Drug use and homelessness are often seen as inextricably linked (McKeown, 2006). Many drug users have difficulty accessing appropriate housing services, this is due to homeless accommodation services operating on a ‘zero tolerance’ to drugs basis, often resulting in directly or indirectly excluding drug users from housing services, unless they can evidence they are actively working with drug agencies toward abstinence.
These requirements exacerbate the problem of homelessness amongst drug users and is often the reason people do not access services or, to be accommodated do not disclose any drug misuse issues. Thus, missing a vital opportunity to engage with support to reduce risks associated with substance misuse. Furthermore, “unstable housing intersects with elevated risk of blood-borne infections associated with injecting drug use” (Briggs, 2010). Nationally, a considerable rise has been seen in the prevalence of hepatitis C. “This appears to be linked to increased numbers of new drug injectors coupled with an increase in the sharing of needles and syringes” (Health Protection Agency. www.hpa.org.uk).
Health and safety
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The stages of change model regarding substance abuse by Prochaska, DiClemente & Norcross, (1982,1992) is an approach aimed at changing behaviours, resulting in complete abstinence from substances. However, an individual must accept they have an issue and be ready to change for this approach to have an effective impact, the low numbers of people completing treatment and the high numbers of people re-presenting to treatment services within 6 months, show that complete abstinence is not always a viable approach (National Drug Treatment Monitoring System (NDTMS),