Study examines links between opioid epidemic and rural homelessness

A recent study conducted by a researcher from Georgia State University reveals the compounding effects of the opioid epidemic and rural homelessness, leading to severe consequences.

April Ballard, an Assistant Professor at the School of Public Health, along with her team, analyzed data from the Rural Opioid Initiative involving over 3,000 individuals with drug use history in eight rural regions across 10 states.

The findings, published in the January issue of the journal Drug and Alcohol Dependence, indicate that 54% of the participants had experienced homelessness in the previous six months. This statistic suggests that the traditional Point in Time Counts method, used for allocating state and federal funding, significantly underestimates homeless populations in rural areas.

According to Ballard, the combination of the opioid epidemic and rural homelessness presents unique challenges, such as lack of awareness and limited resources, intensifying the issue.

Factors like unemployment, financial instability, and severed social connections resulting from opioid use disorder can lead to housing instability and homelessness. The harsh living conditions faced by individuals without stable housing often contribute to drug use as a coping mechanism, creating a cycle that worsens health outcomes and reduces lifespans.

The study revealed that individuals with unstable housing were 1.3 times more likely to be hospitalized for serious bacterial infections and 1.5 times more likely to experience drug overdoses compared to those with stable housing. Ballard explained that inadequate access to clean water for hygiene and drug preparation increases infection risks, while solitary drug use raises the chances of accidental overdoses.

Despite methodological differences between the Rural Opioid Initiative survey and the Point in Time Counts mandated by the Department of Housing and Urban Development, Ballard’s study suggests a significant underestimation of homeless populations in rural areas by the latter method.

For instance, in Kentucky, the researchers identified up to five times more homeless individuals compared to the Point in Time Counts, even though their sample size represented less than 1% of the adult population. In three counties where Point in Time Counts reported zero homeless individuals, Ballard’s team found over 100 drug users who had experienced homelessness in the past six months.

Addressing the challenges of conducting accurate Point in Time Counts in rural areas, Ballard emphasized the importance of allocating resources proportionately to tackle rural homelessness effectively.