Alcohol and Drug Use Disorders Among Homeless Veterans

Homeless Veterans and Substance Abuse Programs

The United States is experiencing increasing levels of homelessness. Between 2019 and 2020, the levels have increased by an alarming 2.2%. Homelessness can happen to anybody, and veterans especially may find themselves in difficult circumstances that often lead to homelessness.

Among the more vulnerable people who often become homeless are veterans. Homelessness plagues modern society, and nobody is immune to it, mainly due to the current economic situation in the world.

Veteran homeless rate is twice as prevalent as among non-veterans due to poverty, inequality in housing, and poor living conditions in overcrowded or inadequate residences. Veterans spend nearly six years homeless in contrast to their non-veteran counterparts, who spend four years homeless on average.1

What Is a Homeless Veteran?

What exactly is a homeless veteran? Homeless veterans are those who served in the military and currently don’t have a home. They live in places not meant for human inhabitance or are about to lose their home and have no other options but to seek shelter elsewhere. An individual who stays in private or public areas not intended for sleeping, for example, bus or train stations, parks, or abandoned buildings, because they don’t have a proper place to stay at night. They might find temporary solutions as a place of residence in the form of homeless shelters, motel accommodation financed by the government, or charities.2

Substance Abuse and Veteran Homelessness Statistics

Veteran’s experiences in combat should be the hardest of their lives. Yet, many veterans wind up homeless for eight or nine times as long as their service. Veterans reported having spent approximately 9 years homeless, which statistically tends to be more than an average 7 years for non-veterans. This disparity matters because the more time on the street, the bigger the risk of disease or other health risks such as alcohol or drug addiction.3

The 100,000 Homes Campaign has shown some veteran homeless statistics and rates. Of 62% of Veterans who spent 2 or more years on the street, more than half experienced severe physical or mental health issues. In comparison, astoundingly, 76% of homeless veterans experienced substance abuse and addiction issues. 32% of them have had all 3 conditions.1,3

There was also a higher rate of tri-morbidity (a combination of physical illness, mental illness, and substance abuse) and dual diagnoses (a combination of mental illness and substance abuse).3

Estimates say over 40,000 veterans are homeless at any given time and take up 11% of homeless adults in the USA. This is a severe problem that needs to be addressed by the authorities. The number of homeless veterans has been declining since 2011. Veteran homelessness is primarily caused by PTSD, social isolation, unemployment, and substance abuse.4

What are the Causes for Veteran Homelessness?

Homelessness is a complex phenomenon involving many factors such as severe scarcity of affordable housing, income inequality, and access to health care.5 Still, there is also an enormous number of displaced and disadvantaged vets with post-traumatic stress disorder (PTSD) and substance abuse.6 This is further complicated through absence of family and social support. Also, some veterans are disadvantaged when competing for jobs due to the low transferability of their skills to the civilian workforce. For homeless veterans, clean, secure, safe housing and a drug- and alcohol-free environment are paramount.7

Homelessness affects around 1.5 million veterans. Staying beyond the poverty level and paying more than half of their income to rent are the risk factors that often make a veteran homeless. Also included are households with a disabled member, veterans living alone and unable to work.8

1 in 5 veterans are living alone at present, and divorce rates for veterans are higher than the general population. Those in crisis situations or in need of temporary help rely on social support, and they can easily end up on the street without social support3

Almost half a million veterans are below the poverty level and can barely afford the rent since it takes up more than half of their income. Many veterans on the verge of homelessness also turn to food stamps.8

About 45% of the 1.6 million Iraqi and Afghan veterans seeking disability compensation are waiting for their claims to be processed. The average wait time for a disability claim is now eight months.9

Risk Factors Within Homeless Veteran Community

It is not always easy to answer the question of why do veterans become homeless? Homeless veterans’ rates are higher than any other group of adults in the USA. Various factors lead veterans to become homeless. Unfortunately, there is no one size fits all solution. Despite all issues, certain trends cannot be ignored in veteran homelessness. Substance use and mental illness are the two leading causes of veterans ending up on the streets.5

Studies have shown that homeless veterans identified substance abuse as the leading cause. Veteran homelessness was also strongly associated with mental health conditions, specifically post-traumatic stress disorder PTSD. It was determined, however, that PTSD, while a risk factor, was no more significant threat than any other mental health disorder. Veterans with PTSD may be more likely to misuse drugs to cope with PTSD.5 Substance abuse disorders and mental illnesses interact strongly, which could explain why homeless veterans often experience both. Other studies also identified other risk factors that may contribute to veteran homelessness.6  

The most prevalent risk factors that may lead to veteran homelessness are substance abuse, mental illness, low or no income, absence of social support, negative experiences from childhood, and transition stress.5

How Does Substance Abuse Play in Veteran Homelessness? 

