Substance abuse, also known as drug abuse, is use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases criminal or anti-social behaviour occurs when the person is under the influence of a drug, and long term personality changes in individuals may occur as well. In addition to possible physical, social, and psychological harm, use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.
The Substance Abuse and Mental Health Services Administration is a branch of the U.S. Department of Health and Human Services. It is charged with improving the quality and availability of treatment and rehabilitative services in order to reduce illness, death, disability, and the cost to society resulting from substance abuse and mental illnesses. The Administrator of SAMHSA reports directly to the Secretary of the U.S. Department of Health and Human Services. SAMHSA's headquarters building is located outside of Rockville, Maryland.
The Downtown Eastside (DTES) is a neighbourhood in Vancouver, British Columbia, Canada. The area, one of the city's oldest, is the site of a complex set of social issues including extremely high levels of drug use, homelessness, poverty, crime, mental illness, and sex work. It is also known for its strong community resilience and history of social activism.
Homelessness in Canada has grown in size and complexity since 1997. While historically known as a crisis only of urban centres such as Montreal, Laval, Vancouver, Edmonton, Calgary, and Toronto, increasing homelessness in suburban communities requires new services and resources.
Homelessness in the United States refers to the issue of homelessness, a condition wherein people lack "a fixed, regular, and adequate nighttime residence" as defined by The McKinney–Vento Homeless Assistance Act. Point-in-time single night counts prepared by shelter providers differ greatly from federal government accounts. In 2014, approximately 1.5 million sheltered homeless people were counted. The federal government statistics are prepared by the United States Department of Housing and Urban Development's Annual Homeless Assessment Report; as of 2018, HUD reported there were roughly 553,000 homeless people in the United States on a given night, or 0.17% of the population. Annual federal HUD reports contradict private state and local reports where homelessness is shown to have increased each year since 201 across several major American cities, with 40 percent increases noted in 2017 and in 2019. In January of 2018 the federal government statistics gave comprehensive encompassing nationwide statistics, with a total number of 552,830 individuals, of which 358,363 (65%) were sheltered in provided housing, while some 194,467 (35%) were unsheltered.
Homeless shelters are a type of homeless service agency which provide temporary residence for homeless individuals and families. Shelters exist to provide residents with safety and protection from exposure to the weather while simultaneously reducing the environmental impact on the community. They are similar to, but distinguishable from, various types of emergency shelters, which are typically operated for specific circumstances and populations—fleeing natural disasters or abusive social circumstances. Extreme weather conditions create problems similar to disaster management scenarios, and are handled with warming centers, which typically operate for short durations during adverse weather.
Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives, and is an active "community services and funding" stream across the United States. Supportive housing is widely believed to work well for those who face the most complex challenges—individuals and families confronted with homelessness and who also have very low incomes and/or serious, persistent issues that may include substance use disorders, mental health, HIV/AIDS, chronic illness, diverse disabilities or other serious challenges to stable housing. Supportive housing can be coupled with such social services as job training, life skills training, alcohol and substance use disorder treatment, community support services, and case management to populations in need of assistance. Supportive housing is intended to be a pragmatic solution that helps people have better lives while reducing, to the extent feasible, the overall cost of care. As community housing, supportive housing can be developed as mixed income, scattered site housing not only through the traditional route of low income and building complexes.
So Others Might Eat (SOME) is a nonprofit organization which seeks to help deal with poverty in Washington, D.C.. SOME provides food, clothing, and healthcare services to the poor and homeless. In addition, SOME provides job training, counselling, and low-cost housing, and other services to "break the cycle of homelessness".
Housing First is a relatively recent innovation in human service programs and social policy regarding treatment of people who are homeless and is an alternative to a system of emergency shelter/transitional housing progressions. Rather than moving homeless individuals through different "levels" of housing, whereby each level moves them closer to "independent housing", Housing First moves the homeless individual or household immediately from the streets or homeless shelters into their own accommodation.
Pathways to Housing is a not-for-profit organization founded in 1992 by Dr. Sam Tsemberis. It is the mission of Pathways to Housing to transform individual lives by ending homelessness and supporting recovery.
