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Experiences of homeless people who use psychoactive substances: an interpretative phenomenological study

Chris Wagstaff (Department of Nursing and Midwifery, University of Birmingham, Birmingham, UK)
Anna Davis (Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK)
Elizabeth Jackson-McConnell (University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK)
Matilda MacDonald (Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK)
Ashley Medlyn (Department of Nursing and Midwifery, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK)
Sandra Pillon (Department of Nursing, University of São Paulo, São Paulo, Brazil)

Drugs, Habits and Social Policy

ISSN: 2752-6739

Article publication date: 11 August 2023

Issue publication date: 12 September 2023




Homelessness and psychoactive substance (PS) use are both determinants of physical and mental ill health, with the homeless population using, and dying of PSs more frequently than the general population. However, there is a gap in research on the real-world implications psychoactive substance use (PSU) has on the homeless population. This study aims to explore the experiences of PSU from the perspective of homeless users.


Purposive sampling was adopted to recruit participants and semi-structured interviews collected data from participants, with interpretive phenomenological analysis (IPA) generating common themes from the data gathered.


Four participants were interviewed. The themes generated were family and close relationships; cyclical patterns; mistrust in people and services; and low self-worth.

Research limitations/implications

This study is limited by potential bias from researchers who built relationships with participants through the data collection process. Despite efforts to remove this bias, through reflexivity throughout data collection and analysis, some bias may be still present. The researchers saw the participants as vulnerable people who were striving to overcome adversity. Such conception of the participants is reflective of how the participants portrayed themselves. The small sample is suitable for IPA purposes. Of course, it could have been possible that if different participants had been recruited or more participants had been recruited, then there could have been different themes and findings. IPA prides itself on its idiographic focus.

Practical implications

More research is needed on a wider scale to assess the extent and cause of these issues. Increased education and dissemination of research such as this is required to break down stigma within the public and guide policy change in professional services.


This paper interpretatively presents themes generated by semi-structured interviews with four homeless PSUs. As such, these individuals are vulnerable and have faced adversity throughout life from both society and the services they use. Their vulnerability leads to a cycle of substance use and a feeling of low self-worth, which is perpetuated by the perceived views of those around them.



The authors would like to acknowledge Feedo Needo for their introductions, warmth and support.

Declarations of interests: None.

Ethical statements: All authors contributed to the commentary as shown and agree for the work to be published. There was no funding for producing this commentary.


Wagstaff, C., Davis, A., Jackson-McConnell, E., MacDonald, M., Medlyn, A. and Pillon, S. (2023), "Experiences of homeless people who use psychoactive substances: an interpretative phenomenological study", Drugs, Habits and Social Policy, Vol. 24 No. 3, pp. 205-219.



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