Background: It been established by numerous studies that the homeless have poorer general health than the rest of the population. One of the main causes of this is substance abuse.
Aims: The aim of this SSM is to assess the health problems associated with substance misuse, particularly those of drugs and alcohol, among the homeless. The treatment services in Liverpool will also be reviewed and potential areas for improvement identified.
Method: Literature searches of the databases AMED, MEDLINE, EMBASE and PsycINFO with the key words ‘homeless health’, ‘substance misuse’, ‘alcohol’ and ‘drugs’ were performed. Grey literature accessed through the FADE library was also reviewed. Service learning visits were carried out to a number of organisations in Liverpool directed at helping the homeless. Case histories were taken and staff at the organisations provided detailed information about the services for which they worked.
Results: For alcohol abuse problems, treatments were mainly psychological whereas for drug abuse, numerous harm reduction strategies were employed. These included a needle exchange service and substitute prescribing. While these services prove beneficial for most of those who come into contact with them, there are still many homeless people not accessing adequate health care for their substance addiction. There are also a number who are excluded from treatment for various reasons, limiting the benefit of the services to the homeless community as a whole.
Conclusion: Although the current service provision in Liverpool is effective at an individual patient level, there are too many homeless substance misusers not accessing treatment. To tackle this issue services need to receive more funding so that they can become more accessible and better advertised within the homeless community. This will encourage higher attendance levels resulting in greater benefits.