Homelessness and the Opioid Crisis: Background, Funding, and Resources

November 3, 2017  |  Publications

In October, 2017, President Donald Trump declared the opioid crisis a public health emergency.  Years of rising prescription opioid use and misuse, followed by a surge in the use of illicit opioids have led to a spike in both overdoses and deaths in the United States.

Opioid use disorders are particularly hard on homeless populations, where prevalence of mental health conditions and substance misuse is high and access to health care is often limited.

The Department of Health and Human Services (HHS) has shown a robust commitment to addressing the epidemic in the past year, through several grants, with more anticipated action to come with the President’s recent declaration. Housing service providers are encouraged to work with their respective state agencies to ensure people experiencing homelessness are at the forefront of local strategies to end the epidemic.


On December 13, 2016, President Obama signed the 21st Century Cures Act, which designated $1 billion in new funding to combat the opioid crisis.  By April 2017, SAMHSA awarded the State Targeted Response to the Opioid Crisis Grant to all fifty states and U.S. territories.  The program currently provides single state agencies with $485,000,000 annually over the next two years.

The grant aims to address the opioid crisis by:

  • Increasing access to treatment and reducing unmet treatment need
  • Reducing opioid overdose related deaths through prevention
  • Supporting treatment and recovery activities for opioid use disorders (including prescription and illicit drugs)
  • Supplementing current activities taken by state agencies or territories to address the opioid crisis

As part of the grant, states must develop a needs assessment to determine where opioid abuse is most prevalent, and design a strategic plan to address gaps.  Although the funding cannot be used for housing directly, it can be used to support activities that assist people to secure housing.

Please contact your state agencies and let them know the importance of securing access to treatment and housing for vulnerable populations impacted by the opioid epidemic. The time is now to make sure people experiencing homelessness are part of the strategic planning around these grants.

The full list of grantees and contacts is available here. Project summaries for each state are also available.

Additional Funding

Soon after the first announcement under the Cures Act, HHS announced additional funding for opioid abuse through the following grants:

  • Medication-Assisted Treatment and Prescription Drugs Opioid Addiction: $28 million to 5 grantees to increase access of medication-assisted treatment for opioid use disorder.  As part of the 2017 Omnibus, this funding is limited to the 17 states having the highest rates of primary treatment admissions for heroin and opioids per capita and includes those with the most dramatic increases for heroin and opioids: Alabama, California, Delaware, Florida, Georgia, Maine, Michigan, Minnesota, Nebraska, Nevada, New York, North Dakota, Ohio, Pennsylvania, South Dakota, Tennessee and Utah.
  • First Responders: $41.7 million over 4 years available to approximately 30 grantees to train and provide resources for first responders and members of other key community sectors on carrying and administering an FDA approved product for emergency treatment of known or suspected opioid overdose.  States, Native American/Alaskan tribes, tribal organizations and local governmental entities are eligible for this grant.
  • Improving Access to Overdose Treatment: $1 million over 5 years to one grantee to expand availability to overdose reversal medications in healthcare settings and to establish protocols to connect patients who have experienced a drug overdose with appropriate treatment.  Eligibility is limited to Federally Qualified Health Centers (FQHCs), opioid treatment programs and practitioners dispensing narcotic drugs.
  • State Pilot Grant Program for Treatment for Pregnant and Postpartum Women: $3.3 million to support a range of family-based services for pregnant and postpartum women with substance use disorder.  State agencies for substance abuse are eligible for this grant.
  • Building Communities of Recovery: $2.6 million to mobilize resources within and outside of the recovery community to increase the prevalence and quality of long-term recovery support from substance abuse and addiction.  This funding is for Recovery Community organizations (RCOs).

By September 2017, HHS announced even more funding for opioid use disorder.  The department awarded another $144 million to the five grants listed above and included funding under the Services Grant Program for Residential Treatment for Pregnant and Postpartum Women. 

These additional grants also offer an opportunity for housing service providers to work with state agencies, non-profits and others to address the impact of the crisis on homeless populations.  

The grantees are listed here