Father Joe’s Villages uses the Harm Reduction Model to empower those experiencing homelessness to reach their goals.

According to the National Center for Drug Abuse Statistic, there are thousands of substance abuse related deaths in the United States each year—and the numbers are continuing to rise. Since the year 2000, there have been 700,000 deaths from drug overdoses in the United States.

In just the last ten years, San Diego County has seen major increases in substance abuse related fatalities. San Diego County officials reported a record number of deaths due to substance abuse in 2020. In fact, prescription drug and opioid deaths reported in San Diego in 2020 more than doubled the 275 fatalities reported in 2019.

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The Harm Reduction Approach to Substance Abuse Among the Homeless

Substance Abuse in San Diego

Long before the 2017 hepatitis A outbreak began its assault on homeless people in San Diego, there was another scourge waging battle: substance abuse. Both situations are complexly intertwined with homelessness and both disproportionately affect individuals experiencing homelessness.

As we detailed in our blog about hep A, older people who contract Hepatitis A have a higher frequency of symptoms and tend to get a more severe illness. Death, from Hep A, while rare, most commonly occurs in persons over 50 years old and those with chronic liver disease. Heavy drug or alcohol use can weaken the immune system and cause liver damage leading to chronic liver disease.

Additionally, substance abuse often occurs alongside other illnesses. As UC San Diego psychiatrist and professor Dr. Carla Marienfeld recently said in a Union-Tribune commentary:

“People who have active substance use disorder, a clinical condition that affects millions of Americans, often have high rates of co-morbid depression, anxiety or severe mental illness. Conversely, those with mental health struggles are at higher risk for misusing substances.”

According to the San Diego Medical Examiner, there are hundreds of reported unintentional drug/alcohol related deaths each year. In 2016, the Central San Diego area had one the highest drug/medication related death rates in San Diego County.

Homeless individuals, in particular, suffer from substance use disorders at disproportionate rates. Although accurate numbers are difficult to obtain, a report on Substance Abuse and Homelessness by the National Coalition for the Homeless cites one study that found “38% of [the] homeless people [who participated in their study] were dependent on alcohol and 26% abused other drugs.” An analysis of Father Joe’s Villages data shows that of 5,728 single adults who exited any Father Joe’s Villages’ Transitional Housing program from 1/1/2010 to 12/31/2014, 46% reported Substance Abuse issues.

There are many reasons that might contribute to the high rate of use among individuals who are homeless including the stress of being homeless, mental illness, self-medication for health conditions, prioritizing basic survival over recovery, trauma and more.

Addressing Substance Abuse Among the Homeless

Homeless individuals, in particular, suffer from substance use disorders at disproportionate rates. Although accurate numbers are difficult to obtain, a report on Substance Abuse and Homelessness by the National Coalition for the Homeless cites one study that found “38% of [the] homeless people [who participated in their study] were dependent on alcohol and 26% abused other drugs.”

Even worse, the Substance Abuse and Mental Health Services Administration states that people who are homeless have a higher risk of overdose from illicit substances.

There are many reasons that might contribute to the high rate of substance use among individuals who are homeless including the stress of being homeless, mental illness, self-medication for health conditions, prioritizing basic survival over recovery, trauma and more.

At Father Joe’s Villages, we know that with the right tools and support, individuals living with addiction can live happy, healthy, and self-sufficient lives. That’s why, in our efforts to end homelessness in San Diego, Father Joe’s Villages offers integrated services catered to the individual situations and goals of our clients. We work to address an array of complex barriers that people experiencing homelessness face.

We use the Harm Reduction Model in response to substance abuse issues.

In accordance with the Harm Reduction Model, the specialized programs offered through our Village Health Center, such as Behavioral Health, Substance Use Disorder Treatment and Psychiatric services, can help provide the resources individuals need to manage their mental health symptoms instead of having their symptoms manage them.

Health and wellness counseling for the homeless in San Diego Father Joe's

What is Harm Reduction?

Harm reduction, also known as Harm Minimization, is a set of evidence-based public health strategies that work to meet people struggling with addiction where they are at by providing safer use options and/or medication-assisted treatments. The purpose of the Harm Reduction Model is to reduce the negative consequences of drug or alcohol use and have a positive impact on individual and community health.

Harmreduction.org defines Harm Reduction as “a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.”

Harm Reduction incorporates a range of health and social services and practices that include:

  • Drug consumption rooms
  • Clean needle and syringe programs
  • Medication Assisted Treatment
  • Drug checking
  • Overdose prevention and reversal

Harm reduction “does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use” but works to offer a “non-judgmental, non-coercive provision of services and resources” (source). It is a best practice approach which empowers people to make their own goals and gives them access to the tools they need to achieve those goals.

At the core of the Harm Reduction model is the idea that people with substance use disorders have rights and deserve services that promote health. It encourages us to see the human behind the addiction and tailor solutions to each individual’s needs.

Harm Reduction Testimonial: Jake’s Story

Our Addiction Treatment and Education (ATEC) counselors have seen many clients successfully obtain their goals by practicing harm reduction—like Jake, who was drinking three bottles of vodka every day.

His body had become so accustomed to the alcohol, he had to drink just to keep his body functioning.

Eventually, Jake sought treatment through Father Joe’s Villages’ state-certified Addiction Treatment & Education Center (ATEC), a program dedicated to helping individuals struggling with substance use disorders and homelessness achieve their goals. With the help of ATEC’s knowledgeable Certified Alcohol and Other Drug Counselors, Jake created a plan to help him move toward sobriety.

Jake began attending group therapy sessions and other addiction treatment classes offered through ATEC. With a lot of hard work and the support of his Counselors, Jake was eventually able to reduce his intake of alcohol to one bottle a day. Then, in order to prevent the life-threatening symptoms that can arise from quitting, he attended a two-week detox program.

Jake has now been sober from alcohol for years. “His life has improved to the point where he’s taking college classes, he’s taking golf lessons, he’s taking pottery lessons. So, he’s functioning a lot better,” his ATEC counselor said.

Integrated Services & Harm Reduction

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Father Joe’s Villages offers a whole range of services all aimed toward helping clients accomplish their goals, including housing, mental health services, therapeutic childcare, employment and education services, medical and dental services and more.

The depth and breadth of our services gives clients the tools to face the many complexities and barriers that might be preventing them from gaining employment, housing and other objectives.

  • Village Health Center: Offers medical, dental, addiction counseling and mental health resources to help clients to live their healthiest lives. We help our neighbors reach their goals and overcome mental health, physical health and substance abuse barriers to income, housing and happiness. Learn more >>
  • San Diego Day Center: Offers dignity services such as showers, mail and a safe environment. We connect people living on the street to resources: local substance abuse groups, detox and rehabilitation centers, medical services or Father Joe’s Villages’ housing programs and supportive services. Learn more >>
  • Emergency Shelter & Transitional Housing: Provides clients a warm bed, clean linens, storage for their belongings, hot meals and access to the wide range of services, which allows them to reflect on their goals and future instead of just survival and safety. Clients can then work with Father Joe’s Villages’ supportive services to remove barriers to more permanent income and housing. Learn more >>
  • Permanent Supportive Housing: Supports people living with disabilities with housing and coordinated services based on individual needs, abilities, goals and preferences. Learn more >>