Unmet Drug and Alcohol Service Needs of Homeless People in London: A Complex Issue

Abstract

Little research has been conducted on the drug use of those who sleep rough (on the streets) in the United Kingdom (UK). During 2000, to fill in the gaps in the knowledge base, researchers at the National Addiction Centre, London, carried out a community survey using a structured questionnaire amongst 389 homeless people recently or currently sleeping rough, in order to investigate their met and unmet drug and alcohol service needs. In total, 265 (68%) had a need for drug services and 97 (25%) for alcohol services. Over half of the current drug users (170/324, 52%) and 88 (33%) of the 264 current alcohol users wanted help with their substance use, but few were currently accessing the appropriate services, other than needle exchanges. The challenge for services is to build these potential clients' motivation to accept health-conferring intervention.

• Homelessness
• Drug services
• Alcohol services
• Needs assessment

Notes

In this paper, “homeless” refers to all those who have no home, and includes those living in hostels for homeless people, in temporary accommodation provided for homeless people, and sleeping on the streets. “Sleeping rough” refers specifically to homeless people who are sleeping on the streets.

Several times a year, throughout the United Kingdom, the numbers sleeping on the streets are counted by special teams. It is widely thought, however, that many people sleeping rough are hidden—deliberately or otherwise—from these counters.

Below is the checklist of symptoms derived from, and compatible with, both DSM-IV and ICD-10 (American Psychiatric Association, [1994]; World Health Organisation, [1992]) as it appeared in the study's questionnaire. Three or more “yes” responses indicate dependence. Instructions to interviewers are in italics.

Additional information

Notes on contributors

Jane Fountain

Jane Fountain, B.A. (Hons), Ph.D. is a Reader in Ethnicity and Health at the Centre for Ethnicity and Health, University of Central Lancashire, and has been researching aspects of drug use for 14 years, eight of them at the National Addiction Centre, London. Recent projects in the United Kingdom include studies of the diversion to the illicit market of drugs prescribed to drug users in treatment and several Black and minority ethnic drug service needs assessments. For seven years she has been the coordinator of a qualitative research network and website (www.qed.org.uk) for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

Samantha Howes

Samantha Howes, B.Sc. has worked in the addictions research field for nine years, based at the National Addiction Centre, London. Recent projects include various prevalence estimations and needs assessments, stimulant drug use, and drug substitution treatment in the European Union.

John Strang

John Strang, M.B.B.S., F.R.C.Psych, M.D. is Director of the National Addiction Centre, London. He leads the research activities including treatment studies, investigations of nontreatment samples, and policy analyses, and is also Clinical Director of the Drug and Alcohol Services at the South London and Maudsley National Health Service Trust. He heads the training activity at the National Addiction Centre, which includes an M.Sc. in Addictions, within King's College London, Institute of Psychiatry.