Drug use is the most common health problem among people accessing homelessness services in England — reported in almost two thirds of clients (Mental Health Foundation). One in five people starting drug treatment in 2024–25 had no home of their own; for people with opioid problems, it rises to two in five (OHID, 2025). Almost two in five deaths of homeless people in England and Wales involve drug poisoning (ONS, 2022).
Drug use and homelessness are deeply connected. Each can cause and worsen the other. Both are closely linked to trauma, bad childhood experiences and mental ill-health.
Your service is not a drug treatment service. But your staff encounter drug use every day. A harm-reduction approach — one focused on reducing risk and keeping people engaged, rather than requiring abstinence — keeps people alive and keeps them coming through your door.
Guidance and resources on drug use
Guidance articles
Guidance and resources
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Case study
Naloxone in homelessness services
Naloxone is a medicine that reverses opioid overdoses. Drug poisoning causes almost 2 in 5 deaths of homeless people. Find out how to get naloxone for your service.
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Case study
New psychoactive substances in homelessness services
NPS such as spice and nitazenes are increasingly present in homelessness services and can cause fatal overdose. Find out what services need to have in place.
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Case study
Drug and alcohol support for migrants experiencing homelessness
Most drug and alcohol services are free to migrants, whatever their immigration status. Find out what your clients can access and how to navigate the system.
Talking to clients about drug use
- The words you use matter. Say 'person who uses drugs' rather than 'addict' or 'drug user'. Say 'drug use', not 'drug abuse'.
- Do not assume someone is ready to stop using drugs. Keeping someone engaged with your service — even when they are not ready for treatment — has real value.
- Frame harm reduction as practical safety. It is not a compromise or an endorsement of drug use.
- Brief, non-confrontational conversations that acknowledge the person's own perspective are more effective than warnings or ultimatums.
Developing a peer support/volunteer programme
There is great merit in providing involvement opportunities for individuals with lived experience of addiction within homelessness services. If done correctly (and resourced where possible), an effective peer support programme can add value to the reputation of an organisation, its governance and performance.
The involvement of people with lived experience will add additional credibility with people accessing the service and embrace the therapeutic value of one individual with lived experience of addiction helping another, which can lead to positive outcomes for all involved.
A vibrant peer support/volunteer programme can play a role in supporting individuals, gaining feedback through consultation, raising awareness, representing the organisation, setting up new initiatives and gaining a much deeper understanding of the issues that people accessing the service are facing.
Here are some practical tips for setting up a programme:
- Ensure ‘buy in’ from key individuals within the organisation (e.g. trustees, managers and people accessing the service)
- Convene a meeting with prospective peer supporters
- Create, review and/or update the organisational volunteer and expenses policies
- Highlight at least one lead staff member
- Provide regular supervision to peer supporters
- Develop a needs analysis and professional development regime
- Ensure that the peer supporters' activity is monitored and recorded
- Promote the programme as part of staff and service user inductions
- Ensure that peers are invited to attend team/management meetings and have a dedicated agenda item for feedback.
Related resources
Drug and alcohol awareness training
This course will introduce the main issues associated with drug and alcohol use among people experiencing homelessness. You will explore the reasons for drug and alcohol use, learn how to recognise the resulting effect, and develop your professional practice skills to support individuals.