Homelessness is defined as living in housing that is below the minimum standard or lacks secure tenure. People can be categorized as homeless if they are: living on the streets ; moving between temporary shelters, including houses of friends, family and emergency accommodation ; living in private boarding houses without a private bathroom or security of tenure. The legal definition of homeless varies from country to country, or among different jurisdictions in the same country or region. United States government homeless enumeration studies also include people who sleep in a public or private place not designed for use as a regular sleeping accommodation for human beings. People who are homeless are most often unable to acquire and maintain regular, safe, secure and adequate housing due to an unsteady or lack of income. Homelessness and poverty are interrelated. There is no methodological consent on counting the homeless and identifying their special needs; thus in most cities only estimated homeless populations are known.
Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; driving while intoxicated; and physiological withdrawal symptoms. Drug classes that are involved in SUD include: alcohol; caffeine; cannabis; phencyclidine and other hallucinogens, such as arylcyclohexylamines; inhalants; opioids; sedatives, hypnotics, or anxiolytics; stimulants; tobacco; and other or unknown substances.
Episcopal Community Services of San Francisco (ECS) is a non-profit organization benefiting homeless and low-income men, women, and children in San Francisco, California. ECS was founded in 1983 and is now one of San Francisco's foremost agencies serving homeless people.
The Vulnerability Index is a survey and analysis methodology for "identifying and prioritizing the street homeless population for housing according to the fragility of their health". It is a pragmatic methodology based on concern and inquiry into the reasons for recurring fatalities of homeless living in the outdoor urban context. It was developed by Jim O'Connell of Boston Health Care for the Homeless Program.
Keeping Families Together is a program of the Corporation for Supportive Housing (CSH) that aims to provide supportive housing to vulnerable families in order to enhance children’s safety and help prevent foster care placement. It brings together affordable housing with other social services and city agencies to help families with issues like substance abuse, medication management, parenting skills and career counseling.
In a study in Western societies, homeless people have a higher prevalence of mental illness when compared to the general population. They also are more likely to suffer from alcoholism and drug dependency. It is estimated that 20–25% of homeless people, compared with 6% of the non-homeless, have severe mental illness. Others estimate that up to one-third of the homeless suffer from mental illness. In January 2015, the most extensive survey ever undertaken found 564,708 people were homeless on a given night in the United States. Depending on the age group in question, and how homelessness is defined, the consensus estimate as of 2014 was that, at minimum, 25% of the American homeless—140,000 individuals—were seriously mentally ill at any given point in time. 45% percent of the homeless—250,000 individuals—had any mental illness. More would be labeled homeless if these were annual counts rather than point-in-time counts.
The San Francisco Bay Area comprises nine northern California counties and contains four of the ten most expensive counties in the United States. Strong economic growth has created hundreds of thousands of new jobs, but coupled with severe restrictions on building new housing units, it has resulted in an extreme housing shortage which has driven rents to extremely high levels. The Sacramento Bee notes that large cities like San Francisco and Los Angeles both attribute their recent increases in homeless people to the housing shortage, with the result that homelessness in California overall has increased by 15% from 2015 to 2017. In September 2019, the Council of Economic Advisers released a report in which they stated that deregulation of the housing markets would reduce homelessness in some of the most constrained markets by estimates of 54% in San Francisco, 40% in Los Angeles, and 38% in San Diego, because rents would fall by 55%, 41%, and 39% respectively. In San Francisco, a minimum wage worker would have to work approximately 4.7 full-time jobs to be able to rent a two-bedroom apartment.
Community Solutions is a New York City-based non-profit organization, created by Rosanne Haggerty. It works with communities across the United States to create a lasting end to homelessness that leaves no one behind. Community Solutions leads Built for Zero, a national initiative of more than 80 communities working to measurably end homelessness. Community Solutions also led The 100,000 Homes Campaign, a national campaign that housed more than 105,000 people experiencing chronic homelessness.
Homeless veterans are persons who have served in the armed forces who are homeless or living without access to secure and appropriate accommodation.
A managed alcohol program is a program meant to reduce harm for chronic alcoholics. The program involves providing a regular dose of alcohol to individuals with alcohol addiction, typically at a shelter-based harm reduction centre.
