Because it’s the holiday season, a lot of people are sharing online about giving. Recently on Facebook[1], one particular post kept showing up in my feed. In the photo, a woman is hugging a homeless person she had just bought a meal for. The lengthy post speaks of compassion and kindness, of caring for others, of treating homeless folks with humanity.

But the post ends with this: “Not all of them are homeless because of a drug addiction or because they are lazy.”

An estimated 554,000 people[2] are currently homeless in the United States. Where I live in New York City, homelessness is at levels we have not seen since the 1930s[3], during the Great Depression. The primary cause of homelessness is a lack of affordable housing. But the rates of addiction disorders, mental illness and other significant health issues are far higher among homeless populations.

This probably doesn’t surprise you. It certainly doesn’t surprise me. As someone who struggled with heroin addiction[4] for 15 years, as well as mental health issues, I can see the trajectory that leads to homelessness for so many folks struggling with these issues. I also worked with homeless youth as a case manager. In the population I worked with, more than 70% were struggling with an addiction disorder, mental health issues or both.

After seeing that Facebook post pop up over and over again, I thought back to a few weeks prior, on a brisk Sunday morning. I was out walking the dog with my husband and toddler in our Greenwich Village neighborhood. It was a quiet and beautiful morning, if a little chilly. A homeless couple walked past us. They were both thin and displayed many of the signs of drug use

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