Homelessness and Addiction Statistics 2026: Current National Data, the New Hampshire and Massachusetts Picture, and What Treatment Access Actually Looks Like

Homelessness and addiction intersect in ways that statistics describe better than stereotypes do. The problem: most of the statistics circulating online are 15 to 25 years old, copied from page to page long after the underlying surveys stopped being current.

This page rebuilds the numbers from primary sources as of mid-2026: the newest federal count, the largest representative study of homeless adults in decades, current peer-reviewed prevalence and mortality research, and the only state-level New Hampshire and Massachusetts compilation in this topic space. Every figure carries its source and year inline, and where a famous old number deserves retirement, we retire it by name.

Key numbers at a glance

• 745,652 people experienced homelessness in the United States on a single night in January 2025, a 3 percent decrease from the record 771,480 counted in January 2024 (HUD 2025 AHAR Part 1, released May 2026).
• Pooled current estimates: 36.7 percent of people experiencing homelessness have an alcohol use disorder and 21.7 percent have a drug use disorder (Gutwinski et al., PLoS Medicine, 2021).
• 65.3 percent of homeless adults in the largest representative US study reported regular illicit drug use at some point in life; 37.1 percent reported regular use in the prior six months (CASPEH, JAMA, 2025).
• For comparison, 16.8 percent of all Americans aged 12 or older (48.4 million people) had a past-year substance use disorder in 2024 (SAMHSA, 2024 NSDUH, published 2025).
• 23.2 percent of homeless adults who used drugs regularly began doing so only after they first became homeless (CASPEH, JAMA, 2025).
• Drug overdose accounted for 24.2 percent of deaths in a 60,092-person homeless cohort, at a rate 12 times higher than the general population (JAMA Network Open, 2022).
• 155,750 chronically homeless individuals were counted in January 2025, the highest number on record (HUD 2025 AHAR Part 1, 2026).
• 32,495 veterans experienced homelessness in January 2025, the fewest ever recorded, down 56.1 percent since 2010 (U.S. Department of Veterans Affairs, 2026).
• New Hampshire counted 2,406 people homeless in January 2025 (up 7.2 percent); Massachusetts counted 28,311 (down 3.6 percent) (HUD PIT counts by state, 2026).
• Among homeless-experienced patients in office-based addiction treatment, retention was 45.2 percent at 1 month, 21.7 percent at 6 months, and 11.3 percent at 12 months (JAMA Network Open, 2021).

How many Americans are homeless right now?

On a single night in January 2025, there were 745,652 people experiencing homelessness in the United States, according to HUD's 2025 Annual Homeless Assessment Report Part 1, released May 29, 2026. That is a 3 percent decrease, 25,828 fewer people, from the record 771,480 counted in January 2024.

The decline is notable: HUD reports that unsheltered homelessness among individuals fell for the first time since 2016, and 22 states plus the District of Columbia saw decreases. Context still matters: the 2025 count remains 15 percent higher than in 2007, when national data collection began, and 26 percent higher than in 2013.

How people were sleeping that night matters for everything else on this page:

• 479,332 people (about 64 percent) were sheltered, in emergency shelters, safe havens, or transitional housing (HUD, 2026).
• 266,320 people (about 36 percent) were unsheltered, sleeping on streets, in vehicles, in encampments, or in other places not meant for human habitation.
• Nationally, about 22 of every 10,000 Americans were homeless on that night.

Within the overall decline, two populations set records: homeless individuals (people not in families with children) reached 515,286, and chronically homeless individuals reached 155,750. Family homelessness dropped 11 percent to 230,366 people, and 35,159 unaccompanied youth were counted. Any page still quoting the 2020 count (580,466) or the 2022 count (582,462) is describing a country that no longer exists.

How many people experiencing homelessness have a substance use disorder?

The honest answer is a range, not a single recycled percentage. Two current sources frame it.

