Homeless Facts

The following is some current information on Homelessness—national and local. Since our primary service is to provide food to the homeless, we begin here:

FOOD INSECURITY IN A NUTSHELL

While the factors contributing to homelessness have always been varied and complex, the growing shortage of affordable housing has significantly impacted low-income individuals. Compounded by unemployment, physical and behavioral health issues, domestic violence, and substance abuse, homelessness continues to impact both rural and urban communities statewide. Many are without appropriate identification and have no credit history. Others have pets who are their only family and abandoning them for shelter is not considered a viable choice. Still others are hampered by crime and drug-free housing policies that keep them unsheltered. Many, particularly people who have experienced chronic homelessness and/or have special needs, require extensive and long-term support. Supportive services and affordable housing are essential to preventing initial or repeated homelessness.

The unhoused homeless must deal with surviving in the elements as well as dealing with their challenged safety and personal needs. Between January 2020 and January 2023 the total count of people experiencing homelessness in Pima County, as captured by the Point In Time Count, increased 67% (SIROW, U.A.) Granted, some prefer living outdoors (with few responsibilities) and refuse to calculate the toll on their mind and bodies.

Food insecurity can cause a myriad of health problems. Studies have shown that decreased nutrient intake can cause increased rates of mental health problems and depression, diabetes, hypertension, and poor health and sleep outcomes in adults. Health outcomes for people experiencing unsheltered homelessness are worse than those for people experiencing sheltered homelessness. The California Policy Lab reports that, compared to sheltered people, unsheltered people are:

• Over four times as likely to report a physical health condition (84 percent of unsheltered vs. 19 percent of sheltered participants)
• Nearly 1.5 times as likely to report a mental health condition (78 percent of unsheltered vs. 50 percent of sheltered participants)
• Over five times as likely to report a substance abuse condition (75 percent of unsheltered vs. 13 percent of sheltered participants)
• 25 times as likely to report all three conditions concurrently (50 percent of unsheltered vs. 2 percent of sheltered participants)

• While these are often linked to health issues that begin before a person loses their housing, they can be exacerbated by the conditions of unsheltered homelessness. Per the California Policy Lab, 50 percent of unsheltered individuals have difficulty “taking care of basic needs like bathing, changing clothes, using a restroom, and having access to food and clean water,” compared to 3 percent of sheltered individuals.

 

SUMMARY OF PUBLIC OPINION POLLING ON HOMELESSNESS, June 2024:

Homelessness in the United States is currently at the highest levels in the history of record keeping by the U.S. Department of Housing and Urban Development. Al though extensive research points to the nation’s prolonged affordable housing crisis as the primary driver of this increase, widespread misunderstanding of the causes of and solutions to end homelessness persists among the public. These gaps in knowledge are impacting efforts to end homelessness in this nation. In recent years, misunderstandings about homelessness have been exploited in an effort to make it a political wedge issue that can divide constituents. The negative consequences are manifold, including a growing sense of cynicism about homeless ness, increasing hostility towards people experiencing homelessness, attacks against established best practices for ending people’s homelessness, and increased support for harmful and historically failed carceral tactics that force people into shelter and services under the threat of arrest. In June 2024, the National Alliance to End Homelessness commissioned Morning Consult to conduct a national public opinion poll to learn about the public’s attitudes and understanding of the homelessness crisis. The objective of this research was to identify areas of support, as well as gaps in awareness and understanding, regarding efforts to address the homelessness crisis in the United States. The ultimate goal is to use the findings to craft more effective communications strategies and tactics to support best practices throughout the homelessness field. NAEH

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HOUSING INSECURITY INDICATORS FOR ARIZONA & PIMA COUNTY:

This report paints a bleak picture and sends a clear signal that there is an urgent need to improve our local capacity to prevent homelessness. The structural drivers of housing insecurity, including home values, rent prices, and poverty, all remain elevated in Pima County. Elevated housing insecurity is driving increased inflow into homelessness, visible in the 59% increase in the number of unique households seeking homelessness-related services (by completing a coordinated entry assessment) between 2021 and 2023. The capacity of our local system (beds/units) has not increased over this time frame and the proportion of newly inflowing households served in any project type decreased from 39% in FY2021 to 28% in FY2023. This means that in FY2023 72% of households completing an assessment and seeking assistance were not served in any project type (meaning that nothing happened as a result of their engagement with the system). This is a portrait of an overburdened system increasingly struggling to keep pace with rising need. Since 2021 there has been a steady increase in the number of people on our By-Name List considered “actively homeless” and these increases have continued through 2024. We not yet observed any slowing of inflow into homelessness and there is increasing visibility of unsheltered homelessness in our community.

