Effectiveness Bank web site Homelessness
Supported by    Society for the Study of Addiction web site   Alcohol Change UK web site
World Homeless Day 2020
The inaugural World Homeless Day was on 10th October 2010, and has been marked around the world every year since, providing an opportunity to raise awareness and generate support for ideas and policies that can bring an end to homelessness.

Homelessness is commonly associated with extreme hardship, but the experience goes much further than the individual and the personal. Homeless people are deeply socially excluded, and at the same time can be subject to intense public scrutiny and judgement. This duality becomes very apparent in respect of homeless people who drink and take drugs, who are often assumed to be making a ‘choice’ to be homeless by continuing to drink and take drugs, and a ‘choice’ therefore not to be part of mainstream society.

The Effectiveness Bank hot topic Dignity First was created in the context of large gaps in knowledge and empathy around homelessness and substance use. It aims to tell a story about the harms this population experience, and to consider what works and what hasn’t worked against the most important criteria of saving lives and improving lives. It questions the public disorder lens through which homelessness and substance use problems tend to be viewed, and challenges the lack of public responsibility for the conditions that lead to these problems. It also brings to the fore a key debate in the field of substance use: the validity of harm reduction not just as a mechanism to engage people who use drugs with treatment, but as a legitimate goal in itself.

Read in full or use the navigation pane (shown below) to skip to a topic that peaks your interest:
  1. Rough sleeping is just the ‘tip of the iceberg’
  2. ‘A profoundly unequal set of risks’
  3. The overlap between substance use problems and homelessness
  4. Antisocial ‘street lifestyles’
  5. Taking it off the streets and supervising consumption
  6. The problem with demanding abstinence
  7. The right foundation for recovery
  8. Shifting public perceptions of homelessness
  9. Changing lives in the age of austerity
  10. A ‘dignity first’ approach to homelessness, drugs, and alcohol
Also choose below from a sample of entries in the Effectiveness Bank about these cross-cutting issues – from expecting homeless people to pursue abstinence to interventions that put ‘housing first’, from street drinking bans to helping hostel residents access treatment.
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Featured in the Effectiveness Bank
Counterproductive to expect too much too soon
Conducted for the Scottish government, this comprehensive and thoughtful review of the UK-relevant literature warns that services which impose rigid and unrealistic expectations of abstinence or independent living on homeless people dependent on drugs or alcohol would deny treatment and housing to vulnerable adults with complex needs.

Undoing the ‘double bind’ of homelessness and substance use problems
Housing first is part of the UK Government’s plan to end rough sleeping by 2024, cementing the programme’s role in addressing chronic homelessness, including among people with substance use problems. In New York City researchers asked whether housing first could indeed help the target group remain in housing, as well as support their retention in methadone maintenance therapy up to three years later.

Winners and losers from street drinking bans
So-called ‘alcohol-free zones’ proliferated across the UK, preventing an individual drinking in public when police believed their drinking was causing a problem. Review found such measures reassured communities, but at the expense of further marginalising street drinkers.

Making the difficult to reach reachable
How a team in London’s West End set about systematically overcoming the barriers which prevented the residents of a homelessness hostel getting the treatment they needed. The key step was simple: asking residents just what it was which stood in the way.

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Hot topics – important, controversial, dividing opinion over facts or interpretation.

The Drug and Alcohol Findings Effectiveness Bank offers a free mailing list service updating subscribers to UK-relevant evaluations of drug/alcohol interventions. Findings is supported by the Society for the Study of Addiction and Alcohol Change UK, and advised by the National Addiction Centre.