The broadest evidence is a 2021 meta-analysis in PLoS Medicine by Gutwinski and colleagues, pooling 39 studies covering 8,049 people experiencing homelessness in high-income countries. Its estimates:

• Alcohol use disorder: 36.7 percent (95 percent confidence interval, 27.7 to 46.2)
• Drug use disorder: 21.7 percent (95 percent CI, 13.1 to 31.7)
• Any current mental disorder: 76.2 percent (95 percent CI, 64.0 to 86.6)

The most detailed recent US data come from the California Statewide Study of People Experiencing Homelessness (CASPEH), the largest representative study of homeless adults in decades, run by the UCSF Benioff Homelessness and Housing Initiative and published in JAMA in 2025. Among 3,200 adults surveyed across eight California counties, 65.3 percent had regularly used illicit drugs (three or more times per week) at some point in their lives, and 37.1 percent reported regular use in the prior six months.

For scale, the general-population baseline from the 2024 National Survey on Drug Use and Health: 16.8 percent of Americans aged 12 or older, 48.4 million people, had a past-year substance use disorder.

Read together, the data say two things at once: substance use disorders are several times more prevalent among people experiencing homelessness than in the housed population, and, contrary to stereotype, a majority were not using drugs regularly in the past six months. A page that presents only one of those facts is telling half the story.

The statistics most websites still cite, and what current data shows

Two numbers dominate the top-ranking pages on this topic, and both are old enough to vote. Neither was fabricated; each was a reasonable estimate when published, then copied for decades without a date. This table retires them beside their modern replacements.

If you cite homelessness and addiction statistics, the simplest quality test is to ask what year the underlying data were collected. Numbers without dates are how a 2003 estimate ends up presented as news in 2026.

Which comes first, addiction or homelessness?

Older sources framed substance use as the cause of homelessness, full stop. Current evidence shows the arrow points both ways.

Substance use raises the risk of losing housing. In a national longitudinal study of 30,558 adults who had never been homeless, published in the American Journal of Public Health in 2013, a drug use disorder increased the odds of becoming homeless for the first time within three years by 2.51 times, and an alcohol use disorder by 1.34 times, after adjusting for poverty. Among veterans, a 2015 systematic review of 31 studies in Epidemiologic Reviews concluded that substance use disorders and mental illness were probably the strongest risk factors for homelessness apart from extreme poverty itself.

Homelessness also drives new and escalated substance use. In the CASPEH study published in JAMA in 2025, 23.2 percent of participants who had ever used drugs regularly began doing so only after they first became homeless, and 27.3 percent of those with any substance use history reported using more during their current episode of homelessness. Much of this is survival: staying awake in unsafe places, enduring cold, coping with the trauma of unsheltered life.

For a fuller discussion of why the two conditions feed each other and what integrated care looks like, see our companion explainer on the connection between substance abuse and homelessness. This page stays with the numbers.

"In the exam room, the chicken-or-egg debate is the wrong question. By the time someone reaches us, housing instability and substance use are braided together, and pulling on one strand tightens the other. So at intake we screen for housing the same way we screen for withdrawal risk, because a plan that ignores where a person will sleep tonight is not a complete plan."

Dr. Richard Marasa, Medical Director, Clear Steps Recovery

Alcohol versus drugs: what the substance mix looks like now

The substance mix among people experiencing homelessness has shifted with the broader drug supply, and current data look very different from the alcohol-dominant picture in older reports.

In the CASPEH study (JAMA, 2025), the most commonly used substance in the prior six months was methamphetamine, at 33.1 percent, followed by opioids at 10.4 percent and cocaine at 3.2 percent. Alcohol remains a major factor: 9.7 percent reported heavy episodic drinking, six or more drinks on one occasion, at least weekly, and 19.6 percent of the whole sample reported a lifetime nonfatal overdose. In the pooled international data, alcohol use disorder remains the single most common substance use disorder in this population at 36.7 percent (PLoS Medicine, 2021).

Region matters. The California data reflect a Western meth-dominant supply; New England's crisis has been opioid-led. In the Boston cohort described below, the synthetic opioid death rate rose from 21.6 to 327.0 deaths per 100,000 person-years between 2013 and 2018 as fentanyl took over the Northeast supply (JAMA Network Open, 2022).

