Understanding Housing First and Substance Abuse

As the opiate epidemic has continued to spread throughout the country over the past decade, the toll that it has taken on countless families is both staggering and heartbreaking. As the epidemic has worsened, so has homelessness. Permanent Supportive Housing (PSH) using the Housing First model offers homeless individuals who are coping with addiction a viable way to overcome homelessness and seek effective treatment.

What Does Housing First Actually Mean?

The National Alliance to End Homelessness has championed Housing First as the most viable approach to address homelessness among both families and individuals. Simply put, it recognizes that the solution to homelessness is housing.

When people are living in shelters or spending nights on the street, it is difficult if not impossible for them to address the problems that have contributed to their inability to maintain housing. They cannot stay engaged in care to treat physical disabilities, mental health conditions, or substance use disorders. Stable housing equips them with the resources that they need to access care and stay in housing.

Why Has Housing First Been Met With Opposition?

Many people simply do not understand the root causes of homelessness and the role that substance use plays in this pervasive problem. Likewise, they may erroneously conclude that sobriety should be a prerequisite for any type of housing subsidy. In reality, people need stable housing to surmount addictions. PSH which offers onsite case management services can help people practice harm reduction and work towards overcoming addictions.

While it may be hard to explain substance abuse and treatments to people who view dependencies as some form of moral defect, the opponents of PSH for people who are battling an addiction cannot argue with the economic practicality of the Housing First model. The availability of PSH facilitates effective and affordable health care. It also reduces the utilization of emergency services. By increasing available PSH, cities do not have to expend the same amount of resources on policing and other public services.

Ultimately, increasing awareness about the social and economic viability of Housing First can help to dispel misconceptions about addiction and homelessness. With more supporters, these vital programs could gain access to more funding. That would enable them to provide housing and services to more individuals.

How Can Cities and Nonprofits Create More PSH?

Community Development Corporations and nonprofit organizations have to work diligently to get the resources that they need to expand PSH. Federal funds from the Continuum of Care Program can go towards essential project expenses such as real estate acquisition and capital needs improvements.

Funding opportunities are limited and competitive. After the issuance of a Notice of Funding Availability, organizations have to work quickly to prepare an application prior to the deadline for submissions. Leveraging resources and establishing cooperative partnerships between organizations may help to strengthen applications.

There are no quick fixes for the escalating homelessness crisis in cities where the opiate epidemic has hit hard such as Boston and San Francisco. Developing PSH in these struggling areas is going to require strategic collaboration and ongoing policy advocacy on behalf of health and human service organizations.

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