TACKLING ADDICTION ON THE STREETS

Homeless People Can Overcome The Odds And Get Clear Of Drink And
Drugs. But When Eighty Per Cent Of The Homeless Have Drugs Problems, A
Shift Of Focus From Criminalisation To Treatment Is Urgently Needed.

The appalling statistic from our research - over 4 out of 5 homeless people
addicted - says it all. The strangle-hold that drugs and drink have on our
clients is destroying lives at an alarming rate.

Drugs have not always been a part of the homelessness landscape. Fifteen
years ago, it was drink that was killing homeless people. Now, a
combination of the two dominates people's experiences of homelessness and
in all the time that I have worked for Crisis, it has been a very rare
occurrence to meet a homeless person who doesn't have a drug or drink problem.

Getting out of addiction is hard enough for anyone, but homeless people
have the hardest battles to fight. One in five homeless people suffering
from a severe mental health problem, making mental distress a defining
characteristic of homeless.

For a person with poor mental health, an addiction and no home, life can be
incredibly chaotic and frightening. Constantly on the move, switching from
hostels, to squats, to B&Bs and the streets, their lives are unbelievably
unstable. The chances of being registered with a GP are often slim, the
probability of being surrounded by people with more severe addictions high.
How a person is supposed to find the courage to seek out help for their
problems I don't know.

And yet homeless people do it. In spite of the chaos and pain in their
lives, they can and do turn the corner and decide to become clean.But
getting help is another battle entirely, which many people are failing to
win. In our research, around half the addicts who wanted help had not
received it in the past twelve months. The reasons for this - a basic lack
of services, a lack of choice and long waiting times - were constant
obstacles which robbed our interviewees of their motivation to get clean
and left them feeling betrayed.

For those addicts who are lucky enough to get help, the problems don't end
there. A place in a detox unit, as precious as it is, is no use to a person
if they are not supported to stay clean. A person nursing a 20-year
addiction may not get it right the first time round and emerge as a
fully-rehabilitated person after eight days. After-care and support are
critical because completing a detox programmes carries many dangers.A
person's physical tolerance of drugs plummets after a stint in detox and if
they suddenly start using again, the risk of overdosing and dying are high.

To prevent this from happening, addicts need to be supported not just to
stay clean but also to get housing, training and even a job. Sadly, we are
a long way off from this position and in the meanwhile, even more lives
will be wasted. For those people who are too terrified or whose lives are
yet too unstable for treatment, we must provide support. Harm minimisation
services - such as needle exchanges - and compassionate health-care must be
available for them until they are ready to move forwards.

The opportunity to put an end to the damage of addiction lies in our reach.
Drugs policy is at a critical juncture in this country. Recent reports on
drug use, from the Audit Commission and Home Affairs Select Committee have
been excellent in highlighting the urgent need to provide more treatment
for drug users. The Home Secretary has responded positively by pledging
more money and an expansion of treatment services. Whether the money will
be enough, only time will tell; it will certainly need to be sustained in
the long-term.

However money alone is not enough and it's important that the right
policies and services are in place to provide addicts with the range of
treatments they need to overcome their addictions. Positive steps forward
have been made - the expansion of heroin prescribing is welcomed news for
Crisis - but the Home Secretary's decision to not introduce safe injecting
rooms is a missed opportunity to save lives.

If we are to be truly effective at tackling addiction amongst homeless
people, a dedicated national drugs strategy is needed for them. Who owns
this strategy is another matter. Be it the Home Office or the Department of
Health, one thing is clear - compassion and treatment, not criminalisation,
must be key.

Implementation rests on the shoulders of the Drug Action Teams (DATs) who
commission all drug services in local areas. The remit of the DATs is vast,
the pressure on their time immense. Although homeless people are used to
being bottom of the pile, it is not acceptable for them to fall off the
priority list. Drug Action Teams need specific targets and ring-fenced
budgets for homeless people, to ensure their needs are being met. Without
this, homeless people will continue to die and this shameful situation can
no longer be tolerated.