Overdose and mortality

The strongest current mortality evidence comes from a 2022 JAMA Network Open study that followed 60,092 adults who received care at Boston Health Care for the Homeless Program between 2003 and 2017, with follow-up through 2018. This replaces the much older Boston research many websites still lean on.

• Drug overdose caused 1,727 of 7,130 deaths in the cohort, 24.2 percent, roughly one in four.
• The age- and sex-standardized overdose mortality rate was 278.9 deaths per 100,000 person-years, 12 times the Massachusetts general-population rate of 23.2.
• Overdose mortality in the cohort rose from 177.6 to 321.1 deaths per 100,000 person-years between 2004 and 2018, with synthetic opioids driving the surge.

A related 2021 study of homeless-experienced patients in addiction treatment (JAMA Network Open) found an all-cause mortality rate of 29.0 deaths per 1,000 person-years, with drug overdose accounting for 51.8 percent of deaths. The same study found recent treatment attendance was associated with a substantially lower risk of death: staying connected to care is protective.

Mental health and dual diagnosis

Substance use rarely travels alone here. The 2021 PLoS Medicine meta-analysis estimated that 76.2 percent of people experiencing homelessness have a current mental disorder, including schizophrenia spectrum disorders at 12.4 percent and major depression at 12.6 percent. The 2024 NSDUH report notes that co-occurring substance use and mental disorders carry a higher risk of homelessness, incarceration, and suicide than either alone.

The federal count reflects this concentration of complex need. HUD defines chronic homelessness as an individual with a disabling condition, which can include a substance use disorder or serious mental illness, who has been homeless for a year or more or repeatedly across three years. In January 2025 there were 155,750 chronically homeless individuals, the highest number since data collection began (HUD 2025 AHAR Part 1): 30 percent of all homeless individuals, six in ten of them unsheltered, an 81 percent increase since 2013.

Clinically, these numbers argue for integrated treatment: care that addresses the substance use disorder and conditions like depression, anxiety, or PTSD in the same plan. That is the model behind dual diagnosis programs such as our mental health treatment program in Massachusetts.

Who experiences homelessness: age, gender, and race

Demographic claims on this topic are often published without citation. Here is what the federal data show, each figure from the 2025 AHAR Part 1 unless noted.

• Age: 18 percent of people experiencing homelessness in January 2025 were children under 18, and 7 percent were young adults aged 18 to 24. Among homeless individuals, nearly half (46 percent) were between 35 and 54, and that age band makes up 49 percent of the unsheltered population.
• Gender: in the 2024 count, more than two-thirds of homeless individuals identified as men and 30 percent as women, and men and boys made up nearly 70 percent of the unsheltered population (HUD 2024 AHAR Part 1).
• Race and ethnicity: in 2025, about one in three people experiencing homelessness was White (non-Hispanic, 32.6 percent) and another one in three was Black, African American, or African of any ethnicity (32.7 percent), far above the Black share of the US population. People identifying as Hispanic or Latino of any race were 27.5 percent, and American Indian, Alaska Native, or Indigenous people were 2.7 percent. HUD changed how it collects race and ethnicity data in 2024 and cautions against comparing these shares to earlier years.

Veterans and homelessness

Veteran homelessness is the clearest success story in this dataset, and most statistics pages barely mention it.

On a single night in January 2025, 32,495 veterans experienced homelessness, per the U.S. Department of Veterans Affairs: the fewest since veteran data was first reported in 2009, a 1.2 percent decrease from 2024, and a 56.1 percent decline since 2010. Of those counted, 18,977 were sheltered and 13,518 were unsheltered. Veterans now make up about 4 percent of all people experiencing homelessness, computed from the two HUD counts.

The decline tracks two decades of dedicated investment: HUD-VASH housing vouchers paired with VA case management, Supportive Services for Veteran Families, and the VA homeless programs that coordinate the count itself. Substance use treatment sits at the center of that system for a reason: the 2015 Epidemiologic Reviews meta-analysis identified substance use disorders and mental illness as the strongest veteran-specific risk factors for homelessness, and NIDA reports that more than 1 in 10 veterans has been diagnosed with a substance use disorder.

