Australian Institute of Health and Welfare 2021. Alcohol, tobacco & other drugs in Australia. Cat. no. PHE 221. Canberra: AIHW. Viewed 31 July 2021, https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. (2021). Alcohol, tobacco & other drugs in Australia. Retrieved from https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Alcohol, tobacco & other drugs in Australia. Australian Institute of Health and Welfare, 22 July 2021, https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. Alcohol, tobacco & other drugs in Australia [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2021 Jul. 31]. Available from: https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare (AIHW) 2021, Alcohol, tobacco & other drugs in Australia, viewed 31 July 2021, https://pp.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
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The most recent data from the census of population and housing show that there were approximately 116,000 people experiencing homelessness in Australia in 2016 (ABS 2018). This is a rate of 50 people for every 10,000 population and includes people who were in supported accommodation for the homeless, in temporary accommodation, in severely crowded dwellings (those requiring 4 or more extra bedrooms to accommodate them adequately) and people who were ‘sleeping rough’ (ABS 2018).
The Journeys Home project (a longitudinal survey of Australians), found that of those people who had experienced housing instability or homelessness, risky use of substances was also reported for alcohol (57%), illicit drug use (39%) and the injection of drugs (14%) in the previous 6 to 12 months (Scutella et al. 2014).
Research from homelessness services in Melbourne showed that 43% of the homeless population reported that they had alcohol and other drug use problems. Of these, one-third reported that they had these problems prior to becoming homeless, with the remaining two-thirds reporting that they developed problems with alcohol and other drugs following homelessness (Johnson & Chamberlain 2008). The duration of substance use problems is often prolonged in the homeless population, because their social networks may perpetuate their alcohol and other drug problems.
There is a strong association between problematic drug and/or alcohol use and experiences of homelessness
In 2019–20, 10% of clients of specialist homelessness services (SHS) reported having problematic drug and/or alcohol use
Three-quarters (75%) of SHS clients with problematic drug and/or alcohol use were returning clients in 2019–20
In 2019–20, 6% of SHS clients sought assistance for problematic drug use and 3% sought assistance for problematic alcohol use
Alcohol consumption and illicit drugs
In 2019–20, 44% of SHS clients with problematic drug and/or alcohol use also reported a current mental health issue
Health and harms
18% of clients who sought assistance from both SHS and alcohol and other drug treatment services sought treatment for multiple drugs
View the People experiencing homelessness fact sheet >
Specialist homelessness services (SHS) are delivered by non-government organisations and include specific services for those persons seeking housing as well as other services that assist them to maintain housing. These include people who experience alcohol and/or other drug issues.
In 2019–20 (AIHW 2020):
Of the 28,500 SHS clients who reported problematic alcohol and/or drug use:
The general health status of the people experiencing homelessness tends to be poorer than the general population.
Research has found that problematic alcohol consumption is associated with homelessness.
Regular drug use is correlated with entries into homelessness (Johnson et al. 2015). In 2018–19 around 6% of clients (18,519) who sought assistance from SHS in 2019–20 reported problematic drug or substance use (AIHW 2020).
The Illicit Drug Reporting System (IDRS) is an annual survey of people who regularly inject illicit drugs across Australia (Peacock et al. 2021). Of the 884 participants interviewed in 2020, less than one-quarter (23%) reported that they were homeless (that is, current accommodation was no fixed address, shelter/refuge or boarding house/hostel). This remained stable from 2019 (Table S3.21).
Data collection for the 2020 IDRS took place from June–September 2020, after COVID-19 restrictions were introduced in Australia. This should be taken into account when comparing 2020 IDRS data with previous years.
The 2016 IDRS also asked people who had recently injected drugs about their lifetime history and duration of experiences of homelessness (Stafford & Breen 2017). The report showed that:
Queensland (91%), New South Wales (NSW) (90%) and Victoria (86%) had the highest proportion of respondents reporting a lifetime history of homelessness, while Tasmania (70%) and the Australian Capital Territory (ACT) (73%) had the lowest.
Similarly, NSW (37%), Victoria (31%) and Queensland (29%) had the highest proportion of respondents currently homeless (Table S3.22).
For clients with problematic alcohol and/or other drug use, additional vulnerabilities such as mental health issues, may make them more vulnerable to homelessness. In 2019–20, 44% (or more than 12,400) clients with problematic drug and/or alcohol use also reported a current mental health issue and 31% (almost 8,700) reported a current mental health issue and experiencing family and domestic violence (AIHW 2020).For clients with problematic alcohol and/or other drug use, additional vulnerabilities such as mental health issues, may make them more vulnerable to homelessness. In 2019–20, 44% (or more than 12,400) clients with problematic drug and/or alcohol use also reported a current mental health issue and 31% (almost 8,700) reported a current mental health issue and experiencing family and domestic violence (AIHW 2020).
