Report #7: Can Housing First Beat Fentanyl, Meth, and Psychoses? The Crisis of Chronic Homelessness and the Case for Heterodox Housing Policy

The crisis of chronic homelessness is accelerating, fueled by the widespread availability of fentanyl, psychosis-inducing methamphetamine, and severe mental illness. While "Housing First" (HF) remains the dominant strategy for addressing this challenge, a close examination of the evidence reveals that its reputed benefits for mental health and substance abuse disorder are often exaggerated and show no more efficacy than other treatment models for achieving recovery. This report argues that policymakers must move beyond HF as the only solution and instead adopt a heterodox housing policy that strategically combines HF with "Treatment First" (TF) options to better tailor interventions to individual circumstances, which is the only way to successfully fight the symbiotic scourges of chronic homelessness, mental illness, and addiction.