New England's veteran numbers are small enough to count precisely: New Hampshire's January 2025 count found 140 homeless veterans and Massachusetts found 550, per HUD's state-level veteran data. Veterans in either state can use VA benefits for community-based addiction treatment; our VA rehab program page explains eligibility, and our guide to veterans' addiction treatment through VA Community Care covers how referrals work.

New Hampshire and Massachusetts: the New England numbers

No other page ranking for homelessness and addiction statistics publishes state-level New England data, so we compiled it. The table combines HUD's official state point-in-time counts for January 2024 and January 2025 with percent changes we calculated from those counts (HUD PIT counts by state, 2007-2025).

New Hampshire's story is a decline that reversed, with the hardest cases growing throughout. The NH Coalition to End Homelessness 2025 State of Homelessness report documents that the state's 2024 count fell 8.0 percent to 2,245 people, the nation's third-largest percentage decrease that year, behind Maine and Tennessee. But inside that decline, chronic homelessness rose 16.5 percent (from 545 to 635 people in NHCEH's accounting, which includes families), and unsheltered homelessness jumped 71.3 percent in one year, from 338 people in January 2023 to 579 in January 2024, part of a near-quadrupling since 2019. Homelessness among Granite Staters 65 and older spiked 23.0 percent across calendar year 2024. NHCEH flagged that the 2025 count would likely erase the 2024 progress, and HUD's data confirmed it: 2,406 people, up 7.2 percent.

Massachusetts moved the other way for a policy reason. The statewide count fell 3.6 percent to 28,311, a drop HUD attributes largely to family shelter policy: people in homeless families with children fell 7 percent (1,644 fewer) after the state reduced shelter beds, tightened eligibility, and imposed length-of-stay limits in late 2024. Meanwhile the harder indicators rose, with unsheltered homelessness up 6.9 percent and chronically homeless individuals up 3.7 percent.

The overdose backdrop in both states is genuinely improving. Massachusetts recorded 978 confirmed and estimated opioid-related overdose deaths in 2025, the first year under 1,000 since 2013 and 27 percent below 2024, per the Massachusetts Department of Public Health, whose current opioid statistics series tracks the trend quarterly. New Hampshire's provisional drug overdose deaths fell from 484 in the 12 months ending December 2022 to 268 in the 12 months ending December 2025, per CDC provisional data. Falling overdose deaths alongside rising unsheltered and chronic homelessness means the remaining need is concentrating in the group with the least access to care.

"These tables describe what we see at the door in southern New Hampshire and greater Boston: more people reaching out from a car, a tent, or an encampment rather than from a shelter bed, and they are older than they used to be. When a patient has no fixed address, we arrange a referral to a detox facility first when one is needed, then build the outpatient plan around the contact points that will actually hold: a phone, a case worker, a pharmacy, a schedule that fits shelter hours."

Dr. Richard Marasa, Medical Director, Clear Steps Recovery

Treatment access, barriers, and outcomes

The treatment gap is wide for everyone and widest for people without stable housing. In 2024, 18.2 percent of Americans aged 12 or older (52.6 million people) needed substance use treatment, only 3.5 percent (10.2 million) received any, and just 19.3 percent of those who needed it got it (SAMHSA, 2024 NSDUH).

Among people experiencing homelessness, the CASPEH data (JAMA, 2025) sharpen the picture. Of participants with lifetime regular substance use, 46.5 percent had ever received any treatment, but only 6.7 percent were currently in treatment, and 21.2 percent of those with recent regular use said they currently wanted treatment but could not get it. The barriers the researchers describe are practical, not motivational: no transportation, no documents, nowhere to store belongings, survival needs that crowd out appointments. Cost fears loom large too, which is why it is worth knowing who qualifies for free or low-cost rehab options.

What happens when treatment is reachable? The key retention study followed 1,467 homeless-experienced adults in Boston Health Care for the Homeless Program's office-based addiction treatment program (JAMA Network Open, 2021). Continuous retention was 45.2 percent at 1 month, 21.7 percent at 6 months, and 11.3 percent at 12 months. The curve is steep, but the study's mortality finding cuts the other way: patients recently engaged with the program had a substantially lower risk of death. Intermittent engagement is not failure; every month connected to medication-assisted treatment is a month of reduced overdose risk.

