The relationship between homelessness and substance abuse is a complex one that can be described as a chicken and egg situation.
Some scholars believe that substance abuse is a risk factor for homelessness, where as others are of the view that, homelessness is one factor that triggers substance use. This debate can be termed as the argument of temporal order.
Johnson, Freels, Parsons and Vangeest (1997), view this debate from the ideas of Social Selection and Adaptation Models.
Based on the Social Selection Model, they posited that, homelessness is the result of a process, characterized by a gradual depletion of a person’s economic and social resources.
That is, a person’s maintenance of his or her drug abuse habit, may lead to unemployment, depletion of financial reserves, rent arrears and subsequent eviction, breakdown in family and friends’ relationship, which can render him or her homeless.
The Social Adaptation Model however, employs the sociological argument that, social behavior can be best understood by examining the social context in which it occurs.
Homeless people encounter several physical and emotional health threats, and as a coping mechanism, may resort to the use of drugs and other substances.
Generally, homelessness can be defined as a state of lacking a permanent, descent, safe and adequate housing.
However, the legal definition may vary from country to country. In Ghana, living on the street, moving between temporary shelters, kiosks housing, under bridge shelters, ‘uncompleted buildings’, are all considered homelessness.
The Economic and Social Affairs Section of the United Nations (UN) in 2004, defined a homeless household as a household without a shelter that falls within the scope of living quarters due to a lack of a steady income.
It is difficult to know the exact number of homeless people across the world, however, it is estimated that about 150 million people worldwide are homeless.
The Habitat for Humanity in 2015, estimated that 1.6 billion people around the world live in “inadequate shelter”.
In Ghana, it is estimated that about 100,000 people are homeless on any given night, with about 5.5 million people living in slums (African Research institute, 2016).
Homelessness is generally an urban phenomenon, occurring mostly in the capital and other major cities and towns.
Homelessness whether chronic, transitional or episodic is caused by several factors, notable ones include; urbanization, unavailability of affordable housing, poverty, domestic violence and abuse, breakdown in the extended family support system, inadequate needed services for mental health and other disabilities, among others. Single adults, children and women with children in general, are more likely to be homeless.
The World Health Organization (WHO) defines substance abuse as the harmful use of psychoactive substances (including alcohol and illicit drugs) which can lead to dependence.
Several factors may drive a person into substance abuse, for example; access and availability, cultural norms, environment, occupation and so on.
Homeless victims suffer a number of adverse effects, this may include; loss of self-esteem, stigmatization, sexual abuse, mental illness (like; depression, paranoia, insomnia…), skin diseases, pneumonia, malaria, among others.
Despite all these problems, people in this circle are the least cared for within the general population. So, in their attempt to minimize these problems, they sometimes resort to substance abuse.
Substance abuse is generally an accepted practice among homeless people, so it is easier for newly homeless people (especially adolescents) to experiment or try available substance, such as; alcohol, painkillers, marijuana, cocaine, etcetera.
Studies show that, homeless people are six times likely to have problematic substance use (substance use disorder) than people in the general population.
Although there is evidence of substance abuse among homeless people in Ghana, there isno baseline survey proving that homelessness is the cause.
However, a survey conducted in Melbourne, Australia indicated that, 43% of the sample had substance use problems, with one-third of the people having substance abuse problems before becoming homeless and two-thirds developed the problems after becoming homeless.
Further studies showed that, young people were more at risk of developing substance abuse problems after becoming homeless than older people.
There is the need for interventions to resolve the homelessness situation in the country else the war against substance abuse will forever remain a charade.
The government should make available more affordable housing with support services to help in their acquisition. The available affordable housing in most instances is not affordable to the ordinary Ghanaian, so the government has to cut down on the building cost to make it cheaper and also accessible.
Government can also partner with private entities to establish emergency shelters and hostels which will be given out to victims of domestic violence, sexual abuse, disasters and other people (like fresh graduates, unemployed youth…) who come to the cities in search of job opportunities, till they start earning.
Existing rent laws need to be enforced to reduce homelessness. High rent charges and collection of bulk advance payment by house owners are factors contributing to the surge in homelessness in our cities.
If the government takes over and regulate the rent system, it will help reduce the number of homeless people. There is the need to also make available needed service and care centers or homes for people with special needs, mental health issues and other physical disabilities to help wean them off the streets.
Also, proper decentralization and provision of basic social amenities in the districts and rural areas will bridge the gap between city and rural development which will help reduce rural-urban migration, which is a major cause of homelessness.
Lastly, family and community support system need to be encouraged. The citizenry must be educated and sensitized to appreciate the need for helping the homeless.
By Rees Hakeem Oduro
Silver Spring, Pedu – Cape Coast
