Introduction to the Special Series on Addiction and Homelessness

Throughout the U.S. and the world, people who experience homelessness are stigmatized to the extreme, ranging from criminalization (i.e., hostile architecture) to cruel attitudes and unspeakable hate crimes.  When it comes to people who experience mental illness and homelessness—even among our cherished veterans—their combined stigma has sustained generations of blame, humiliation and casual devaluation. For the tens of thousands of Americans who experience addiction and homelessness, the stigma is virtually inescapable.

Nearly 50 years after the deinstitutionalization of patients from state mental hospitals, the state of mental illness and homelessness in the U.S. remains in crisis. This is largely attributed to the 95% decline in the number of available psychiatric beds compared to a half-century ago, and inpatient capacity that has not kept up with the needs of patients who have psychiatric disorders. Among this population, it is not uncommon for those who experience both mental illness and homelessness to self-medicate with alcohol and street drugs, leading not just to addiction, but disease transmission from injection drug use as well.

Here at the Division on Addiction, we are all too familiar with the broadly misunderstood factors that can lead to stigma. That is why we are devoting the entire month of January to a new Special Series on Addiction and Homelessness. Today, The WAGER reviews a study exploring how gambling-related problems relate to homelessness. Later in the month, The DRAM, ASHES and STASH will address addiction and homelessness pertaining to their unique area of addiction research. We will supplement these materials with an op-ed by renowned “street doctor” Dr. Jim O’Connell, President of Boston Health Care for the Homeless and Assistant Professor at Harvard Medical School, who will discuss his experience providing high quality health care to some of the most vulnerable members of the Boston community for the last 30 years.

We hope you enjoy this new Special Series and invite you to post your comments throughout the month.

— Vanessa Graham

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