John Makohen—author and counselor with lived experience—details why people who are unhoused face steep barriers to SUD treatment (IDs, phones, insurance, transportation,rigid abstinence-first rules) and calls for Housing First, person-centered MOUD, and compassion over compliance.

Homeless people and substance use disorder addiction often co-occur, and, unfortunately, many people struggling with both issues are unable to get the help they need. Substance abuse can develop due to the stressors associated with homelessness. On the other hand, addiction can also contribute to homelessness. Additionally, many homeless people have an addiction as well as other co-occurring psychiatric disorders, which can further complicate their living situations.