People experiencing homelessness (PEH) have increased rates of polysubstance use and more than 12x the risk of overdose mortality compared to the general population (Fine, 2022). Being homeless makes it difficult to meet basic biological needs, and shelters often utilize congregate living arrangements that can be challenging for people seeking recovery. The Housing First approach has been effective at providing PEH with rapid housing that can stabilize medical conditions without increasing substance use (Baxter, 2019). However, housing is only one step towards improved health, and an addiction treatment gap persists along the continuum of unsheltered homelessness to stable housing. Primary care providers that serve PEH are uniquely positioned to deliver low-threshold addiction care to combat the escalating rates of homelessness and associated overdoses. This workshop will cover the core components of addiction care, including the basics of medications to treat addiction in low-threshold settings, trust-building practices and harm reduction approaches to engage PEH in addiction treatment. An addiction medicine/internal medicine clinician and two addiction psychiatry physicians with extensive experience in homeless mobile outreach will lead the session. Small group discussions based on videos of people with lived experience of homelessness (PLEH) will be used to demonstrate the barriers that patients face in getting addiction care, and open dialogue on how to address these barriers. The session will end with case-based discussions to model complex medication management needs for PEH, and teach a framework for creating an addiction care plan for a patient experiencing homelessness. This workshop will better equip providers to provide equitable and evidence-based addiction care for patients experiencing homelessness.
Speakers: Fabiola Arbelo-Cruz: Assistant Professor of Psychiatry, Yale School of Medicine; Dr. Jeremy Weleff: Addiction Psychiatrist; Yale School of Medicine; Nicholaus Christian: Yale Program in Addiction Medicine
Session Materials:
