This paper provides an overview of the intersection between homelessness and substance use, alongside existing care responses and guiding principles. From a policy perspective, we aim to promote cross-sector collaboration between health systems, housing authorities, and support services. When examining the link between substance use and homelessness, it is important to recognise that the relationship is complex and requires a flexible approach. Not all people experiencing homelessness use substances, nor do all who use substances become homeless. However, the needs of those who experience both must be acknowledged, and services should address this intersection empathetically and without judgment.