Homelessness and Addiction: Part I

In recent months my travels have taken me to Philadelphia and New York City, two of the most amazing cities in America. While I have enjoyed staying at comfortable hotels and dining on delicious food, it has been impossible to ignore the significant number of homeless people on the streets, begging for money and food.

In fact, many have approached me and asked for help.

homeless-dogAs someone who has spent a career treating those who struggle with addiction, my stance has always been that giving money to the homeless essentially equates to giving them the means to engage in addiction – because of course they will use the money to buy alcohol or drugs!

And this stance has been so easy to implement. All I have to do is walk on by, pretend not to notice, and feel good knowing that I am doing my part not to further addictive behaviors in the homeless.

America’s homeless population

But then I discovered Wayne Teasdale’s enlightening book, A Monk in the World: Cultivating a Spiritual Life and my resolute stance on (not) giving to the homeless began to crumble. He put names and stories to the faceless and awakened me to how the homeless mirror many of my own insecurities.

Very few who become homeless have chosen this lifestyle. Various risk factors conspire – much like addiction – to bring about the unfortunate state of homelessness. Behind every person wrapped in newspaper, sleeping on a park bench on a cold night, is a story. In America approximately 500,000 individuals experience homelessness (100,000 are chronically homeless) on any given night. A report by SAMHSA indicates that more than a third had chronic substance abuse problems and many also suffer from mental illness.

A study conducted in Philadelphia and NYC on the chronic homeless – my two recent destinations – revealed that most were male and over 90% Black. In January of this year, for the first time ever, NYC recorded over 50,000 individuals showing up at shelters, one in ten being children.

picture of graph of homeless population
NYC Shelter Census Report (updated for 2014)

Homelessness is a growing and omnipresent problem that I now see everywhere – now that I am actually seeing.

What to do about the homeless?

For the first time in my life I am now engaging the homeless. Instead of walking by and ignoring their pleas for help, I am stopping and doing my best to listen to their stories. This past weekend in NYC I met Nelson. He suffered from a vascular disorder that injures blood vessels called Hemangioma.

He came to NYC a few years ago from a South American country in hopes that doctors could help him, and they did. As we chatted on the street, he pulled out a stack of family photos and told his story. He was incredibly grateful to be alive and reminded me that relationships are at the center of a good life.


Our conversation also highlighted the incredible discrepancies between those that invest significant amounts of time, energy, and money on materialistic things, and those that have nothing. In addition to Nelson, there have been others recently whom I have engaged and listened to their stories. At the same time, I don’t stop for everyone.

My relationship with the homeless is still evolving. I don’t mind giving money anymore. But what I have learned in the brief time that I have opened to this problem, is that money alone is not the answer. A permanent solution to homelessness will require a transformation in our society, a systems approach that understands how to intervene at the root of the problem.

For now, I will no longer ignore or be afraid of the homeless. I will embrace the vulnerabilities they mirror in myself, and take the time to listen to their stories.

Read Homelessness and Addiction: Part 2.


  1. says

    I recently read an article in The Oregonian that told how many people who are unemployed have now dropped off the list. Unable to find work, they give up. Many are losing their homes, some their families. Some will find shelter with relatives or friends, but how many will end up on the street? It’s part of our new reality that not everyone sitting on the sidewalk with a sign asking for help is addicted. They’re hungry. And scared. Like you, I have always ducked my head when passing people sitting on the sidewalk. But last year before Thanksgiving I made up a bunch of lunch bags, took them downtown and handed them out to those on the street. It changed my whole perspective. I heard many stories, and saw the gratitude in their eyes, as much for a listening ear as for the food. Thank you for posting this. You expressed very well the need for more understanding of individuals we pass by on the street, whether addicted or simply down on their luck. In either case, simply displaying compassion, under any circumstances, is good for the soul–for both the person who’s sitting on the sidewalk and for yours.

  2. admin says

    Carol, thanks for the nice feedback! I absolutely agree that the demographics of the homeless are shifting given our present economic situation. Your words are a good reminder that we simply don’t know the story of those on the street if we don’t take the time to engage, like you did with the lunches on Thanksgiving. Addressing this growing issue will require us all to get more involved and find ways to contribute.



