Facing the harsh realities of homelessness often leads individuals to seek solace in substance use, creating a difficult cycle that can be challenging to break. Many individuals turn to drugs or alcohol as a way to cope with trauma, mental health issues, or the relentless pressures of living on the streets. Although used as a method to escape, reliance on substances tends to exacerbate their issues, undermining stability and intensifying feelings of isolation. 

     In recent years, a disturbing trend has emerged in Ontario, reflecting a dire crisis that intertwines homelessness and opioid overdoses. A new study conducted by researchers from the Institute for Clinical Evaluative Sciences, and published in the journal Addiction, highlights the alarming rise in opioid overdose deaths among people experiencing homelessness.

     The study's findings are both shocking and heartbreaking. In 2021, one in six opioid overdose deaths involved homeless individuals, up from one in fourteen in 2017 (CP24, 2023). This study in Ontario further revealed a troubling trend: opioid overdose deaths among homeless people have spiked. Researchers looked at 6,644 deaths from July 2017 to June 2021 and found that early on, 7.2% of those who died were homeless. By the end, that number had jumped to 16.8%.

     “Dealers often advertise their product as the strongest because it's what users want…you want something stronger; you're also saving money. If you're homeless, money is hard to come by.”  Joey, a London, Ont., a homeless a fentanyl drug user whose name is being kept confidential (CBC News, 2023)

     For individuals facing homelessness, every penny is meticulously allocated for survival, making stronger drugs appear to be a better economical solution. More potent doses mean fewer purchases, stretching limited funds further. This grim existence makes stronger, often more dangerous drugs highly attractive. But this economical consideration carries severe risks, as stronger drugs significantly increase the likelihood of overdose, particularly when individuals are unaware of the exact toxicity and strength of what they are consuming. This desperation to save money and achieve a more significant effect can lead to fatal consequences, especially among the homeless population, who already face numerous vulnerabilities. The cycle of poverty and addiction feeds into itself, creating a deadly vacuum that pulls individuals in a deeper spiral. As dealers continue to market their strongest products to meet this demand, the danger only escalates. 

    Dr. Stephen Hwang, Director of the MAP Centre for Urban Health Solutions at St.Michael’s Hospital, emphasizes the devastating impact of drug overdoses on individuals experiencing homelessness. There is a huge gap in public health services and policy intervention to prevent overdoses and save lives, particularly post-pandemic. Researchers emphasize the importance of expanding access to supervised consumption facilities, fentanyl testing strips, and naloxone (Narcan) kits, which can reverse opioid overdoses. Implementing low-barrier opioid agonist therapies and tailored office-based addiction treatments is also essential. While stable housing is a necessary component, it alone is insufficient to address the high rates of morbidity and mortality among homeless individuals (Unity Health Toronto, 2022). 

References:

CP24. (2023). Opioid overdoses among homeless people rose dramatically: Ontario study. Retrieved from https://www.cp24.com/news/opioid-overdoses-among-homeless-people-rose-dramatically-ontario-study-1.6604444

CBC News. (2023). Toxic drug supply in London, Ont. prompts calls for safe supply programs. Retrieved from https://www.cbc.ca/news/canada/london/london-ontario-drugs-toxic-safe-supply-1.6877395

Unity Health Toronto, & Hwang, S. (2022, March 14). Emergency department visits for drug overdoses disproportionately higher among homeless population during the pandemic: Study. MAP Centre for Urban Health Solutions. https://maphealth.ca/emergency-department-overdose-study/#:~:text=The%20authors%20are%20calling%20for,agonist%20therapies%2C%20and%20tailored%20office%2D 

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