Home > Heroin - the mental roof over your head: Links between homelessness and drug use.

Keane, Martin (2005) Heroin - the mental roof over your head: Links between homelessness and drug use. Drugnet Ireland , Issue 13, Spring 2005 , pp. 5-6.

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This research was carried out by Marie Crawley and Mary Daly on behalf of the Tallaght Homeless Advice Unit (THAU).1 The main aim of the research was to explore the issues, policies and practices faced by homeless heroin users that contributed to their becoming and remaining homeless. 1 The methodology adopted involved semi-structured interviews with 17 users of the Advice Unit and 13 representatives from statutory, voluntary and community agencies working in Tallaght. This article will focus on the findings from the interviews with service users.

The profile of the 17 service users interviewed (8 women and 9 men) revealed a pronounced experience of social exclusion and social problems.Eleven were experiencing homelessness at the time of interview and 15 were on a methadone maintenance programme. The group of interviewees had 27 children between them (17 among the women; 10 among the men). Sixteen (59%) of the children were aged four or under.

The researchers explored whether drug use initially contributed to homelessness, and whether homelessness was sustained by continued drug use. A majority of interviewees stated that their drug use contributed to their becoming homeless initially. Over half of this group reported that their families were unable to cope with their drug use. Evictions under anti-social behaviour legislation and relationship breakdown were cited as additional factors contributing to homelessness. Most interviewees agreed that their drug use acted to sustain their experience of homelessness and created a barrier to moving out of homelessness. For example, all but one reported being evicted from hostels and B&Bs because of drug-related incidents. In addition, interviewees reported that becoming homeless greatly exacerbated their drug use. For example, the transition to using heroin intravenously was strongly associated with moving into the homeless scene, particularly when frequenting emergency hostels and sleeping rough. Repeatedly, interviewees identified the lack of accommodation for homeless people in Tallaght as a factor in exacerbating their drug use, as travelling into the city centre to access emergency accommodation increased the likelihood of involvement in the 'drug scene'. 

Experience of homelessness was mixed, with some interviewees reporting experiences of extreme social exclusion. For example, all had some experience of rough sleeping – under trees, in building sites, on rooftops, railway carriages, shop doorways, and on church steps. Some reported having to walk the street during the day due to policies of daytime exclusion from emergency hostels or because of movement between different accommodations from night to night. On the other hand, some managed to achieve a degree of stability when staying in the same B&B for more than three months. With support from some B&B staff, interviewees stabilised their drug use and ensured their children attended local schools.

When settled in B&Bs or in supported/transitional accommodation with support and structure in their lives, interviewees reported stability in their drug use. The biggest threat to this stability was being moved into emergency hostels where peer pressure to misuse and deal drugs was prevalent. Emergency hostels were clearly identified by all as the primary risk accommodation associated with chaotic use of drugs. Hostels were classed on a par with rough sleeping in terms of exposure to drug dealing and drug misuse. All repeatedly stated that their drug use escalated in hostels. Most associated emergency hostels with their most chaotic periods in terms of drug use.

Respondents highlighted the consequences of drug misuse while experiencing homelessness. Almost a quarter reported the prevalence of suicidal thoughts; heroin overdose resulting in hospitalisation was reported by five respondents. All respondents had experience of intravenous drug use, with heroin and cocaine the main drugs being injected. Injecting heroin was associated with feelings of being out of control around drugs.

Interviewees reported mixed experiences of their engagement with drugs and homeless services. Most homeless services were perceived to show a lack of respect for clients when drug use was a factor. Consequently, interviewees did not feel they could disclose their drug use to homeless services for fear of further discrimination. On the other hand, respondents had little criticism of drugs services except in reference to the high turnover of addiction counsellors being a barrier to getting support with their addiction problems. The majority of respondents did not experience any attempt at an integrated approach between homeless and drugs services.

Although it is difficult to generalise from this local study to the wider population of homeless drug users, the study does raise some issues that merit further attention from policy makers and service providers. For example, there was unanimous agreement that accommodation in emergency hostels is directly associated with an escalation in chaotic drug use. On the other hand, when provided with stable and supported accommodation, some interviewees stabilised their drug use and ensured their children attended school. The research also highlighted the lack of an inter-agency approach towards drugs and homelessness and a lack of accommodation provision for homeless people in Tallaght.

The report contains a number of recommendations for policy makers and service providers.  One particularly pertinent recommendation reads: 'There is a need for a strategic local approach involving all agencies providing a range of options to facilitate the phased progression of clients out of drug use and out of homelessness – this needs to included a range of accommodation options, including, but not limited to, B&Bs and local authority housing.’ The challenge now for the local authority and drug service providers in Tallaght is to develop an inter-agency approach to the problems of homelessness and drug misuse at local level, and to concentrate resources on providing localised stable accommodation so as to prevent vulnerable individuals with drug problems being exposed to the drug scene in the city centre and surrounding emergency hostels. Such an approach over time could provide a good practice model from which other affected areas could draw inspiration and guidance. 

1. Tallaght Homeless Advice Unit (2004) Heroin – the mental roof over your head: links between homelessness and drug use. Dublin: National Advisory Committee on Drugs.

Item Type:Article
Issue Title:Issue 13, Spring 2005
Date:January 2005
Page Range:pp. 5-6
Publisher:Health Research Board
Volume:Issue 13, Spring 2005
EndNote:View
Accession Number:HRB (Available)
Subjects:MA-ML Social science, culture and community > Social condition > Homelessness
VA Geographic area > Europe > Ireland
T Demographic characteristics > Homeless person
B Substances > Opioids (opiates) > Heroin
A Substance use, abuse, and dependence > Effects and consequences

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