Addiction and Homelessness in Austin, Texas

Mark Twain once said there were three terrible things in this world: “Lies, damn lies, and statistics.” Another quote attributed to him is, “Figures don’t lie, but liars will figure.” It seems America’s author had a love/hate relationship with statistics.

We’re much the same way.

Statistics on homelessness obscure the true humanity and suffering people experience. Paradoxically, the more people who suffer make it seem less personal and immediate.

The homelessness of one person? A tragedy. But the homelessness of thousands of people? A mere statistic.

Austin’s Homelessness Statistics

Austin is both the state capital and county seat of Travis County, Texas. This year, in Travis County, nightly homelessness estimates range from approximately 3157 to 5455 people.[1][2]

Those estimates rock us to our core here at Recovery Unplugged.

That’s the highest nightly total of homeless persons in the entire state of Texas. The lower estimate would still work out to a homelessness rate 50% higher than the national average.[3]

Homelessness seems straightforward, but there are different categories of homelessness people can fall into[4]:

• Literal Homelessness: A “home” is defined as a fixed, regular, and adequate nighttime residence. Renters who are not facing eviction do not count as homeless; neither do couch-crashers as long as a couch is available to them. To count as “literally homeless,” you must either:
  • Sleep somewhere overnight that is a public/private place not meant for human habitation.
  • Live in a shelter designated to provide temporary residence.
  • Leave a temporary shelter and plan to sleep somewhere not designed for accommodations due to a lack of other options.
• Imminent Risk of Homelessness: An individual at risk of losing access to sleep somewhere fixed, regular, and adequate within 14 days. If the individual is a couch-crasher but cannot stay there longer than 14 days, you are at imminent risk of homelessness.
• Homeless Under Other Federal Statutes: If someone has not had a permanent place in a fixed, regular, and adequate nighttime residence of any kind in the last 60 days. Or they have moved twice or more in the last 60 days and can expect to do so again in the future.
• Fleeing or Attempting to Flee: They are fleeing permanent housing without a subsequent option. The reasons are personal, but could include:
  • Trading sex for housing.
  • Fleeing domestic violence, emotional abuse, etc.
  • Being trafficked.

The cost of homelessness is acutely felt by the persons and families experiencing it, but there is also a very real financial cost. From 2019 to 2021, the city of Austin budgeted $179 million dollars for homelessness assistance.[5]

Risk Factors for Homelessness

Besides an eviction notice, there is nothing out there that is guaranteed to make you homeless. However, there are risk factors that increase your chances of finding yourself homeless on a given night:[6]

• Substance Addiction: While the prevalence of drug dependence ranges from 2-6% in the general population, drug dependence ranges from 5-54% in the homeless population.
• Mental Health Disorders: While the prevalence of mental health disorders like psychosis, depression, or personality disorders ranges from 1-10% of the general population, mental health disorders range from 0-71% in the homeless population.
• Dual Diagnosis (Co-Occurring Mental and Substance Use Disorders): While the prevalence of dual diagnosis accounts for less than 1% of the general population, a dual diagnosis accounts for 58-65% of the homeless population.
• Domestic Violence: Physical, emotional, or sexual violence can contribute to homelessness.
• Economic Challenges: A lack of jobs for only a high-school diploma, inflation, and high housing costs.
• Racial Inequalities: In Austin, a black person is 6x more likely to experience homelessness than a white person.[7]

Treatment for Homelessness and Addiction

While the treatment for homelessness is fairly straightforward (stable housing), the solution can become more complex when you add the layer of addiction. The reality is both must be addressed together.

Give unhoused people adequate residence in the form of low-income housing and then give them the option to work on their addiction. Research shows this method works.

One study found the opioid overdose rate was 6x higher (1.8% vs. 0.3%) for homeless persons than persons living in low-income housing.[8] The cost this imposes on our healthcare system is both significant and expensive.

In another study, homelessness was not specifically targeted, but about half of the residents of a sober living home had a history of homelessness.[9] A high percentage of historically homeless and historically housed residents successfully stayed in the program longer than six months (42%), and more than a quarter left the house on good terms (27%).

The treatment for addiction is less straightforward. Abstinence could be achieved by going “cold turkey,” but that success is usually short-lived. Simply eliminating substances from your body rarely gives you the tools you need to navigate triggers and ensure long-term sobriety, and in some cases can be physically or psychologically dangerous.

For example, immediate withdrawal from benzodiazepines (Valium, Xanax, etc.) is associated with panic attacks, difficulty concentrating, heart palpitations, and other concerning symptoms. The same is true with opiates which are associated with serious withdrawal symptoms that include severe pain, psychological distress, and even death by suicide.

Our goal for you is abstinence, but the path to get from here to there is complicated. Here at Recovery Unplugged, we believe in the healing power of music. But we also believe in housing, pharmacology, and cognitive behavioral therapy too.

How To Help Someone You Know Struggling With Homelessness And Addiction

If you know someone who is struggling with homelessness and addiction in Austin, the most important way to help is to find a way to get them housed and clean. There are several community-based solutions available for this:

At Recovery Unplugged, we offer residential treatment with a housing component for anyone struggling with addiction. We offer compassionate care and dignity to the people who need it most. We are a music-based treatment center, so we use music as a therapy along with pharmacotherapy and cognitive behavioral therapy.

Austin Echo is a community non-profit organization that is working to end homelessness for good in Austin. They don’t provide housing directly, but they coordinate a number of organizations that do. You can complete a “Coordinated Assessment” to see your options.

If you’re a woman or child, you can stay at the Salvation Army’s Austin Shelter for Women and Children. It’s open 24 hours/day and the phone number is 512-933-0600.

Sources:

• [1] SOH: State and coc dashboards. National Alliance to End Homelessness. (2023, May 16). https://endhomelessness.org/homelessness-in-america/homelessness-statistics/state-of-homelessness-dashboards/?State=Texas
• [2][7] Homelessness in Austin. ECHO. (2022, October 10). https://www.austinecho.org/about-echo/homelessness-in-austin/
• [3] Homelessness in America. (n.d.). https://www.usich.gov/resources/uploads/asset_library/Homelessness-in-America-Focus-on-chronic.pdf
• [4] Criteria for defining homeless – Hud Exchange. (n.d.-a). https://files.hudexchange.info/resources/documents/HomelessDefinition_RecordkeepingRequirementsandCriteria.pdf
• [5] Special report homelessness spending – austintexas.gov. (n.d.-c). https://www.austintexas.gov/sites/default/files/files/Auditor/Audit_Reports/Special_Request_Homelessness_Spending_September_2021.pdf
• [6] Fazel, S., Geddes, J. R., & Kushel, M. (2014, October 25). The health of homeless people in high-income countries: Descriptive Epidemiology, Health Consequences, and clinical and policy recommendations. Lancet (London, England). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520328/
• [8] Yamamoto, A., Needleman, J., Gelberg, L., Kominski, G., Shoptaw, S., & Tsugawa, Y. (2019, December). Association between homelessness and opioid overdose and opioid-related hospital admissions/emergency department visits. Social science & medicine (1982). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023863/
• [9] Polcin, D. L. (2016). Co-occurring substance abuse and mental health problems among homeless persons: Suggestions for research and practice. Journal of social distress and the homeless. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833089/