homeslessness, and we aim to educate them on finding healthy coping mechanisms to deal with mental health challenges that they are experiencing.

As seen in the table above from the study performed through the Youth Pathways Project (YPP) conducted by researchers at the Centre for Addiction and Mental Health and the University of Toronto, 24% of the youth were found to have concurrent mental health and substance abuse problems. Twenty-seven percent of the studied group also reported experiencing suicidal ideations in the past 12 months. These statistics are disappointing, and prove that there is a clear correlation between substance abuse and increased issues with one’s mental health.

Peter Saunders (also known as “Rabbit”) filmed a video depicting his “day-in-the-life” of someone experiencing homelessness and an addiction to fentanyl and other opioids. In his video documentation, he explains how he wants to have a future life that is more than being homeless. He explains how much he does not like his life, yet once he gets high, he goes from “feeling terrible, irritable, anxious, frustrated, to normal and blissful and happy.” Drug use is often used as an escape from reality and to feel something outside of a negative surrounding. Although this video is difficult to watch, Saunders highlights the pervasiveness of addiction and how it has played a part in his story of homelessness. Unfortunately, Saunders passed away in November 2019, but his story lives on as an example of someone who was actively asking for help and wanted freedom from his addiction and from homelessness. We must do better to understand the unique challenges our peers face while living on the street. It is unfortunate that there are not enough resources to aid in prevention and education to help others dealing with similar issues to Saunders.



Reducing Abuse and Harm in the Homeless Population

Reducing abuse in the homeless population ties into our core principle of promoting mental well-being and physical health. Harm reduction is also important, as it provides other options that are geared towards creating an experience that is ideally, the least harmful possible. Some harm reduction ideas include intervention, safe injection sites, supply distribution, overdose prevention and treatment, motivational interviewing, and more.

How can you help?

  • Fight the stigma on substance abuse by continuing to educate those around you.

  • Spread resource guides for those in need.

  • Have conversations with children about mental health and drug use.

  • Support safe environments for safe injections of medicines.

  • Support a better healthcare infrastructure that includes programming meant to keep youth away from the streets and remain drug/alcohol free.

This link serves as a guide of resources and centres that can help Canadian youth experiencing homelessness. For anyone experiencing addiction or substance abuse, please also refer to the Canada Drug Rehab site.


Thank you for reading our blog! Feel free to leave a comment with your feedback and/or insights to help us enrich the quality of future posts and cater to the interests of our community of changemakers.


- The CCP Team



Sources

Embleton, L., Lee, H., Gunn, J., Ayuku, D., & Braitstein, P. (2016). Causes of Child and Youth Homelessness in Developed and Developing Countries: A Systematic Review and Meta-analysis. JAMA pediatrics, 170(5), 435–444. https://doi.org/10.1001/jamapediatrics.2016.0156


Harm reduction. Harm Reduction | The Homeless Hub. (n.d.). Retrieved November 8, 2022, from https://www.homelesshub.ca/about-homelessness/substance-use-addiction/harm-reduction

Kirst, M., & Erickson, P. (n.d.). Substance Use & Mental Health Problems among Street-involved Youth: The Need for a Harm Reduction Approach. Homeless Hub. Retrieved November 1, 2022, from https://www.homelesshub.ca/sites/default/files/attachments/11KIRSTweb.pdf

Without a home: The National Youth Homelessness Survey. (n.d.). Retrieved November 8, 2022, from https://www.homelesshub.ca/sites/default/files/attachments/WithoutAHome-final.pdf



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