Homeless veterans with substance use issues have fewer options for housing or employment, experience higher levels of interpersonal conflict, are more likely to contract HIV and other severe health conditions and engage in criminal behavior.5 Recently, incarceration has also been identified as a contributor to homeless veterans’ mental health and substance use problems. Mental distress and suicidal ideation are more common in homeless veterans when compared to veterans with permanent housing. Psychiatric disorders and substance abuse predicted suicidal ideation among older homeless veterans. There is also evidence that depression and violent behavior are predictors of suicidal ideation among homeless veterans.10

Homelessness among veterans is often caused or contributed to by substance misuse. A veteran with substance use disorder (SUD) may adhere to their compulsions despite the harm they are causing. SUD can make it difficult for veterans to manage their finances, work obligations, and relationships. A veteran with SUD can easily become homeless.11

A veteran with SUD is also highly likely to experience mental health issues. Homelessness is more likely to occur when both conditions are present. Veterans can get the help they need to recover by engaging in a co-occurring disorder treatment program.11

How To Help A Homeless Veteran to Avoid Substance Abuse?

Substance abuse is one of the toughest challenges that homeless veterans face. Approximately 70% of homeless veterans struggle with substance addiction. Offering treatment to these people can be challenging since they are homeless.

There are ways they can be helped: outreach services, case management, and help with housing can improve their chances of recovery immensely. In 2011, 21% of veterans admitted to substance abuse treatment were homeless.12 Housing, employment, and community help are of the most significant value.

Some official programs help struggling veterans, but in reality, every one of us can contribute. Substance abuse is one of the most effective and life-threatening problems homeless veterans face. This is why it is vital to try and put them in quality programs that offer substance addiction treatment and other forms of assistance to navigate them to a more quality life.13

Loneliness, isolation, and difficulties transitioning back home to everyday life may often lead to substance abuse issues.8 This is why connecting veterans through a platform where they can share their stories and experiences is crucial. ‘’My VA Story’’ is one such platform that was launched in 2016. The platform aims to help veterans share their experiences with Department of Veterans Affairs health care.13

How to Find Effective Homeless Veteran Rehab Programs?

Outpatient and inpatient rehab programs are available for veterans struggling with substance addiction. Depending on the severity of the addiction, they can opt for either of these programs, just like a non-veteran would.14

Veterans generally face more difficulties because they need to reintegrate into everyday life after service. SAMHSA reports that there are 3.7 million veterans that struggle with substance abuse or mental illness. There’s been a spike from 2008 to 2018 in veterans diagnosed with mental illness. Due to additional obstacles veterans face in their reintegration process, they need the highest support and should receive the best care. For this reason alone, many inpatient rehab programs organize a veteran-specific treatment.14,15

Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs)

The MH RRTPs serve veterans with multiple and severe medical conditions, mental illness, addiction, or psychosocial problems, providing high-quality treatment and rehabilitation services in a residential setting. The MH RRTP addresses specific medical conditions, mental illnesses, addictive disorders, homelessness, rehabilitation, recovery, self-care, self-improvement, and community integration. Inclusion of clinical treatment gains into a lifestyle of self-care and personal responsibility is a critical component of the residential program. Individualized treatment intensities, environments, milieu, and supervision are influenced by various factors, such as age, ethnicity, and culture, depending on the population served.15,16

For those who have combat-related PTSD, the Posttraumatic Stress Disorder Residential Rehabilitation Treatment Program (PTSD-RRTP) provides highly structured treatment over the course of six weeks. Veterans with PTSD can recuperate in a supportive environment with groups based on trauma-focused therapies. Attendance is voluntary. The PTSD-RRTP cannot be forced upon anyone.15

VA Supportive Free Housing

Homeless or at-risk veterans can use Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) vouchers to pay for rent in affordable housing options. Landlords can provide affordable housing to low-income Veterans and their families in new and existing developments.17

Homeless Veterans Reintegration Program

A grant from the Department of Labor, Veterans’ Employment and Training Service (DOL-VETS) focuses exclusively on providing employment opportunities to homeless veterans through Homeless Veterans’ Reintegration Program (HVRP). Two of the HVRP’s main objectives are to assist homeless veterans in finding meaningful employment and develop effective service delivery systems to accommodate their complex needs.16

Compensated Work Therapy

Compensated Work Therapy (CWT) is a rehabilitation program that offers vocational training. Every VA medical center should offer this type of treatment. The CWT aims to help homeless veterans dealing with mental illness or physical disability get better job opportunities and maintain them.18

Frequently Asked Questions