Stigma of Homelessness and Substance Use

Introduction: Individuals with lived experiences of substance use and homelessness experience public, systemic and self-stigma at a high rate. I conducted research for this thesis to fill a gap in existing literature by addressing the research question “What are the experiences of stigma for persons simultaneously experiencing homelessness and substance use?” Methods: I conducted this research in two phases: 1) A scoping review to synthesize existing literature about the stigma of homelessness and substance use; and 2) a secondary analysis of existing qualitative research data to identify experiences of stigma for persons who use methamphetamine and experience homelessness. Findings: The findings from both studies reveal that experiences of stigma create barriers to essential care and resources. Individuals who experience homelessness and substance use encounter public stigma, stigma from healthcare providers and self-stigma that negatively impact their health and well-being. This compounded stigma reveals that experienced of stigma can lead to a sense of social exclusion and diminished sense of self-worth. The findings from this thesis also reveal that persons who are unhoused are resilient and make efforts to assert their humanity and dignity, even when faced with public, structural and self-stigma. Conclusion: Addressing stigma is imperative to promote dignified and equitable treatment for all individuals, irrespective of substance use or housing status. The findings from this thesis highlight the need for structural and institutional policy reform to effectively address stigma faced by this population. Service providers are urged to approach caring for persons who are unhoused and who are experiencing substance use judgement-free without preconceived negative beliefs. Future research should focus on creating and evaluating anti stigma interventions to meet the needs of persons who are experiencing homelessness and substance use.