By David Marlon

Las Vegas is in crisis. Homelessness and substance abuse are running rampant, tearing apart our communities.

Despite increased support for drug decriminalization efforts and harm reduction programs, drug overdose deaths in America have only risen. From 17,000 in 2000 to over 70,000 by 2017, we are now seeing the highest number of lives lost to drug overdoses in our country’s history.

Clearly, we are in the midst of a massive drug-induced catastrophe, and it feels like nobody is offering a clear explanation of how we got here, let alone an effective solution.

The team at Vegas Stronger, a rehabilitation nonprofit, became frustrated watching these seemingly intractable problems proliferate in Las Vegas and throughout America. We set out to diagnose the problems driving the interlinked issues of homelessness and substance abuse, and to find lasting solutions.

Las Vegas is a special community. We are essentially on an “island” with hundreds of miles of the Mojave Desert surrounding us. In this stark landscape, our city has grown, proving it has a soul fueled by the compassion of its residents.

In 2021, the Census showed about 5,000 people were homeless in Clark County. Just about half live in shelters, while the rest are unsheltered.

Our Las Vegas community can band together to solve the social condition of homelessness and help these folks get back on their feet. The team at Vegas Stronger has seen firsthand the complexities associated with the issue, and we want to work to create a long-term solution.

First, we need to acknowledge the problem and acknowledge that the federal response to it is flawed.

Giving a home to someone experiencing homelessness and a substance use disorder is counterproductive to the recovery process. Instead, the evidence-based best practice in treating substance use disorders is to have patients’ detox on a unit, then move them to a congregate living environment where they also receive treatment. Giving an active user a home is enabling and counter to the recovery process. Providing inpatient detoxification and crisis stabilization followed by congregate shelter immediately post detox. As the client progresses through treatment providing more independence as the client progresses is an evidence based practice shown most effective in therapeutic communities. No one should be homeless, people who are struggling deserve treatment.

The next step is to move them to a sober living environment with at least one roommate as they receive partially hospitalized or outpatient treatment. At that point, usually 60-180 days after they have begun treatment, case managers should work with patients to transition them to independent living while they move from the treatment phase to the support phase of addiction recovery.

This tried and tested model is far superior to giving a person housing at the onset, therefore removing the consequences of substance abuse and exacerbating the problem.

Using our deep knowledge of treating patients suffering from homelessness and substance use disorders, Vegas Stronger has created a 6-point plan to tackle these issues at their root:

1. More Shelter Beds – We must provide enough shelter beds to accommodate all homeless individuals in the city and make it mandatory for them to live there so they can receive the help they need.
2. Treatment – Once their housing needs are met, we must provide excellent SUDs and mental health treatment, deploying top-notch clinicians and providing quality amenities to patients.
3. Community Education – Building public awareness of the solution is crucial, since just having excellent, low-cost treatment facilities isn’t good enough — people need to reside in them. It will require broad-based community buy-in for us to get homeless people who need help into shelters where they can access the treatment and support, they need to rebuild their lives and become productive members of society. Our communities will be safer, healthier, and more prosperous for it.
4. Legislative – We must end entitlements for the homeless population, including programs to provide them with food and other resources while they live unhoused. While this may sound harsh, we have found it is the most effective way to assist unhoused folks in bettering their situation. Abundant resources should be widely available to them within the shelters but providing them on the streets often incentivizes continued homelessness by discouraging individuals suffering from addiction from moving into a shelter where they can no longer access substances. In cities like Vegas, shelter beds sit empty because people don’t want to move into them.
5. Homeless Specialty Drug Court – Temporarily arresting a person with an opiate dependency who is homeless and refusing help is sometimes the only option to help them break out of the cycle of addiction. That said, getting them out of jail and into treatment via a specialty court in a timely manner is key – it is an effective, evidence-based approach to help people who are suffering.
6. HMIS (Homeless Management Information System HUD) – Shelters and treatment providers should collect data to track patient progress once, ensuring that outcomes are measured in a robust manner so they can pre-empt and prevent relapse.

This plan addresses the causes of homelessness holistically, and we hope we can count on support from the community so we can tackle the problem once and for all, making Las Vegas a better place to live.