NEARLY NINE-IN-TEN people who died while homeless had a history of problem substance use, a new report by the Health Research Board shows, as researchers call for more medically supervised injecting centres.

Deaths of homeless people that occurred in 2021, the latest year for which figures are available, shows 128 of deaths were premature and preventable.

Some 80% of the people who died were men, with the median age being 44. The median age among women who died was 37.

Almost half of deaths were due to drug poisoning while the rest were due to other causes, mainly medical conditions.

Multiple substances were involved in all poisoning deaths among women and the majority of poisoning deaths among men (85%).

Methadone, an opioid, was the most common drug found in the bodies of those who died by poisoning. It is often used to treat addiction to other opioids, as it can relieve cravings and offset withdrawal symptoms.

Dr Suzi Lyons, a senior researcher at the Health Research Board and co-author of the report, said the statistics highlight the importance of the HSE’s naloxone take-home project.

Naloxone is a prescription medication used to temporarily reverse the effects of opioid drugs such as heroin, morphine, codeine, and synthetic opioids like methadone.

Lyons added that the life-saving drug is no use unless another person is present to administer it. 

Of the 128 preventable deaths, 83 people were in temporary or crisis accommodation, while 30 were sleeping rough. The remainder were living in what is classified as “unstable,” “severely substandard” or “highly insecure” accommodation.

A fifth of people who died had a known history of injecting drugs, with one in 10 injecting when they died.

Lyons said it shows a need for more supervised injecting centres so that professionals can intervene if things go wrong. 

If you are alone, there’s no one to call an ambulance or give you first aid.

The first injecting centre opened in Dublin in January of this year.

The most common drug groups implicated in the 61 poisoning deaths were opioids (82%), benzodiazepines (69%), alcohol (38%), and cocaine (36%).

Over a third of those who died while homeless were known to have accessed treatment for their substance use at some stage in their life, while 28% were undergoing treatment at the time of their death.

Half of homeless women who died had a known history of mental health issues, while 29% of men did.

“They are a group of individuals living really difficult lives,” said Lyons.

The Chief Executive of the Health Research Board, Dr Mairéad O’Driscoll, said the statistics are further evidence that harm-reduction strategies are the way forward.

“These findings highlight the difficult reality faced by some of the most vulnerable people in society, caught in a cycle of homelessness, substance use and mental health issues.”

Deaths that were not linked to drug poisoning were mainly due to medical causes (70%) such as cardiovascular issues, while 30% involved trauma such as drowning or falling.

Some 14% of deaths were among people who were homeless and had no recorded history of drug or alcohol use. The median age of this group was 56 years.

Breakdown by region

Dublin city and county accounted for 63% of homeless deaths in 2021, while 9% occurred in Cork city and county.

Some 13% of deaths occurred in the South-West and 10% occurred in the Mid-West, West, and North-West regions

The Mid-East, North-East, and Midlands regions accounted for 9% of deaths and the South-East accounted for 6%.