Homelessness and drug and/or alcohol abuse often go hand-in-hand. Homeless people who abuse drugs and alcohol are more likely to demonstrate ineffective coping skills, low levels of self-efficacy and to end up in prison. They are also vulnerable to hepatitis and HIV, victimization, sexually-transmitted diseases, unwanted pregnancy, depression and suicidality. A focus-group study of 54 homeless and drug-using people between the ages of 18 and 24 looked into their attitudes to drugs and what they saw as the facilitators of and barriers to good-quality health care. Participants saw substance abuse as a health risk and a barrier to care but also as an adaptive response to psychological pain and survival on the streets. Facilitators to care and suggestions for improved health delivery and quality of care included using health mentors to assist in navigating the medical system, culturally-competent care, improved amenities in waiting rooms and expanded pharmaceutical services.
Christiani, Ashley ... [et al] - Attitudes of homeless and drug-using youth regarding barriers and facilitators in delivery of quality and culturally sensitive health care Journal of Child and Adolescent Psychiatric Nursing August 2008, 21(3), 154-163