ABSTRACT
Substance misuse is inextricably linked into the homelessness story of many of the individuals who find themselves homeless in the UK. Many patients will not be seeking treatment for their substance misuse but can be reassured that treatment will be forthcoming should their attitude change in the future. Alcohol is an important factor in the addiction picture for many homeless patients. It is a fact of life in the homeless environment, with many homeless people having primary alcohol problems. Even if the patient is not using alcohol at the time of assessment, it is extremely common, if not the norm, for alcohol use to creep in as substitute prescribing is instituted and street drug usage decreases. Homeless people live in a dangerous and threatening environment. Substance misusers who are homeless are prone to chronic illnesses such as epilepsy, asthma or chronic obstructive pulmonary disease or chronic hepatitis C.
