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Facts Fight Fentanyl (FFF): Homelessness & Overdose Risk

Purpose

To provide clear, compassionate, and evidence-informed information on how homelessness intersects with fentanyl use and overdose risk, while promoting harm reduction, housing solutions, and stigma reduction.

Why This Matters

  • People experiencing homelessness are disproportionately affected by fentanyl-related overdoses.

  • Overdose is a leading cause of death among unhoused populations in many U.S. communities.

  • The increasing presence of fentanyl has made the drug supply more unpredictable and more lethal.

Chronic Homelessness & Fentanyl:
Risks, Barriers

Chronic Homelessness

Chronic homelessness refers to individuals or families who have experienced homelessness for at least 12 months continuously or have had 4 or more episodes of homelessness in the past 3 years and have a disabling condition such as a serious mental illness, substance use disorder, or physical disability. People experiencing chronic homelessness often face long-term health challenges, repeated interactions with emergency systems, and increased vulnerability to overdose, especially with fentanyl in the drug supply. Source: U.S. Department of Housing and Urban Development (HUD).

 More Definitions 

Consistency

Showing up regularly and following through on commitments

How Homelessness Increases Risk

  • Using alone reduces the chance of overdose reversal.

  • Interrupted tolerance after incarceration, hospitalization, or detox increases overdose risk.

  • Unsafe environments lead to rushed or hidden substance use.

  • Limited access to healthcare and treatment services.

  • High rates of trauma, stress, and mental health conditions.

Fentanyl Overview

  • Fentanyl is a synthetic opioid 50–100 times stronger than morphine.

  • It is often mixed into heroin, methamphetamine, cocaine, and counterfeit pills.

  • Many individuals are unaware fentanyl is present, increasing overdose risk.

  • Fentanyl acts rapidly, often causing overdose within minutes.

What Works

(Evidence-Based Approaches)

  • Naloxone (Narcan) distribution and training

  • Fentanyl test strips to detect contamination

  • Syringe services programs to reduce harm

  • Peer support to increase engagement and trust

  • Medication-Assisted Treatment (MAT) such as buprenorphine and methadone

  • Housing First approaches that provide immediate access to housing

Systemic Barriers

  • Lack of identification and documentation

  • Limited transportation

  • Stigma and discrimination in healthcare settings

  • Limited access to phones or internet

  • Criminalization of substance use

  • Long waitlists for housing and treatment services

What Works: Housing and Trust-Based Outreach

Housing is Prevention

Stable housing improves health outcomes, increases access to care, and significantly reduces overdose risk. Housing First models have been shown to improve long-term recovery and stability.

Why trust matters

• Increases engagement with services and care
• Improves acceptance of naloxone and harm reduction tools
• Encourages safer use practices and reduces overdose risk
• Supports long-term stability and recovery
 

Trust Building in Outreach & Support

Building trust is essential when working with individuals experiencing homelessness and substance use. Many have faced stigma, trauma, and negative experiences with systems of care. Effective trust-building strategies include:



 

Language Matters 

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  • Language shapes how people are treated in healthcare, policy, and everyday interactions.

  • Stigmatizing language can increase shame, discourage people from seeking help, and contribute to fatal overdoses.

  • Using person-first language recognizes the individual, not their circumstance or condition.

Instead of saying:

'Homeless person'

(Say)

'Person experiencing homelessness'

Why It Matters

​

  • Reduces stigma and discrimination

  • Encourages people to seek care and support

  •  Improves outcomes in healthcare and treatment settings

  •  Promotes dignity, respect, and human connection

  • Research shows stigma is a significant barrier to accessing care and is associated with increased overdose risk.

Key Takeaways

  • Fentanyl has significantly increased overdose risk across all populations.

  • Homelessness increases vulnerability due to systemic and environmental factors.

  • Overdose is preventable with the right tools and support.

  • Harm reduction, housing, and compassion are essential to saving lives.

Call to Action

  • Carry naloxone and learn how to use it

  • Support harm reduction and housing initiatives

  • Share trusted resources

  • Promote compassion and reduce stigma in your community

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