Three federal agencies jointly released the first-ever Treatment First Toolkit on Aug. 11, directing states and localities to prioritize substance use disorder treatment as the entry point for homeless services rather than shelter alone. The Department of Health and Human Services, the Office of National Drug Control Policy, and the Department of Housing and Urban Development collaborated on the toolkit, which provides implementation guidance for restructuring how federal homelessness dollars are spent, HHS said.
The three-agency collaboration is the first of its kind, linking federal housing funds with drug treatment programming in a unified policy framework. Implementation guidance directs HUD grant recipients on how to restructure service delivery around treatment-first models.
For the roughly 650,000 Americans experiencing homelessness on any given night, many of whom struggle with substance use disorders, the policy shift could change what services are available when they seek help. The toolkit directs communities to offer addiction treatment as a first contact rather than routing individuals through traditional shelter systems alone.
The policy represents a formal departure from shelter-first approaches that have dominated federal homelessness strategy for decades. Critics of the previous model have argued that providing shelter without addressing underlying addiction often results in individuals cycling through the homeless system without achieving stable housing.
ONDCP has identified the intersection of addiction and homelessness as a priority area, noting that substance use disorders are both a cause and a consequence of housing instability. Fentanyl and methamphetamine use, in particular, have been cited as drivers of chronic homelessness in many Western cities.
HUD grant recipients, including Continuum of Care programs and Emergency Solutions Grant recipients, will receive specific guidance on how to integrate treatment services into their existing programming.