People who experience homelessness often have intersecting health problems including poor mental and physical health and problem substance use. The co-occurrence of these three problems has been termed ‘tri-morbidity’. Problem substance use is often a contributing factor to someone becoming homeless and accounts for over a third of deaths in homeless people. Engagement with treatment services, particularly those which expect abstinence, can be extremely challenging. While harm reduction approaches are recommended for those unlikely to achieve abstinence, there is virtually no specific guidance on how harms from problem substance use can be reduced for homeless people. International models of care and housing provision exist but their relevance to Scotland has not been systematically explored. 

To address this gap, this programme created a dialogue on international, national and local best practices in this area and, most critically, on how we can work better together across sectors and disciplines to develop Scottish solutions. The programme brought together a diverse group who have substantial knowledge of the issues to develop a nuanced understanding of the current position and how this can better inform policy and practice developments going forward.