Looking ahead, TPCH’s 2024 Housing Inventory Count report registered decreases in beds/units across all project types, especially Permanent Supportive Housing units, indicating reduced local capacity to meet these challenges. Recent election results have decreased the likelihood of infusions of funds from the federal or state government to address the drivers of the housing crisis or to mitigate current levels of homelessness. While there are multiple serious city and county level efforts currently being implemented to address the shortage of affordable housing, these efforts will take years to substantially impact the local housing stock. These unique circumstances and the increasing prevalence of homelessness indicate an urgent need for more resources directed towards homelessness prevention to reduce the current and ongoing magnitude of inflow into homelessness.

There is motion locally on many of the elements needed to implement a coordinated local/regional approach to homelessness prevention. Substantial reductions in both homelessness and poverty are achievable, and there is a rich evidence base providing guidance as to how to get there efficiently. Building, and sufficiently resourcing, a community approach to homelessness prevention has the potential to reduce ongoing overwhelm of our homelessness response system, reduce harm among households who avoid an experience of homelessness, and better position our community to weather future challenges (e.g. the next recession, financial disruption, or a resurgence of inflation) to housing stability among our most vulnerable community members.

Suggested reference: Bentele, Keith G. (2024). Housing Insecurity Indicators for Arizona & Pima County – 50th Report. Tucson, AZ: University of Arizona, Southwest Institute for Research on Women.

For the complete report: Housing Insecurity and Homelessness Report_52_Bentele

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7 TAKEAWAYS FROM 2024 POINT-IN-TIME COUNT, National Alliance to End Homelessness:

#1. Homelessness continues to increase, but one subpopulation demonstrates that ending homelessness remains possible.

#2. The homeless response system is not funded to meet households’ growing needs.

#3. Despite a lack of resources, the response system is connecting more people experiencing homelessness with housing and shelter.

#4. More disabled people experienced homelessness for extended periods of time.

#5. The number of children experiencing homelessness increased nearly 33 percent.

#6. Certain groups of color continue to be overrepresented among the unsheltered homeless population.

#7. Gender-expansive people remain overrepresented among people experiencing unsheltered homelessness.

StreetSmarts

Your homeless news source

Courtesy of the Community Emergency Medical Responders Foundation which provides educational services and support directly on the streets to those in need in Tucson, Arizona.

Meth + Heat = Death from low salt
Hyponatremia is a condition that occurs when the level of sodium in the blood is too low.
• Meth, MDMA and spice users are particularly susceptible
• Key symptoms: weakness, fatigue, nausea, memory loss, and confusion
• Make sure to seek medical help immediately if experiencing these symptoms

You've read the flyers for prevention: "avoid dehydration", "drink adequate amounts of water", "drink water -- don't wait until you feel thirsty"

Well, the first two statements ("avoid dehydration" and "drink adequate amounts of water") constitute very solid advice. The last statement "drink water -- don't wait until you feel thirsty" used to be widely accepted, but is now considered by the latest consensus guidelines to be somewhat problematic (especially if you haven't eaten and you're planning on a self-medicated summer escape).

We'll explain this in detail in a bit, but first ... the impetus for today's article came from a friend on the streets who came into Sunday's C-EMR first aid station at the Z Mansion. Without mincing words, he walked in and loudly announced, "Why the f*** do you guys give water and Gatorade to the f***ing meth and Spice heads at the library?"

Good question. The answer comes in the form of an equation:
• Meth and/or Spice use + heat + plenty of water - adequate food = high risk of death from low levels of salt.

