Failed federal housing policy undermines Trump’s opioid reforms

By Lance Izumi and Michele Steeb

Over the past two years, President Trump has promoted bold reforms designed to address the opioid crisis. Congress, in a rare bipartisan effort, wholeheartedly supported Trump’s significant reforms, but these initiatives are being undermined by the failures of federal housing policy.

In October 2018, the president signed landmark legislation that attacked the opioid crisis by expanding recovery centers, improving coordination to curb illicit drug shipments, lifting treatment restrictions, fast-tracking new research, and expanding Medicare coverage for opioid treatment.

Yet this $5.5 billion investment in fighting opioid addiction could end in futility if the addiction-homelessness connection is not addressed.

A significant proportion of people struggling with addiction enter into homelessness at one point in their struggle, with estimates varying from 38% to 80% of the homeless population, depending on the source.

We might reasonably expect that federal housing policy would be aligned with the administration’s opioid initiative and would emphasize sobriety requirements for housing recipients, especially for those who suffer from addiction.

Think again.

The federal Housing and Urban Development Department’s current policy called “Housing First” is spending over $4 billion this year alone to provide lifelong, permanent housing for all who become homeless, while strictly prohibiting sobriety or accountability requirements for the individuals it seeks to help.

Because states and local jurisdictions are responsible for housing for the homeless, with strong encouragement from HUD, the majority of states and counties have adopted Housing First as their one-size-fits-all, low-expectations approach to homelessness.

As a result, these state and local programs place recovering and “trying to recover” addicts in housing, often provided by nonprofits, that does not allow for the requirement of sobriety and where illegal drug use is uncontrolled.

Such a low-expectations policy not only runs counter to what Trump is trying to accomplish in the battle against opioid addiction, but it goes against best practices in substance-use disorder treatment and plain old common sense. This policy also places innocent children whose parents have become homeless in very dangerous environments, leading to generational addiction.

HUD’s Housing First policy promotes dependency, fails to focus on recipients extricating themselves from addiction and homelessness, and fails to account for full program costs.

Even more frustrating, successful programs that stress sobriety and self-accountability are prevented from receiving federal funding grants because bureaucrats disparagingly view these programs as being “high-barrier.”

For example, Saint John’s Program for Real Change, a Sacramento, Calif.-based residential program for women and children struggling with addiction, domestic violence, and homelessness, emphasizes sobriety and accountability. Eight out of 10 women at Saint John’s are struggling with addiction, and all of those women became homeless due to their addiction.

Saint John’s supports these families in discovering the root causes of their homelessness and in beginning to make enormous life changes. The program provides comprehensive mental health therapy, drug and alcohol counseling, high school diploma attainment, and employment training.

The goal for these families is that they become self-sustaining, enabling them to permanently exit the cycle of poverty and homelessness. While mothers are working on themselves, their children also receive emotional, developmental, and academic support through the children’s program.

Yet, programs like Saint John’s that have very strong outcomes and refuse to abandon sobriety requirements are ineligible for funding through HUD and the other government entities that have adopted Housing First as their solution to homelessness.

The National Coalition for Homelessness Solutions, an organization composed of more than 50 accountability-centered programs which have collectively lost more than $25 million in funding, has urged HUD Secretary Ben Carson “to prioritize children and families within the homelessness assistance programs, as well as programs that encourage accountability on the part of their participants/residents.” Their plea to Carson has never received a response.

By focusing on the root causes of homelessness, such as addiction, these accountability-centered programs want to transform the lives of the homeless to become self-reliant.

Kevin Corinth, a homelessness expert at the American Enterprise Institute, has pointed out that homelessness programs must “focus on helping people overcome the problems that made them homeless so that they can move on with their lives.”

We know that drug and alcohol addiction often results in homelessness. Congress and the Trump administration say they are committed to solving the addiction crisis. Now, we only need for failed policies to be eliminated so that these crucial reforms can be given the chance to succeed.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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