Bringing treatment to where people already are works in the models built to test it. A 2024 JAMA Network Open study simulated offering buprenorphine in Massachusetts homeless shelters, drawing on data from more than 100 shelters statewide: the programs were projected to avert 254 overdose deaths over 10 years, a 9.2 percent reduction, while saving about $1,300 per person in lifetime health costs.

Housing itself is treatment infrastructure. A CDC Community Guide review of 26 studies (Journal of Public Health Management and Practice, 2020) found that Housing First programs, which provide permanent housing without requiring sobriety first, decreased homelessness by 88 percent and improved housing stability by 41 percent versus Treatment First approaches.

"That retention curve is the most honest chart in this field. The cliff comes early, so we design for the cliff: medication continuity so a missed visit never becomes a gap in buprenorphine, appointment times that flex around work and shelter hours, and a virtual check-in option for the weeks when getting across town is the hardest part. None of that is complicated medicine. It is logistics done with respect."

Dr. Richard Marasa, Medical Director, Clear Steps Recovery

Telehealth and low-barrier care

Telehealth removes the exact barriers the access data describe, and no other statistics page on this topic mentions it at all.

The strongest evidence comes from a national Medicare cohort of 175,778 beneficiaries with opioid use disorder, published in JAMA Psychiatry in 2022. When pandemic-era rules allowed treatment by phone and video, use of opioid-related telehealth jumped from 0.6 percent to 19.6 percent, and the people who used it did better: telehealth receipt was associated with 27 percent higher odds of staying on medications for opioid use disorder (adjusted odds ratio 1.27) and 33 percent lower odds of a medically treated overdose (adjusted odds ratio 0.67).

For someone staying in a shelter, couch surfing, or living in a car, a program that exists wherever their phone is changes the math of attendance. Virtual intensive outpatient care applies the same logic to counseling and groups; our overview of virtual IOP explains the format and who it fits.

What this means for getting help

Statistics describe populations; treatment decisions happen one person at a time. Three access routes matter most for anyone whose housing is unstable.

First, medication treatment for opioid or alcohol use disorder should start as early as possible, because it carries the clearest mortality benefit in this population. Second, outpatient levels of care, from counseling up through an intensive outpatient program or a day treatment program, let treatment fit around shelter schedules, work, and housing appointments. Third, when medically supervised withdrawal is needed first, reputable outpatient providers coordinate a referral to a licensed detox facility and continue care afterward; Clear Steps Recovery provides outpatient treatment in Londonderry, New Hampshire and Needham, Massachusetts, and arranges detox by referral when an assessment calls for it.

If you or someone you care about is navigating substance use and housing instability at the same time, an honest conversation about options costs nothing: call (603) 769-8981. In an immediate crisis, call or text 988.

Methodology and sourcing notes

Every statistic on this page comes from a primary source: federal agencies (HUD, SAMHSA, CDC, VA, NIDA), state health departments, a state homelessness coalition's published research, or peer-reviewed journals. No figure was taken from another treatment provider's website or an aggregator page, and each number is labeled with the year its data were collected or published.

Three caveats matter when using these numbers. First, point-in-time counts undercount: HUD itself notes the true number of unsheltered people could be larger than reported, since counts depend on volunteers finding people on one January night, and youth are especially likely to be missed. Second, national survey baselines exclude the very population this page covers: the NSDUH does not survey people experiencing homelessness who are not in shelters, which is a key reason decades-old prevalence estimates persisted online until dedicated studies like CASPEH replaced them. Third, several figures are provisional or model-based and labeled as such, including CDC overdose counts and the Massachusetts shelter buprenorphine projections, and HUD's 2024 change to race and ethnicity data collection means those breakdowns should not be compared with earlier years.

Citations were verified live before publication. This page was medically reviewed by Dr. Richard Marasa and last reviewed on July 6, 2026.