Understanding Opioid Addiction in Homelessness

It is too easy to dismiss homelessness people as those who made bad choices and fell into drug addiction. In most of our lives, homelessness was merely a cautionary tale that our parents bestowed upon us of what happens if you do drugs. But the truth is, a lot of the homeless population are not the so called “screw ups” that made bad decisions and took drugs recreationally in their youth. Disappointingly, society has dismissed those living on the streets as soulless druggies that do not deserve donation, but this is a wrong narrative. Opioid addiction begins in many ways for different people, and one common way starts in the doctor’s office.

I had a conversation with a homeless man resting in a bus station in Hartford, USA. His name was Roger, he was once an entrepreneurial youth who started a successful auto repair shop in Hartford and had a stable life ahead of him. That was until he was involved in a car accident that fractured his femur and underwent an emergency surgery. He was prescribed opioid painkillers by the doctors, and although many can take the prescription as directed, others like Roger are unfortunate as his body developed a dependence to manage the pain. Over weeks in the hospital, pain management quietly turned into addiction. It’s not that Roger wasn’t disciplined enough to stick with the prescription; opioid addiction is a known medical risk when undergoing prescription. Opioids interact directly with the brain’s reward system, and repeated exposure can alter how the brain regulates pain, stress, and pleasure. Once dependence forms, stopping isn’t just difficult. It can be physically agonizing and dangerous without medical support. Roger was discharged from the hospital with an opioid addiction, and his life deteriorated; job lost, relationships ruined, bills piling up, and ultimately homeless.

Roger’s story is the story of millions of homeless people. Roger was just like any of us -young, healthy, and hard-working-, but it only took one fateful event to turn his life upside down. If you’re ever thinking “this couldn’t be me”, it very much can.

Military veterans are a group that is disproportionately affected by opioid addiction. Those returning from service carry injuries, chronic pain, and post-traumatic stress, and opioids are often prescribed to manage physical and psychological suffering. Not degenerates chasing a high, but traumatised soldiers trying to function, sleep, and ease pain.

The stigma of opioid addiction being a moral failure is dangerous to our communities. It stops those struggling from seeking help, and influences policy and funding. People struggling with opioid addiction were parents, students, soldiers, workers, soldiers; people like us who did not imagine this kind of future for themselves, but whose lives took a devastating turn after injury or trauma. So, let’s start looking at addiction as a health issue rather than a personal defect. Invest in treatment, not punishment. And listen to stories, don’t assume you already know them.