White House Summit Convenes National Experts to Address Addiction Treatment Among Homeless Populations

Published: April 15, 2026
Source: White House Office of National Drug Control Policy, SAMHSA, HUD

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The White House brought together federal agencies, healthcare providers, and local practitioners this week for a two-day summit focused on one of the most challenging intersections of the addiction crisis: treating substance use disorders among people experiencing homelessness. The gathering, hosted by the Office of National Drug Control Policy in collaboration with the Substance Abuse and Mental Health Services Administration and the Department of Housing and Urban Development, aims to develop a national toolkit addressing what officials describe as a critical gap in the current treatment infrastructure.

The summit represents a notable shift in federal policy orientation, emphasizing the integration of housing and healthcare services rather than addressing addiction and homelessness as separate policy domains. It arrives amid broader debates about the direction of federal behavioral health policy, with the administration simultaneously proposing significant restructuring of SAMHSA and substantial cuts to health programs while elevating addiction treatment as a priority through the recently launched Great American Recovery Initiative.

A Whole-of-Government Approach

National Drug Control Policy Director Sara Carter opened the summit by framing the challenge in explicitly moral terms. "There is inherent value and dignity to every human life, no matter the circumstances," Carter said. "We must continue to enhance, expand, and encourage treatment, especially in our homeless population. It is a priority of the Trump Administration to find new and innovative ways to help those in need achieve sobriety."

The participation of three cabinet-level departments — HHS through SAMHSA, HUD, and the VA — signals an attempt to coordinate federal resources across bureaucratic boundaries that have historically impeded effective responses to homelessness and addiction. HHS Secretary Robert F. Kennedy Jr., who has emphasized faith-based and non-pharmaceutical approaches to mental health and addiction since taking office, delivered remarks emphasizing direct service delivery.

"The Trump administration will not tolerate a system that leaves Americans in addiction and on the streets," Kennedy said. "We are bringing treatment directly to those in need and strengthening the link between treatment, housing, and recovery. Today's summit advances a national model that delivers real results."

HUD Secretary Scott Turner used the occasion to articulate a sharp critique of existing federal homelessness policy, specifically targeting the "Housing First" approach that has dominated federal strategy for more than a decade. "We must abandon the failed 'Housing First' policies that have misused taxpayer funded resources without any expectation of results and too often leave individuals trapped in addiction, untreated mental illness, and indefinite dependence on government systems," Turner said. "HUD will promote treatment, recovery, and self-sufficiency."

This framing aligns with the administration's broader emphasis on requiring treatment engagement as a condition of housing assistance — a significant departure from Housing First principles, which prioritize immediate provision of permanent housing without preconditions.

SAMHSA Principal Deputy Assistant Secretary Christopher D. Carroll offered a somewhat different emphasis, highlighting the effectiveness of integrated care models. "At SAMHSA, we're focused on addressing homelessness by confronting behavioral health as a key driver of the problem, while supporting efforts that promote recovery," Carroll said. "Integrated, community-based treatment models outperform fragmented care and systems, giving individuals who are homeless a greater chance at recovery and self-sufficiency."

The Scope of the Challenge

The intersection of homelessness and addiction represents one of the most visible and politically charged dimensions of the overdose crisis. While precise numbers are difficult to establish due to data limitations and definitional challenges, research consistently shows elevated rates of substance use disorders among homeless populations compared to the general population.

Multiple factors create this concentration. Homelessness itself can precipitate or worsen substance use as individuals attempt to cope with trauma, exposure to violence, and the physical hardships of unsheltered life. Conversely, untreated addiction can lead to job loss, family estrangement, and housing instability that results in homelessness. The relationship is bidirectional and self-reinforcing, with each condition complicating treatment of the other.

For people experiencing both homelessness and addiction, accessing treatment presents formidable barriers. Traditional outpatient models assume stable housing where individuals can store medications, maintain hygiene, and establish routines that support recovery. People living in encampments, shelters, or transitional housing often lack these foundational elements, making standard treatment protocols difficult or impossible to follow.

Medication-assisted treatment for opioid use disorder — the most effective intervention for reducing overdose mortality — presents particular challenges. Buprenorphine requires secure storage and daily dosing schedules that are difficult to maintain without stable housing. Methadone maintenance, which requires daily visits to opioid treatment programs, demands transportation resources and scheduling flexibility that homeless individuals often cannot manage.

The summit's focus on developing practical tools for this population reflects recognition that existing treatment models, designed for housed patients with resources and support systems, frequently fail to reach those with the greatest need.

Developing the National Toolkit

The summit's concrete deliverable — a national toolkit for treating addiction among homeless individuals — will draw on input from diverse stakeholders including physicians, social workers, people with lived experience of homelessness and recovery, and representatives from communities that have developed innovative approaches.

According to the White House announcement, the toolkit will address several key domains:

Best Practice Strategies: The summit aims to identify treatment approaches that have demonstrated effectiveness specifically with homeless populations. These likely include low-threshold medication access, mobile health services, peer support integration, and contingency management interventions that provide immediate rewards for treatment engagement.