Here's the explanation we promised:

"A lower-than-normal concentration of sodium (salt) in the blood” is called hyponatremia. According to the Mayo Clinic, "In hyponatremia, one or more factors — ranging from an underlying medical condition to drinking too much water during endurance sports — causes the sodium in your body to become diluted. When this happens, your body's water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to life-threatening."

BTW, being homeless on the streets in Tucson during the summer IS an endurance sport. Think of our community -- given prolonged daily exposure to extreme heat and near constant physical activity -- as unwitting athletes trapped in an unremitting athletic event. And much like one out of every seven marathon runners (see study here), many of the homeless in Tucson suffer from hyponatremia.

What are the symptoms of a lower-than-normal concentration of sodium (salt) in the blood? According to a 2015 study published in theJournal of the American Geriatrics Society, the most common symptoms of profound hyponatremia are:
• Generalized weakness (Found in 69% of patients)
• Fatigue (59%)
• Nausea (44%)
• Disturbance of memory (36%)
• Disturbance of concentration (35%)
• Disturbed gait (31%)
• Disorientation to person, location, time, or the situation (30%)
• Vomiting (30%)
• Headache ( 27% )

Hyponatremia is potentially deadly and should be treated as a medical emergency. In addition, your risk for hyponatremia is even deadlier if you use:

 Meth and/or MDMA (Ecstasy)
According to a 2006 study published in the AAPS Journal, "MDMA and METH produce other acute physiological changes such as changes in body temperature, hyponatremia, and hypertension ...."
Unfortunately, hyponatremia is not the only deadly condition caused by the combination of excess heat and meth. Per a 2016 study in the journal Clinical Case Reports, “(Methamphetamine) may cause hepatotoxicity, rhabdomyolysis, cardiotoxicity, nephrotoxicity, and neurotoxicity separately or sometimes together as multisystem toxicity, mostly as a serious condition requiring hospitalization. Nephrotoxicity generally presents as acute kidney injury, hyponatremia, and hypertension.”
But, you're smart. You know that if you do meth or MDMA you should drink plenty of water to avoid overheating, right? Exactly. And that, according to a 2014 study published in Case Reports in Internal Medicine, is yet another reason why meth and MDMA users are prone to the deadly effects of hyponatremia. Per the study, "Users of MDMA learn to increase their oral water intake as a preventive measure for hyperthermia, resulting in potentially severe cases of MDMA-associated hyponatremia."

The same problems are found in the use of a drug we profiled just two weeks ago. That wretched drug is:

Spice
According to a 2015 study published in the journal Swiss Medical Weekly, “‘Spice’ drugs have become popular alternatives to marijuana among teenagers and constitute an exceptionally large class of novel psychoactive substances …. Although the use of novel psychoactive substances mostly produces minor or moderate poisonings, serious complications occur. (Examples of these complications include) acute serotonin syndrome, hyperthermia, seizures, and hyponatremia.”

So, what can you do to avoid hyponatremia? As an endurance street athlete, start with:
• "Avoid dehydration" and
• "Drink adequate amounts of water"
Then, change the older advice ("Drink water -- don't wait until you feel thirsty") to:
• "Drink according to thirst"

According to the 2015 Consensus Guidelines for Preventing Deaths Due to Exercise-Associated Hyponatremia, "In all cases, blanket statements that can be found on the internet such as 'don't wait until you feel thirsty' make little sense for the majority of casual athletes and have the potential for disastrous consequences as they promulgate the idea that near constant fluid ingestion during athletic events is a reasonable and even necessary thing to do.”

So, what prevention techniques can an endurance street athlete use to rehydrate while preventing hyponatremia? Per the consensus guidelines, "The first is perhaps the most physiological and simple:drink according to thirst. Our thirst sensation is a finely tuned regulatory mechanism that protects plasma osmolality from rising more than a few percentage points above normal. Thus, our thirst sensation will prompt drinking and help to guard against excessive dehydration. … Overriding these mechanisms with continued volitional drinking behavior is unnecessary and potentially dangerous.”

