About 37% of people experiencing homelessness report regular illegal drug use, meaning they used at least three times a week within the prior six months. That figure comes from a large 2023 study of homeless individuals, with researchers noting the patterns likely reflect similar trends nationwide. The number is lower than many people assume, but it’s still significantly higher than drug use rates in the general population.
The picture gets more nuanced when you look at different substances, age groups, and the relationship between drug use and losing housing in the first place.
What the National Numbers Show
HUD’s 2024 point-in-time count, which surveys the homeless population on a single night in January, found that 18% of homeless adults (about 113,000 people) had a chronic substance use disorder. That’s a clinical threshold, meaning a diagnosed, long-term condition rather than any drug use at all. The gap between 18% and 37% reflects the difference between a formal diagnosis and self-reported regular use.
Substance use is considerably more common among unsheltered people (those sleeping outside, in cars, or in places not meant for habitation) than among those staying in shelters or transitional housing. Of the 113,000 adults identified with a chronic substance use disorder, 68,000 were unsheltered, compared to 35,000 in emergency shelters and 10,000 in transitional housing. That share among unsheltered individuals has been increasing in recent years.
Which Substances Are Most Common
Methamphetamine dominates. A nationally representative study published in JAMA in 2024 found that 33.1% of homeless adults reported regular meth use in the prior six months. Opioid use was far lower at 10.4%, and cocaine use was just 3.2%. These numbers challenge the assumption that the opioid crisis is the primary driver of drug use among homeless populations. Meth is cheaper, more widely available in many regions, and produces longer-lasting effects, which may explain its prevalence.
Cocaine, once a major factor in homelessness during the 1990s, has dropped to a small fraction of current use.
Drug Use Among Homeless Youth
Young people experiencing homelessness report higher rates of substance use than the overall homeless population. Research estimates that 39% to 70% of homeless youth abuse drugs or alcohol, with about 60% reporting some drug use and roughly 20% describing themselves as addicted to drugs. Another 13% reported addiction to alcohol specifically.
These rates are two to three times higher than those found among housed young adults of the same age. Cocaine use among homeless youth runs four to five times higher than their housed peers, and amphetamine use is three to four times higher. The instability, trauma, and lack of support systems that come with youth homelessness create conditions where substance use escalates quickly.
Which Comes First: Drugs or Homelessness
One of the most important findings in this area is that drug use doesn’t always precede homelessness. About 42% of homeless individuals said they began using drugs regularly before they lost housing for the first time. But 23% said their regular drug use started after they became homeless. The remaining portion either never used drugs regularly or couldn’t pinpoint the timing.
This means that for a significant number of people, homelessness itself is a risk factor for developing a drug problem, not the other way around. Living without stable shelter brings constant stress, exposure to trauma, untreated pain, and proximity to drug use, all of which increase the likelihood of substance use. About 21% of homeless young people specifically named substance use as a barrier to getting or keeping housing, showing how the cycle reinforces itself once it starts.
Lifetime Use vs. Current Use
The distinction between past and present drug use matters. About 65% of homeless individuals reported using illegal drugs regularly at some point in their lives. But only 37% were doing so currently. That gap suggests that a meaningful number of people have reduced or stopped their drug use, even while remaining homeless. It also means that when people cite high figures for drug use among the homeless, they may be conflating lifetime history with what’s actually happening now.
Overdose data adds another layer. Around 20% of homeless individuals experienced at least one non-fatal overdose during their lifetime, and 10% had an overdose while homeless.
Why So Few Get Treatment
Only about 7% of homeless individuals were receiving any form of substance use treatment at the time they were surveyed. That’s a strikingly low number, especially because 21% said they actively wanted treatment and were trying to access it but couldn’t get the care they needed.
The barriers are mostly structural rather than personal. Long waitlists, limited treatment slots, high costs, and lack of insurance coverage top the list. Many programs aren’t designed to accommodate people without stable housing, creating a catch-22: you need sobriety to qualify for housing programs, but you need housing stability to succeed in treatment. Privacy concerns, stigma, and the belief that treatment won’t work also play a role, but the biggest obstacles are simply about access and availability.
For people with co-occurring mental health conditions, the problem compounds. Treatment programs often address either mental health or substance use, but not both simultaneously, leaving people to bounce between systems that each treat only half the picture.