Ryan D. Assaf
ryanassaf.bsky.social
Ryan D. Assaf
@ryanassaf.bsky.social
Epidemiologist and Assistant Professor at UCSF with the @ucsfbhhi.bsky.social and UCSF @arcforequity.bsky.social. PhD and MPH in Epidemiology from UCLA FSPH. Substance use and homelessness researcher. Views my own.
Recommendations:
1. Prioritizing housing is an important first step
2. Increasing access to treatment that reaches people experiencing homelessness while minimizing barriers to treatment is critical
3. Increasing access to naloxone is important to prevent fatal overdose deaths
August 20, 2025 at 7:47 PM
Take home:
1. Meth is the most common reported drug
2. Their are barriers for people experiencing homelessness to access treatment
3. Naloxone possession, a life-saving medication, is low
August 20, 2025 at 7:47 PM
4. Many people have survived an overdose
-20% have experienced an overdose in their lifetime
-10% experienced an overdose during this current episode of homelessness

25% of people currently carried naloxone, a medication to reverse an overdose
August 20, 2025 at 7:47 PM
3. There is a high unmet need for substance use treatment
-21% of people who used drugs at least 3 times a week reported currently wanting treatment but were not able to access it
-This was higher for people who used opioids (37%)
August 20, 2025 at 7:47 PM
2. About a quarter started using drugs at least 3 times a week after becoming homeless for the first time
-42% used before becoming homeless
-25% never used at all

Drug use may increase the risk of experiencing homelessness, but homelessness increases the risk of substance use
August 20, 2025 at 7:47 PM
Key findings:
1. 37% used illicit drugs at least 3 times a week
-Most common drug= methamphetamine (33%)
-10% used opioids (most people who used opioids also used meth)
-Small % using cocaine/crack cocaine (3%)
https://jamanetwork.com/journals/jama/fullarticle/2830616
t.co
August 20, 2025 at 7:47 PM