Abstract
A community survey using a structured questionnaire was used with 389 homeless<fnoteref rid="fn2">1</fnoteref> people currently or recently sleeping rough (on the streets) in London. Data were collected on respondents' histories of homelessness and of substance use, and dependence on the main substance used in the last month was measured. In the month before the interview, 83% (324) of the sample had used a drug, 36% (139) were dependent on heroin and 25% (97) on alcohol. Sixty-three per cent (244) reported that their drug or alcohol use was one of the reasons they first became homeless, but the majority (80%, 310) had used at least one additional drug since then. Overall, drug and alcohol use, injecting, daily use and dependency increased the longer the respondents had been homeless. A clear link exists between substance use and homelessness: initiatives to tackle homelessness must simultaneously tackle the drug use of homeless people.