Program Characteristics: Beyond specific clinical interventions, the toolkit will presumably address organizational features that support effective service delivery — such as co-location of housing and healthcare services, flexible scheduling, trauma-informed care practices, and harm reduction approaches that meet people where they are rather than requiring abstinence as a precondition for assistance.

Outcome Measures: Developing appropriate metrics for evaluating success presents particular challenges with this population. Traditional measures like treatment retention and abstinence rates may not capture meaningful improvements in quality of life, while housing stability alone does not indicate recovery from addiction. The toolkit will likely propose multidimensional outcome frameworks.

Faith and Medicine Integration: Reflecting Secretary Kennedy's emphasis on spiritual dimensions of recovery, the summit explicitly includes discussion of integrating faith-based approaches with medical treatment. This represents a potentially controversial element, as critics have raised concerns about the constitutional implications of government support for religious programming and the evidence base for faith-based interventions compared to established medical treatments.

Financing Mechanisms: Sustaining effective programs requires addressing the fragmented funding streams that currently support homelessness and addiction services. Medicaid, federal block grants, state and local funds, and private philanthropy each support different service elements with different eligibility requirements and reporting obligations. The toolkit may propose strategies for braiding these funding sources to create coherent service systems.

Drug-Endangered Children: The summit includes specific attention to children in families affected by homelessness and addiction — a population at elevated risk for developmental trauma, educational disruption, and intergenerational transmission of substance use disorders.

Local Innovation and Federal Policy

The summit included representatives from communities that have developed promising approaches to the homelessness-addiction intersection. Manatee County, Florida, was among the jurisdictions selected to participate — reflecting both the severity of the challenge in that community and the development of innovative local responses.

Local programs across the country have experimented with various models for addressing the intersection of homelessness and addiction. Some communities have developed medical respite programs that provide short-term residential care for homeless individuals recovering from acute medical events, including overdose, with integrated addiction treatment. Others have created permanent supportive housing models that include on-site clinical services and peer support.

Housing First programs, despite Secretary Turner's critique, have demonstrated effectiveness in reducing homelessness and improving housing stability — though critics argue they have been less successful in addressing addiction and have sometimes concentrated vulnerable populations in particular neighborhoods without adequate services. The summit's emphasis on treatment integration may reflect an attempt to preserve Housing First's housing stability benefits while adding stronger addiction treatment components.

The national toolkit will presumably synthesize lessons from these diverse local experiences, providing guidance that communities can adapt to their specific circumstances rather than imposing uniform federal prescriptions.

Policy Tensions and Uncertainties

The summit occurs against a backdrop of significant uncertainty about the future direction of federal behavioral health policy. The administration has proposed consolidating SAMHSA into a new agency within HHS, eliminating several mental health and substance use programs, and cutting the HHS budget by approximately 12.5 percent. These proposals, if enacted, could substantially reduce the federal resources available for the very programs the summit aims to strengthen.

Secretary Kennedy's approach to addiction policy has emphasized non-pharmaceutical interventions and expressed skepticism about medication-assisted treatment — the evidence-based standard of care for opioid use disorder. This creates tension with the integration of addiction treatment and housing services, as MAT remains the most effective intervention for reducing overdose mortality among homeless populations with opioid use disorder.

The Great American Recovery Initiative, co-chaired by Kennedy and Senior Advisor for Addiction Recovery Kathryn Burgum, provides a potential framework for reconciling these tensions. The initiative aims to coordinate government, healthcare, faith communities, and the private sector in a comprehensive response to addiction. Whether this coordination can overcome substantive disagreements about treatment approaches remains to be seen.

The summit's emphasis on developing practical tools rather than debating policy frameworks may reflect a recognition that frontline providers need actionable guidance regardless of ongoing political disputes. Communities struggling with homelessness and addiction require immediate assistance, not theoretical clarity about federal policy direction.

Looking Forward

The White House summit represents an acknowledgment that addressing addiction among homeless populations requires more than simply expanding existing treatment programs. The intersection of housing instability and substance use demands integrated responses that address both conditions simultaneously, rather than treating them as separate problems to be solved by separate systems.

Whether the national toolkit developed from this summit can achieve meaningful impact depends on several factors beyond the quality of the guidance itself. Implementation will require sustained funding, workforce development, and political support for the challenging work of serving a population that generates limited political capital and significant neighborhood opposition.

The administration's simultaneous emphasis on addiction treatment and proposed cuts to health programs creates a fundamental tension that the summit cannot resolve. If federal resources for behavioral health services are substantially reduced, communities may lack the capacity to implement the best practices identified in the toolkit — regardless of how well-designed those recommendations may be.

For people experiencing both homelessness and addiction, the summit offers at least the possibility of more effective assistance. The current system frequently fails this population, cycling individuals through emergency departments, jails, and shelters without addressing the underlying conditions that perpetuate their instability. Any serious attempt to improve this system, regardless of its political framing, represents potential progress.

The coming months will reveal whether the summit's practical focus on toolkit development can translate into tangible improvements in service delivery — or whether it will join the long history of federal gatherings that generated recommendations without resulting in meaningful change for the people who most need assistance.