Trump Administration Unveils 'Treatment First' Toolkit Linking Addiction Recovery and Homelessness
Key Insights
The White House ONDCP, HHS, and HUD jointly launched the first-ever "Treatment First" Best Practices Toolkit to address intertwined addiction and homelessness.
The framework prioritizes abstinence and faith-based interventions while rejecting harm reduction principles and the prior administration's "housing first" strategy.
The toolkit cites data showing 75% of homeless Americans are addicted to drugs and 78% suffer from mental illness, emphasizing coordinated, accountability-driven engagement in treatment.
The White House Office of National Drug Control Policy (search) (ONDCP), the Department of Health and Human Services (search) (HHS), and the Department of Housing and Urban Development (search) (HUD) on Wednesday unveiled the first-ever "Best Practices Toolkit: Addressing Homelessness and Addiction Through Treatment First." Announced at the San Diego Rescue Mission, the resource equips state and local leaders with strategies to help Americans transition from homelessness and addiction to recovery and self-sufficiency.
The toolkit advances a "Treatment First" model that prioritizes coordinated and accountability-driven engagement in evidence-based treatment and recovery support services. The framework boosts faith-based interventions while rejecting harm reduction principles and the "housing first" strategy that characterized the Biden administration's approach. While the new strategy favors medicalized approaches to treating addiction, it cites abstinence as the ultimate goal as opposed to also celebrating decreased drug use and related harms.
"Treatment must come first. Recovery begins when we connect people with effective care, not leave them trapped in addiction and homelessness," said HHS Secretary Robert F. Kennedy, Jr. "This toolkit gives communities practical, evidence-based strategies to expand treatment, support lasting recovery, and help people reclaim their independence."
Scope of the Crisis
Data cited in the announcement indicates that 75% of homeless Americans are addicted to drugs, while 78% suffer from mental illness. The toolkit was led by experts nationwide with first-hand experience and knowledge, and supports the Trump Administration's commitment to making American cities safer and improving drug treatment and recovery through the Great American Recovery Initiative.
"I have met men and women whose lives have been transformed by treatment and recovery," said HUD Secretary Scott Turner. "Housing is essential, but housing alone is not enough. This toolkit gives communities a practical playbook designed by experts across the country to put treatment first and help more homeless Americans achieve lasting recovery, stability, and independence."
Key Principles of the Framework
The new program stresses a holistic approach to aiding addiction recovery and helping people experiencing homelessness, ranging from encouraging consistent sleep cycles and daily schedules for treatment-related activity to making employment a central component of the overall strategy.
Above all, the administration stressed that it opposed providing access to housing on an unconditional basis, citing one study that showed veterans in a supportive housing group were more likely to die of a drug overdose. Abstinence was a primary goal, though the toolkit made clear that relapse should be treated as a setback but not necessarily a failure, and that recovery is not necessarily linear.
The strategy also favors prioritizing people who have lived experience with addiction, homelessness, and recovery for influential jobs and positions within organizations conducting homeless outreach and offering pathways to recovery.
Medication and Treatment Approaches
The strategy makes only passing mention of two medications known to vastly reduce one's odds of dying of opioid overdose, methadone and buprenorphine. In recent months, a number of federal government actions have cast doubt on the administration's support for medication-assisted treatment, also known as medications for opioid use disorder (search).
Notably, the document lists contingency management, or the practice of offering financial incentives to people who reduce their drug use or stop altogether, as a favored strategy. While the strategy is aligned with current evidence, many contingency management providers feared it would prove ideologically incompatible with the new administration.
Contrast with Housing First
Despite the Trump administration's intense opposition, "housing first" strategies have seen some success in recent years, perhaps most notably in Houston, where the city moved 25,000 people from the streets into homes over the course of a decade. City officials widely describe the program as both a local success and a national model, though more recently, the program has struggled with funding while homelessness rates have held steady.
"Under President Trump's leadership, we will not abandon those in treatment and recovery from drug addiction because every American is worth fighting for," said ONDCP Director Sara Carter. "This toolkit will present new, evidence-based solutions that offer hope and healing to Americans struggling with drug addiction and homelessness."