What treatment and services are effective for people who are homeless and use drugs?

People who experience homelessness experience disproportionately high rates of drug use and associated harms, yet barriers to services and support are common. This review explores the effects of interventions for this population on substance use, housing, and related outcomes, as well as on treatment engagement, retention and successful completion.

Results of the systematic search identified 843 citations and 25 reviews that met the inclusion criteria.

Key Findings:

• Regarding substance use outcomes, there was evidence that harm reduction approaches lead to decreases in drug-related risk behaviour and fatal overdoses, and reduce mortality, morbidity, and substance use
• Case management interventions were significantly better than treatment as usual in reducing substance use among people who are homeless.
• The evidence indicates that Housing First does not lead to significant changes in substance use. 

The researchers conclude that despite limited evidence relating to interventions designed for this population, harm reduction and case management approaches show positive substance use outcomes while some housing interventions improve housing outcomes and may provide more stability.