Gerald R. Garrett

The Homeless Alcoholic

Although homeless alcoholics constitute no more than 5% of the entire alcoholic population, no alcoholic subgroup has been studied more thoroughly over the past 50 years.1 Homeless alcoholics have been visited by social workers, sociologists, anthropologists, psychologists, doctors and psychiatrists, urban planners, and public health officers. They have been studied and observed in the streets and on skid rows, in bars, jails, drunk tanks, and “bottle gangs.” The body of literature resulting from these studies provides an extensive picture of the social, personal, and medical backgrounds of homeless alcoholics.2

Counseling and Case Managing

Working with homeless persons is more than just a job: it is reaching out to people in extreme crisis; it is creating a bond to restore stability; it is showing that society can respond to the needs of its most destitute members. Working with homeless people involves the most delicate interpersonal problems and the least tractable interorganizational conflicts—it involves being there after others have left.

Responding to Homelessness

Popular conceptions of homeless persons are often vivid, usually poignant, but rarely adequate. An outstretched hand at a subway entrance, an elderly woman pushing an overloaded cart, a bottle gang of disheveled alcoholics, a young family despairing in a motel room—all are images that represent part of the homelessness problem, but none captures fully the experiences or feelings of those who become homeless.

The Problem of Homelessness

Huddled in doorways and on heating grates, standing in lines at soup kitchens and shelters, homeless persons have become an all-too-familiar part of urban American life. Each winter, newspapers report the tragic deaths of these people: freezing on the streets, burning in makeshift shelters, wasting away from a host of illnesses. And throughout the year, homeless persons are vulnerable and victimized: beaten, raped, stabbed, strangled. Securing the basic necessities of life—food, clothing, human companionship—becomes a daunting, sometimes life-threatening, task.

Shelters and Services

An emergency is created when any individual or family becomes homeless. Lack of a home means inadequate food, poor health, diminished social supports, and continual stress—an absence of the most basic moorings of individual identity and well-being. The primary goal of most of the 5,400 shelters in the United States is to meet these emergency needs, preventing them from progressing quickly to even more complete misery and death (U.S. Department of Housing and Urban Development [HUD], 1989).

Homeless People with Drug Problems

Although alcohol abuse remains as the nation’s number one drug problem, public concern over the abuse of other drugs—marijuana, heroin, cocaine, and more recently “crack”—has been far more intense over the past two decades. Media stories that focus on the link between drugs and crime, the gang violence associated with narcotics trafficking, the health risks of drug use, or the epidemic of “crack babies” among others offer convincing evidence that drugs and drug abuse destroy individual lives and families and cost the American economy billions of dollars.

Homeless People with Alcohol Problems

Although Jimmy may not typify all homeless alcoholics in cities in the United States, his case serves to illustrate how drinking and alcohol abuse play major roles in the personal problems of the homeless. In fact, research studies over the past 50 years estimate the prevalence of alcoholism as somewhere from 20 percent to as high as 50 percent. For example, recent studies conducted in Boston (Garrett and Schutt, 1989), Denver (Atencio, 1982), New York (Barrow and Lovell, 1982), and Oregon (Multnomah County Social Services Division, 1984) estimate that from 30 percent to 50 percent of the homeless have a problem with alcohol abuse or alcoholism. Figures based on similar studies in Ohio (Roth and Bean, 1986), Baltimore (Fischer and Breakey, 1987), Milwaukee (Rosnow, Shaw, Concord, Tucker and Palmer, 1985), Phoenix (Brown, MacFarlane, Paredes, and Stark, 1982), and Los Angeles (Ropers and Robertson, 1984) estimate the prevalence somewhat lower at 20 percent to 30 percent.