Evidence from recent research undertakings demonstrate that treatment is an effective antidote to homelessness for those with addictive disorders and that services customized to the unique needs and life circumstances of those without homes can resolve both their addictive disorder and their homeless condition. A comparison of the addictive disorder treatment and recovery continuums for homeless people and gaps therein in thirteen communities across the nation provide an opportunity to make observations about the current state of affairs for homeless persons with addictive disorders in those locations and, by extension, the nation. Every community examined reported a service gap in at least one stage of the treatment and recovery continuum for homeless people. Even in those communities with favorable coordination of services, this coordination is only effective if there are sufficient services at all stages of the continuum. In some communities, barriers to treatment and recovery occur not for a lack of providers but rather for a lack of transportation assistance to enable homeless people to get to those providers located across-town, regions, or even states.
Communities appear to be better skilled at arranging for site-based outreach than street outreach.
The absence of concerted street outreach may signal that a sizable number of chronic public inebriates, who typically do not access emergency shelter, are never approached regarding the opportunity to utilize treatment and recovery resources that are available in the community. Many communities do not have structured public inebriate programs, and instead rely on the police to retrieve inebriates and transport them to emergency rooms or to jails. Not only is this a missed opportunity to provide safe shelter to inebriates and to connect them to the treatment and recovery continuum, but it represents a sizable public cost in terms of law enforcement and hospitalization. Some communities are using pre-treatment shelters as a de facto form of sobering programs. Other communities are looking to establish pre-treatment shelters in an effort to stop the repeated use of detoxification programs while awaiting placement in a treatment program.