Experiences of alcohol and other drugs among people experiencing homelessness

Introduction

There were approximately 122,000 people experiencing homelessness in Australia on Census night in August 2021, a rate of 48 per 10,000 population. There is a strong link between experiences of homelessness and other factors such as unemployment, domestic and family violence, mental health conditions and alcohol and other drug use (ADF 2018).

Smoking, risky use of alcohol, illicit drug use and injecting drug use are all more common among people experiencing housing instability or homelessness than among the general population (Scutella et al. 2014). In addition, regular drug use, smoking and alcohol use can increase the risk of homelessness. Data from the Journeys Home study showed that:

• An average increase in consumption of one cigarette a day increased the risk of experiencing homelessness by 0.2%.
• An average increase in alcohol consumption of one drink a day increased the risk of experiencing homelessness by 0.2% (Johnson et al. 2015).

This page focuses on alcohol and other drug use, harms and treatment among people experiencing homelessness in Australia. The reporting uses data from a range of sources, mostly national administrative and survey data. 

What data sources are available?

There are a limited number of data sources that contain information about alcohol and other drug use, harms and treatment among people experiencing homelessness. These include self-report surveys that ask people about their use of tobacco and administrative data sets (such as administrative data routinely collected by specialist services). Each data set uses a different methodology, and the language used to describe people experiencing homelessness may also differ across sources. 

For detailed information about each data source, see Technical notes.

What do we know about alcohol and other drug use and homelessness in Australia?

There is currently a lack of recent national data pertaining to alcohol and other drug use among people who experience homelessness in Australia, particularly for smoking and e-cigarette use. The Journeys Home survey showed that, in 2014, among people experiencing or at risk of experiencing homelessness:

• over three-quarters (77%) had used tobacco daily at some point in the past 2 years
• over half (52%) had used cannabis in the past 2 years
• 1 in 4 (25%) had used illegal drugs other than cannabis in the past 2 years
• 8.6% reported injecting illegal drugs in the past 2 years (Scutella et al. 2014, Table 6.1).

Alcohol and other drug use among people receiving support from specialist homelessness services

The Specialist Homelessness Services Collection (SHSC) includes data on specialist homelessness services clients who were identified as having problematic drug and/or alcohol use (AIHW 2025). The Specialist homelessness services annual report showed that in 2024–25:

• around 24,600 SHS clients aged 10 and over (8.5%) were identified as having problematic drug and/or alcohol use
• 79% of clients with problematic drug and/or alcohol use were returning clients (having previously been assisted by a SHS agency since 2011), compared with 63% of all clients (AIHW 2025, tables CLIENTS.2, CLIENTS.41 and CLIENTS.42; Figure 1).

Of the 24,600 SHS clients who reported problematic drug and/or alcohol use in 2024–25:

• almost 3 in 4 (74%) were aged under 45 years (AIHW 2025, Table SUB.1)
• of those who needed accommodation (around 19,400), 3 in 5 (60%) were provided accommodation while a further 16% were referred to another agency (AIHW 2025, Table SUB.2)
• almost 1 in 4 (24%) were sleeping rough (no shelter or improvised/inadequate dwelling) at the start of their support and around 1 in 6 (16%) were sleeping rough at the end of their support (AIHW 2025, Table SUB.3)
• around 1,300 (5.2%) were formally referred to an SHS agency by an alcohol and drug service (AIHW 2025, Table SUB.7).

Experiences of homelessness among people who inject drugs

The Illicit Drug Reporting System is an annual survey of people across Australia who regularly inject illicit drugs (Sutherland et al. 2025). Of the 865 participants interviewed in 2025, over one-quarter (27%) reported that they were homeless (that is, current accommodation was no fixed address, shelter/refuge or boarding house/hostel). This is stable when compared to 2024 (28%) (Sutherland et al. 2025, Table 2).

What do we know about health and harms for people experiencing homelessness who use alcohol and other drugs?

People experiencing homelessness are also more likely to face additional vulnerabilities, including mental health conditions and family and domestic violence. In 2024–25, among specialist homelessness clients with problematic drug and/or alcohol use:

• 73% (around 18,000) had reported a current mental health issue
• 42% (around 10,300) had experienced family and domestic violence 
• 33% (around 8,100) reported both a current mental health issue and experiencing family and domestic violence (AIHW 2025, Table CLIENTS.47).

By comparison, around 1 in 3 (31%) of all SHS clients experienced a current mental health issue (AIHW 2025, Table CLIENTS.41).

People experiencing homelessness may adapt their smoking behaviours in order to save money, thus exposing themselves to greater health risks. This can include sharing cigarettes and smoking from used cigarette butts or filters (Okuyemi et al. 2006).

How many people experiencing homelessness receive treatment for alcohol and other drug use?

In 2024–25, almost 1 in 3 (31%, or 7,700) SHS clients with problematic drug and/or alcohol use identified a need for drug or alcohol counselling (AIHW 2025, Table SUB.2). Of these clients, 45% were provided with counselling, 22% were referred only, and 33% were neither provided with nor referred to counselling (AIHW 2025).

To better understand outcomes for clients who access specialist homelessness services and alcohol and other drug treatment services, a study linked SHS data with data from the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) (AIHW 2016). 

The key findings demonstrate that the homeless population experiences additional complexities. Clients who had sought assistance from both SHS and AODTS between 1 July 2011 and 30 June 2014 were:

• less likely to be unemployed than SHS-only clients (6% compared with 13%, respectively)
• more likely to be First Nations people than AODTS-only clients (27% compared with 13%)
• more likely to receive treatment for multiple drugs than AODTS-only clients
• more likely to have poorer AOD treatment and housing outcomes compare to the AODTS-only and SHS-only populations.
• twice as likely to report heroin as a principal drug of concern than AODTS-only clients (11.3% compared with 5.7%) (AIHW 2016, Table S1.1).

Among those who received specialist alcohol and other drug treatment services, alcohol was the most common principal drug of concern (40%) for people who sought support from both SHS and alcohol and other drug (AOD) treatment services (AIHW 2016, Table S1.1). The most common illicit principal drugs of concern were cannabis (28.6%) and amphetamines (20.5%) (Figure 2).

Where do I go for more information?

• Illicit Drug Reporting System
• Specialist homelessness services annual report