  3. Kelsey Quesnell says

    Being someone who lives in Portland, Oregon, I also encounter many homeless people throughout my day. Like Dr. Fitzgerald, I never felt it was a good idea to give them money because I felt like I was enabling their addiction. But it’s true, not everyone is an addict. This changing economy has forced people to do things they would never do. I’m sure many of them growing up never thought they would be on the street. That is why it is important to understand that everyone has a story and not everyone had control over whether they ended up on the streets or not. Despite not giving anybody money, I feel like I still give them my respect. I always politely decline if I have no change on me and hope they have a good day. Sometimes a kind word can be uplifting.

  4. Jorge Rodriguez Jr says

    With the background of living in two different cities I have my experiences with the homeless. From Los Angeles, CA to Portland, OR. Growing up in Los Angeles, seeing homeless people was always a regular site when I would be going to the market or to school. I always had a negative view on them, with statements ,” They chose to be there” and ,” they are bad people”. However this mindset was completley changed when I joined a program in high school that was in effort to help the whole ” bully” mentaility. One of the events was to make bags with food, books, toiletpaper, etc. fror over 200 people. We took a van out to Downtown Los Angeles and just walked around handing out bags to the less fortunate. Now at first I was really angry because I felt that they were just going to sell this for alchohol or drug abuse, but it wasn’t until I got to talking to them that they were once normal people, and were either unforturnate from divorce claims, gambling, and other reasons besides alchohol and drugs. This was a big eye opener to me, and I attempt to be more genourous to the less fortunate when I can.

  5. says

    Thank you John, for this insightful article. I have my own issue with giving to the homeless and I’m still unclear as to which side I’m on. I sometimes give to people and sometimes don’t. When I can tell that its a clear addition or bogus story, I won’t. I have been burned a few times. I do, though, give to the church and that money does go back to helping people. So maybe in a roundabout way I am giving back?

    Anyway, thank you for keeping this conversation going. Too many of us who live in NYC ignore the homeless.

  6. admin says

    I am finding my challenge is maintaining a compassionate heart in all situations. Even if alcohol and drugs may be involved, staying open to another human beings suffering is key for me. Thanks for the feedback.


  7. says

    I find it so hard to see the growing amount of homeless people just around our small town. It saddens me to see how hollow some of them look when you really look into their eyes. I agree that money is not the answer to homelessness problems. I tend to try to give out food if I have any in my car, or a warm drink (because I own a small coffee shop in my hometown). But what I’d like to see more of is not just shelters going up to help these people, but assistance with getting them the proper health care they need, and encouraging them to use it. Mental health is a huge issue for those on the streets, and I’d like to see a program or something of the sort to help out there. When mental health is looked at and you start to get a person back to feeling ok mentally, then the sky is the limit as to what they can then take on and accomplish. As I said, I totally agree, money is not the answer.

  8. amy kuper13 says

    I think a lot of people believe that giving a homeless person money is enabling them with drugs/alcohol or whatever it may be. I have worked with City Teams in Portland which help the homeless communities. I have met plenty of homeless people and they are very sweet, kind people. However a lot of them in the Portland area that I have met say they are happy being homeless. I met one group that called themselves “home-free”. They went on to explain that they don’t like the idea of having four walls to constrain them. They argue that it is too much stress to have bills and a home to take care of. So I believe a lot of people do choose to be homeless. I don’t want anyone to be offended, but I have met homeless people who say they could go get government aid, but they do not want to. They CHOOSE not to go get help. My brothers friend was homeless for a while because he was so high out of his mind he didn’t care where he slept. He Choose to sleep on the street. These people I would argue do have a choice. However the children that are homeless that is sad. I do understand there are people who do not have a choice on being homeless. I see a lot of homeless asking for change and I buy them doughnuts, burgers, fries whatever I have other than money I have even given one lady the coat off my back. Sometimes the reactions are negative when I have food instead of money, but mostly it is appreciated.

  9. Joanna B. says

    This story is touching. While it is easy to judge, the causes of homelessness are complex and vary by individual. It is disheartening to realize the amount of homeless people out there, especially those that are children. Certainly treating these individuals as a nuisance and as less than individuals is wrong.

    Each one of these homeless individuals have their own unique stories and are worthy of being listen to and helped.

  10. Jeudy S. says

    Being regarded as one of the world’s rich and developed nation, I find it hard to believe the huge number of Americans experiencing homelessness. I’ve also gotten caught in difficult situation upon my encounter with these individuals regarding what is the right thing to do. Upon looking at their sad and tired face, I couldn’t bare to ignore them. But at the same time, I felt that my money could possibly do more damage than help (for all I know I could be supporting their addiction with that money). So most of the time, instead of giving them money, I would give things such as bus pass, food or free food coupons. I find your article such a big eye opener and it’s also something we don’t see many people do in our society. I think our society play a big role in shaping our thinking: it seems to often relate homelessness to drug addicts and drug problems. I think this might one of the main cause that lead most people to ignore the homeless completely. I think such stories as seen in this article might be able encourage people to have a second thought before judging homeless.
    Thanks you Dr. Fitzgerald for sharing such insightful story.