So -- when you see the C-EMRs in the blue caps handing out water downtown -- take an ice cold bottle and drink it when you're thirsty.

Together we can fight the deadly effects of dehydration and hyponatremia.

Free Bottled Water & Water Bottles at The Z Mansion.

The C-EMR First Aid Clinic opens every Sunday morning at 9 am at the Z (the big, blue house at 288 North Church just north of the library). There you can pick up free bottled water and refillable water bottles. In addition, the nurses and doctors at the clinic can assess you for heat-related illness and discuss ways to help prevent this life-threatening condition.

Find out more information at tucsonhomeless.org

Just a reminder that you can find the latest information about food, shelter, and services for the homeless at www.tucsonhomeless.org.

Fentanyl

Fentanyl is a synthetic opioid approximately 50 times more potent than heroin and 100 times more potent than morphine. Pharmaceutical fentanyl refers to fentanyl that is prescribed by a medical provider, usually to treat severe pain; whereas, illicitly manufactured fentanyl is manufactured and distributed illegally.

A significant portion of the recent concerns associated with fentanyl are linked to illicitly manufactured fentanyl (IMF). Unfortunately, illicit fentanyl is frequently mixed with other illicitly sourced substances, such as cocaine, methamphetamine, ecstasy, and other opioids such as heroin. These illicit combos amplify the risks of fentanyl overdose and toxicity, as well as the dangerous effects of the illicit drugs. Additionally, sometimes a person may not know they are consuming fentanyl.

Have a safe week!
C-EMR Foundation
(520) 352-9367
In case of an emergency, dial 911

Sources
Hyponatremia symptoms
Nigro, Nicole, Bettina Winzeler, Isabelle Suter-Widmer, Philipp Schuetz, Birsen Arici, Martina Bally, Claudine Blum, Roland Bingisser, Andreas Bock, Andreas Huber, Beat Müller, Christian H. Nickel, and Mirjam Christ-Crain. "Symptoms and Characteristics of Individuals with Profound Hyponatremia: A Prospective Multicenter Observational Study." Journal of the American Geriatrics Society J Am Geriatr Soc 63.3 (2015): 470-75.
Hyponatremia definition
"hyponatremia." McGraw-Hill Concise Dictionary of Modern Medicine. 2002. The McGraw-Hill Companies, Inc. 16 May. 2016
(Link)
Hyponatremia information
"Hyponatremia." Mayo Clinic. Mayoclinic.org, 28 May 2014. Web. 16 May 2016.
(Link)
Hyponatremia in marathon runners
Almond, Christopher S.d., Andrew Y. Shin, Elizabeth B. Fortescue, Rebekah C. Mannix, David Wypij, Bryce A. Binstadt, Christine N. Duncan, David P. Olson, Ann E. Salerno, Jane W. Newburger, and David S. Greenes. "Hyponatremia among Runners in the Boston Marathon." New England Journal of Medicine N Engl J Med 352.15 (2005): 1550-556. Web.
(Link)

Meth, MDMA and hyponatremia
Quinton, Maria S., and Bryan K. Yamamoto. "Causes and Consequences of Methamphetamine and MDMA Toxicity." The AAPS Journal AAPS J 8.2 (2006)
(Link)
Gurel, Ali. "Multisystem Toxicity after Methamphetamine Use." Clinical Case Reports Clin Case Rep 4.3 (2016): 226-27. 
Chang, Julia Chia-Yu, Jiin Ger, and Chen-Chang Yang. "Late Diagnosis of MDMA-related Severe Hyponatremia." CRIM Case Reports in Internal Medicine 1.2 (2014): Web.
(Link)

Spice and hyponatremia
Liechti, M. "Novel Psychoactive Substances (designer Drugs): Overview and Pharmacology of Modulators of Monoamine Signaling." Swiss Med Wkly Swiss Medical Weekly (2015): 

Hyponatremia and fluid intake
Rosner, Mitchell H. "Preventing Deaths Due to Exercise-Associated Hyponatremia." Clinical Journal of Sport Medicine 25.4 (2015): 301-02. Web.
(Link)