Social Networks of Homeless Individuals with Drug Addiction

The idea of social capital, defined as the benefits an individual gains by accessing resources they otherwise wouldn’t have access to via their social network, has extended into the realm of recovery research with a new concept: recovery capital.

RECOVERY CAPITAL: The resources (social, physical, human and cultural), which are necessary to begin and maintain recovery from substance use disorder.

This term refers to the sum of these gained resources that can help an individual to begin and uphold the recovery process.

For homeless people with a substance use disorder (SUD), members of their social network can be of great value or detriment to their recovery; supportive relationships may discourage drug use and help an individual manage their SUD while the presence of drug users in a social network could result in relapse.

Neale and Stevenson studied the nature of social networks and relationships among homeless people with SUD living in homeless hostels in the United Kingdom. Homeless hostels are short-term accommodations for homeless individuals that vary in size and structure but are characterized by shared spaces, lack of privacy, and supervision.

For this study, the authors conducted qualitative interviews with 10 residents from three hostels for a total of 30 participants. The interview was repeated 4-6 weeks later to evaluate changes in social networks over time. Of the 30 interviewed participants, 8 were lost to follow-up and not re-interviewed.

Ages of participants ranged from 21 to 54 with an average age of 38. Twenty four (80%) reported mental health issues. The length of homelessness ranged from a few days to 20 years. Social network size ranged from 3 to 13 people (not counting those referred to as “enemies”) with an average of 8 people. The table below describes substance use of participants.

From the interviews, the authors defined the following core relationships that were most central to participants’ lives:

family members
- Family relationships were discussed the most by participants. For some, family members who used drugs or alcohol were a source of stress for the participant. For example, one participant attributed her homelessness to her mother’s alcoholism as it forced her to leave home. Of 21 participants who discussed family members during the first interview, 11 mentioned the same relatives during interview two, showing how quickly the social networks of these individuals can shift. Fifteen participants had a child who lived with ex-partners or relatives. Feelings of guilt and depression were noted for the third of participants who had no contact with their children. About one third of participants (all men) had no contact with family.
professionals
- Participants generally spoke positively about hostel staff and other professionals (e.g. probation officers) with whom they interacted. They expressed gratitude for their services. However, some felt these individuals did not do enough for them. For some, professionals made up a majority of their network. There was more stability in these relationships over time as compared to family relationships.
other hostel residents
- Relationships with other hostel residents were both positive and negative; some talked and played board games with other residents while some used drugs and alcohol together. Having other drug users around tempted some individuals to use drugs as well, and lack of individual space made this scenario difficult to avoid.
friends outside of hostels
- Relationships with friends outside of hostels were overall positive and stable between the two interviews. These individuals offered sources of emotional and practical support as a majority had homes and did not have issues with drugs or alcohol.
current and former partners
- Eight participants had current partners and another 8 were in touch with an ex-partner. These relationships were mainly positive. Some former partners provided monetary support and had custody of participants’ children. Participants mainly blamed relationship breakdown on drug use.
enemies
- Enemies were defined as people who caused acute distress and were hard to avoid. All were heavy substance users who lived in or near the hostel. The same enemies were not mentioned at both interviews.

IN CONTEXT

Social and recovery capital are important sources of practical and emotional support for homeless individuals with substance use disorder.

This study described how relationships and social networks can either enhance or undermine recovery capital in this population.

Positive relationships could increase physical capital through situations such as earning money by working odd jobs for a relative, meeting a family member for a meal, or having a friend to live with temporarily.

Negative relationships and relationship breakdown reduced human capital by adversely affecting mental health and substance use.

The homeless hostel environment itself impacted recovery capital as shared space and lack of privacy made it difficult for those in recovery to avoid people using substances. The study also revealed the transience of these social networks as many participants noted big changes in relationships after only 4-6 weeks.

Gender differences in social networks warrant future study as women tended to have more contact with family members and larger social networks than men.

LIMITATIONS: This qualitative study provided valuable information about the nature of recovery capital and social networks of homeless people, but it is difficult to draw any firm conclusions or generalize these concepts to other homeless substance-using populations.

NEXT STEPS

Future studies should use this information to evaluate whether and how social networks among homeless individuals influence overall recovery capital as well as substance use outcomes such as treatment initiation and abstinence.

CITATIONS

Neale, J., & Stevenson, C. (2015). Social and recovery capital amongst homeless hostel residents who use drugs and alcohol. International Journal of Drug Policy, 26(5), 475-483.

For individuals & families seeking recovery: A hostel or shelter may provide temporary accommodations but does not have adequate resources to address addiction. For those already in recovery, this may be a difficult environment to maintain abstinence. Family can greatly contribute to a positive social network that allows one to build recovery capital and therefore aid in their recovery process.
For family members: Maintaining positive relationships with a homeless family member can greatly contribute to their social network and allow them to build recovery capital which can aid in their recovery process.
For scientists: Due to the qualitative nature of this study, these conclusions should be used to inform future quantitative research and survey development to grow the evidence-base surrounding recovery capital among homeless individuals with substance use disorder.
For policy makers: The results of this U.K.-based study could inform U.S. policies for homeless individuals with substance use disorder . Reforms to homeless hostels and shelters are needed to better cater to this population.
For treatment professionals and treatment systems: Relationships with homeless patients are important to their social network and accrual of recovery capital. Keeping their specific needs in mind can go a long way in helping this hugely vulnerable population gain hope and achieve a foothold in recovery.