  11. Maikhanh Tran says

    I think that this is extremely relevant because Oregon is among one of the highest rates of homelessness, which is unfortunate. Especially for times like now when it is almost below freezing outside. I think that the majority of the public assumes that the homeless will just take the dollar or two that you give them to go buy alcohol or drugs, this is unfortunate stereotyping. I also think it is true that just having conversation and listening to them will go a long way, sometimes even further than money alone. Especially here in Portland, there are large numbers of the homeless sitting on the sidewalks asking for money and many people walk by as if they aren’t even human. I think that it is something that we need to work on as a whole.

  12. Chris B. says

    Living in Portland, OR there are many people on the streets begging for food and money day and night and rain or shine. I can’t help but feel sympathy for those people cause at any moment that can happen to us. Over the past summer my sister and I volunteered at the Portland Rescue Mission which supplies and provides homeless women, men and children with food and shelter. Also provides and guidance for those who have trouble with addiction and drug abuse. What shocked me the most was when I volunteered there were children my age struggling and trying to make it to the next day. I got to talk to a few and tried to get to know them. Few of them shared their stories; some left abusive families, some turned to drugs at a young to cope with their lives.
    I think that we need to evaluate or create new ways of to help those who struggle with addiction, substance abuse and those who are homeless. I try to do my part and help them with a few dollars here and there or spare food. I know it’s not much but I hope that it makes a difference in their lives. One aspect that some have pointed out that their are posers who aren’t actually homeless and choose that lifestyle compared to those are homeless.

    Overall this was a wonderful and insightful story.

  13. Yuliya Y. says

    This story seriously touched my heart. I used to be one of those people who ignored homless people becaue I heard many stories where people actually go to school to learn how to lie and make other people believe their stories then they go around the corner and drive off on nice cars. But certainly this is no the case with all people. I used to walk past homeless people and not even give a care about them because all they taught us in schools is that they use this money for drugs. We are quick to judge but how my fiance says would Jesus walk past them? My fiance has opened up my eyes about homeless people then I took some classes at PSU and realized that there is a story behind every homeless person. The number of homeless people is outragous and I do not understand those people who are homeless like how they got to homeless life but maybe if more people took the time to help instead to judge then life would be different for everybody.

  14. Olga Golubenko says

    I see a lot of homeless people all around the world. They are almost on every corner, asking for money. And what do they do with that money that they beg from people? They buy drugs! I know, sometimes we feel sorry for them and trying to help them, but most of the time it does more harm than good because they go ahead and buy drugs and become more addicted. Addiction continues to be among our most serious public health problems, and we need to do as much as we can to help those who suffer. I do not usually give people money, just because I am not financially stable myself, and plus I do not want people to spend that money that I work for, on the drugs which lead to addiction. Thank you for posting this post! I like how you express the need of understanding of people we pass by on the street. I would rather give homeless people food and shelter than giving them money. I think this would be a wise decision. (OG)

  15. admin says

    Thanks for the comment. I would only say that the belief that all buy drugs with money is not accurate. While I do believe it happens quite a bit, the purpose of the post is for us to see how such beliefs get in the way of us doing anything. Seeing how we get stuck ourselves in simplistic rationalizations for our own behavior helps us to evolve our own nature of life. It is a challenging problem and I appreciate you engaging it in your feedback.


  16. Juwairiyah R. says

    Hello Dr. Fitzgerald:

    This article of you really surprised me about how many people are actually homeless and living in condition that I would never be able to lives off of. It’s been six years since I have lived in America and see a lot more homeless in my daily life then back home, which is the opposite of what I though before. I always though poor countries like Burma and Thailand (where I came from) have experienced worse situation than America. However, I think we do have good amount of homeless individuals and families back in Thailand, but they still have a place to stay which were warmer conditions, they can build small hut out of anything to stay with their families in area further out in the cities and could still have daily jobs (cleaning yard, working at seasonal worker and some on and off constructions job sites). However, I do see individual who are addict don’t often ask for money from other instead they would rob, steal in order to buy drugs and other things for themselves. I also see how we have different situations here because most homeless are mentally ill or in some with addict problems, and no supports from peers, families/ relatives and people who they might know before. Back in Thailand, it’s a bit different where peers, families/ relatives actually try and help out if one person from the family experienced some kind of troubles in their life. We indeed don’t even have a good rehab places for addict much like here but the King does tried his best with proving places for his citizens to recovers from these problems.

