This session was presented live on September 28, 2023, (and rerecorded in December 2023). 

Presented by Nicholaus Christian, MD MBA / Yale School of Medicine

People experiencing homelessness (PEH) have increased rates of polysubstance use and more than 12x the risk of overdose compared to the general population (Fine, 2022). Being homeless makes it difficult to meet basic biological needs, and emergency 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. Addiction medicine fellowship curricula must prepare the addiction workforce for the complex care needs of people with lived experience of homelessness (PLEH) to combat the escalating rates of homelessness and associated overdoses. This session frames curricular topics, such as trust-building practices and harm reduction approaches, that can be used to teach trainees how to engage PLEH in addiction treatment. Videos of PLEH are used to demonstrate the barriers that patients face in getting addiction care, and case-based discussions modeled how to create an addiction care plan for someone who is unstably housed. This session helps to ensure every addiction medicine provider is prepared to teach belonging & connection to trainees in caring for patients with lived experience of homelessness.

• Recognize the drivers of substance use among people experiencing homelessness or people housed in congregate settings.
• Formulate an addiction care plan for a patient experiencing homelessness or unstable housing.
• Teach trainees or staff strategies to engage people with lived experience of homelessness in addiction care that enhances belonging & connection.