Research has shown that there is often overlap between drug and alcohol misuse and homelessness (AIHW 2016). The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) collects information on treatment provided to clients by publicly funded alcohol and other drug treatment services, yet it does not collect information on the client’s experience of homelessness.
To better understand the characteristics of those experiencing homelessness and alcohol and other drug issues, a recent study linked the AODTS NMDS to the SHS data collection (AIHW 2016). The key findings demonstrate that the homeless population experiences additional complexities. Specifically, clients who had sought assistance from both SHS and AODTS:
Of those who had sought assistance for both homelessness and AOD treatment, the most common principal illicit drugs of concern (the main substance that the client sought treatment for) were cannabis (28.6%) and amphetamines (20.5%) (Figure HOME1).
Persons who sought assistance from both SHS and AODTS were twice as likely to report heroin as a principal drug of concern (11.3%) compared to 5.7% for AODTS only (AIHW 2016) (Table S3.20).
The figure shows that similar proportions of AODT only and matched clients listed alcohol (38.7% for AODT only and 40.4% for matched clients) or cannabis (28.0% and 28.6%) as the principal drug of concern. Compared with AODT only clients, matched clients were more likely to list amphetamines, heroin, or pharmaceuticals as the PDOC, and were more likely to report multiple PDOCs (17.7% compared with 6.9%).
From July 1 2018, the National Housing and Homelessness Agreement (NHHA) replaced the National Partnership Agreement on Homelessness and the National Affordable Housing Agreement (supported by the National Affordable Housing Specific Purpose Payment). The NHHA is a multilateral national agreement and its objective is to contribute to improving access to affordable, safe and sustainable housing across the housing spectrum, including to prevent and address homelessness, and to support social and economic participation (CFFR 2018).
The Federal Government in partnership with states and territories to outline priority homelessness cohorts and policy areas that must be addressed in homelessness strategies (CFFR 2018). The NHHA has a focus on policy areas that include achieving better outcomes for people, early intervention and prevention, and commitment to service program and design. The priority homelessness cohorts identified in the NHHA include:
Other priority homelessness cohorts may be identified with states in their respective bilateral schedules.
Whilst there is not a specific reference to those persons experiencing alcohol and other drug related problems and homelessness, some of the key groups will be likely to include this population.
ABS (Australian Bureau of Statistics) 2018. Census of population and housing: Estimating homelessness, 2016. ABS cat. no. 2049.0. Canberra: ABS. Viewed 25 May 2018.
AIHW (Australian Institute of Health and Welfare) 2016. Exploring drug treatment and homelessness in Australia: 1 July 2011 to 30 June 2014. Cat. no. CSI 23. Canberra: AIHW. Viewed 10 January 2018.
AIHW 2020. Specialist homelessness services annual report 2019–20. Cat. no. HOU 322. Canberra: AIHW. Viewed 11 December 2020.
CFFR (Council on Federal Financial Relations) 2018. National Housing and Homelessness Agreement. Viewed 26 June 2018.
Johnson C & Chamberlain G 2008. Homelessness and substance abuse: which comes first? Australian Social Work, 61(4)342:356. Viewed 1 February 2018.
Johnson G, Scutella R, Tseng Y & Wood G 2015. Entries and exits from homelessness: a dynamic analysis of the relationship between structural conditions and individual characteristics. AHURI Final Report no. 248. Melbourne: Australian Housing and Urban Research Institute. Viewed 31 January 2018.
Kermode M, Crofts N, Miller P, Speed B & Streeton J 1998. Health Indicators and risks among people experiencing homelessness in Melbourne 1995–1996. Australia and New Zealand Public Health, 22:464–70.
Okuyemi KS, Caldwell AR, Thomas JL, Born W, Richter KP, Nollen N, et al. 2006. Homelessness and smoking cessation: Insights from focus groups. Nicotine & Tobacco Research, 8(2):287–96.
Peacock A, Uporova J, Karlsson A, Price O, Gibbs D, Swanton R et al. 2021. Australian Drug Trends 2020: Key findings from the National Illicit Drug Reporting System (IDRS) interviews. Sydney: National Drug and Alcohol Research Centre, UNSW.
Scutella R, Chigavazra, A Killackey E, Herault N, Johnson G, Moschion J et al. 2014. Journeys home research report no. 4. Melbourne: University of Melbourne.
Stafford J & Breen C, 2017. Australian Drug Trends 2016. Findings from the Illicit Drug Reporting System (IDRS). Australian Drug Trend series no. 163. Sydney: National Drug and Alcohol Research Centre, UNSW Australia.
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