  17. admin says

    Thanks for your comment and insight that homelessness is not just in America, but a global problem. Thank you.


  18. says

    Dr. Fitzgerald,
    Thank you for sharing this information. I have had different feelings about the homeless in the past. I have at first thought that they were mostly people that just didn’t want to work. Maybe they felt like the world owed them a living. But as I have gotten older and had my own life experiences, I have grown a compassion for most of them. A few year back if it was not for a good friend I would have been homeless as well. And it was not from drugs or alcohol. My unemployment ran out and I was not able to get a job. I had never been in that situation ever in my life. I had the same job for 26+ years as I raised my 2 sons on my own. I understand the hopelessness that many people are feeling these days. I know, first hand, how a person can become homeless, and desperate. I also know that many of the homeless are in that situation due to mental illness. I have a son who has struggled with this and been homeless, and may be homeless now, as I have not heard from him in a while. My heart aches for him and all of the others that suffer from mental illness. There just is not enough help out there for people that are struggling with these problems. On the other hand, I know there are a small few that are in it for the money. And some that make a lot begging on the side of the road, intersection, etc. Who’s to know which is which. They all deserve the respect as any human does.
    Thank you again,

  19. Isabelle Uwamahoro says

    Thank you very much for this article! I have had the same experience working with the homeless at the “Outside In Syringe Exchange”. This opened m eyes to see and understand the issues that homeless are facing in this society. Also, most of the homeless I worked with were also drug addicts who were in the process of overcoming their addictions. I found that through the program, I was becoming more and more open and understanding towards the homeless. Similar to you, I started to “engage” with them, to “listen” to what they have to say, to show compassion, etc. Thanks to the program, I also understood that being homeless and/or an addict is not a choice. Unlike what many people may think, homeless and addicts have a will to change. They care about there lives, their health. They have talents, skills, knowledge,..but the only thing they lack is compassion and care. They need that more than they need other resources. They need community members to understand them and to push them towards the good path instead of judging them. As you mentioned, “money alone is not the answer” and intervening at the root of the problem” is key in dealing with homelessness and addiction.

  20. says

    Isabelle, thanks for sharing your experiences. The homeless are not separate from us, but a part of us. We are them and they are us, it’s just that so often we fail to see we are all in the same boat.


  21. Emma says

    You are right, there is a common perception that giving money to the homeless enables them. Notice I didn’t say misconception. It enables them to: eat, rent a cheap room for the night, buy cigarettes, booze, sometimes drugs, pay off a small debt, give money to their kids, etc. Any number of things that non-homeless people might do with money, the homeless might do as well.

    My thoughts are that even if the money I give a homeless person ends up going for drugs, well, maybe that’s one less trick that person may have to turn, maybe one less person they feel compelled to steal from in order to get their drug money. My own mother was a heroin and crack addict and was also a prostitute in order to make enough money to buy the drugs she needed. If my mom had received money from kind-hearted people, well that meant she’d have to turn fewer tricks.

    Another reason to give money to the homeless is simply to share human kindness. I wonder what it does to a person’s psyche to be ignored day in and day out. The next time someone asks for money, give them something, even if it’s that $20 you bill you have. No, you can’t do that with everybody but someday that person you gave a $20 to might remember that one time someone was kind to them. That might just be the impetus they need in order to make some changes, knowing that there is still good in the world.

  22. says

    Emma, while you make some very compelling arguments for giving money to the homeless, I continue to believe that what they need most goes beyond money. Sure, they can do with the money what non-homeless people do as well, but the point is for us to find a way to help them. And for that, I believe the best antidote is our time. We can give them our attention, time, ear and listen to their plight. And then decide whether money will help, or perhaps systemically make things worse. What if the money is used to buy an opioid pill on the street that results in the person’s overdose death? Homelessness is a complex problem with no simple solutions. There is no one right answer…thanks for your feedback.


  23. Emma says

    Oh definitely. Of course handing out money is not the only thing we should be doing for the homeless. Not by a long shot. I apologize for having framed my comment in way that would give that impression. Thank you for your response.

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