Homelessness may be a complex issue but we know how to
make a difference, heard delegates at a conference that brought
together academics and experts by experience. DDN reports
utreach workers would try and contact me, but I couldn’t hear,
they couldn’t get through. I was fretful and frightened.’ Kevin
Dooley is now a recovery programme consultant, but at a
conference on addressing complexity: homelessness and addiction’
he cast his mind back to a time when he was homeless, addicted
to drugs and alcohol, and in and out of prison.
‘I would wake up when I was homeless and not know what time it was – I
didn’t know the day or the month,’ he said. ‘I would open my eyes and see Boots
the chemist through the gloom, and I’d know I could shoplift.’
When Dooley left prison, he ‘was on everything but roller skates’, but had no
support, no crisis plan, no therapy, and was homeless. Vulnerable in every way, he
found it impossible to ask for help.
‘Vulnerable people are being penalised rather than supported,’ he said. ‘To
penetrate this, we need to understand the problem… Why do people get out of
their heads every day? To become functional, to find a sense of wellbeing.
Homelessness is not an intelligence deficiency. Addiction is not an intelligence
We needed to attempt a much deeper understanding, which would help to
develop more reflective practice, he said. Relationships were important and
sometimes all people needed was ‘a good listening to’. But it was essential to
become fully informed about the effects of trauma in early life and realise that
‘the problem was there before the drug dealer came, before the first drink’.
‘It’s a growing problem that’s getting worse and that we need to do more to
address,’ said conference chair, Prof Tony Moss. Each measure of homelessness had
increased across England since 2010 and deaths of homeless people had increased
by 24 per cent over five years.
When represented in the media, the problem was caused by drugs, alcohol,
Siberian winds – but never by austerity. ‘The question really should be “why is this
problem happening in the first place?”,’ he said. ‘It’s important not to perpetuate
the myth that people are dying because of drugs and alcohol.’
16 | drinkanddrugsnews | February 2019
LACK OF COMPASSION
Most deaths attributed to drug poisoning were ‘thoroughly preventable’, said Prof
Alex Stevens, of the University of Kent. ‘The problem is not lack of evidence, but
lack of compassion. It’s a class attempt to write people off and not think of them
as fully human.’
Leading a report for the ACMD on how to reduce deaths in 2016, he had
recommended opioid substitution therapy (OST), drug consumption rooms (DCRs),
integrated services, and ‘putting naloxone everywhere’. Latest data from PHE
showed that only 12 per cent of people were leaving prison with naloxone, when
the odds of death from overdose were eight times higher without it.
‘We should be getting people into treatment and keeping them there,’ he said,
explaining that people were nearly twice as likely to die when they were out of OST.
Treatment should also involve service integration and assertive outreach, linking
drug and alcohol treatment to housing, mental health support, HIV and HCV testing,
help with employment, relationships, diet and exercise, and smoking cessation.
There were many things that we could do and should be thinking about ‘rather
than just getting people on a script’, he said, such as offering vaping pens to replace
the ‘crappy roll-ups’ that caused lung disease.
With evidence being ignored on many initiatives that would have a positive
impact, Stevens concluded that the main barriers in drug policy were ‘power and
morality’; fiscal policies had redistributed wealth upwards and you were nine times
more likely to have a drug-related death if you were from one of the poorest
communities. We needed to change the narrative, he said, humanising people who
use drugs as ‘people worthy of compassion and fully worthy of respect’.
There were many practical things that we could do to improve life for homeless
people, the conference heard. In his opening address Prof Tony Moss said, ‘we’re
not particularly good at working together’, so the event went on to share a wide
range of expertise.