2. Substance Abuse and Mental Health Services Administration (2003) estimates, 38% of homeless people were dependent on alcohol and 26% abused other drugs. Substance abuse was the single largest cause of homelessness for single adults 2006 National Household Survey on Drug Use and Health (NSDUH), 15% of people above the age of 12 reported using drugs within the past year and only 8% reported using drugs within the past month. Nearly 690,000 people are homeless on a given night in America – 34.7% of all sheltered adults who were homeless had chronic substance use issues The leading cause of death among homeless Americans used to be HIV, but that has been replaced by a new epidemic: drug overdose National Institute on Drug Abuse; The Science of Drug Abuse & Addiction (n.d.) www.drugabuse.gov U.S. Statistics on Substance abuse in the Homeless Population

3. 10.7% of Michigan residents aged 12 years and older reported using illicit drugs in the past month. When marijuana was excluded, the estimated dropped to 3.6% Since 2003, over 90% of all poisonings have involved drugs, with the largest increase in poisonings related to opioid analgesics (pain relievers) Non-Hispanic, white race is 70% of substance abusers In 2005, more than 1.6 million hospitalizations and over 4 million emergency room visits nationally were for alcohol related conditions. –  Approximately 79,000 people die each year in the United States as a result of excessive alcohol use, making its use the third leading behavior related cause of death for the nation. –  Excessive alcohol consumption has both immediate consequences ‐ such as miscarriage, stillbirth, birth defects, unintentional injuries, and violence ‐ and long‐term consequences, such as neurological problems; cardiovascular problems; social problems; and cirrhosis. Michigan Statistics State of Michigan (MDCH)-Reports and Statistics (2012). Retrieved from www.michigan.gov

4. Kent County’s results for 2009/2010 school year highlight disparities in ADOLESCENTS: Tobacco & marijuana use is more common among boys Prescription drug & alcohol use is more common among girls Tobacco use is most common among white and American Indian students Drug & alcohol use is more common among African American & Hispanic students ADULTS: Binge drinkers 2002: 17.1 adults reported, higher than national average and Michigan average Tobacco use 2002: 19.8 adults reported, lower than the US average and the Michigan average Kent County Statistics Kent County Health Department. (2005). The Health of Kent County. Retrieved from www.ferris.edu/blackboard/NURS340

5. Grand Rapids Area Coalition to End Homelessness – Shelter information – Transportation (Kentride.org) – Food services – Medical services – Dental Services – Free Substance Abuse Centers/help Grand Rapids and Kent County National Alliance to end Homelessness – A vision to end homelessness – Prevention of homelessness, with more resources directed to this strategy. – A dramatic decrease in emergency shelter need, use, and bed capacity – Increased coordination of systems and services – The expansion of the role of Housing First as a local strategy for permanent housing – The Vision will be brought to fulfillment through an implementation plan to end homelessness in Kent County by the end of 2014. Programs already in place for Kent County Homeless Ke nt County Assistance Program – Help paying bills – Help preventing foreclosures – Free medical bills – Work from home – Help paying rent HSD-Helping the Needy; Homeless directory – Shelters – Food banks – Other resources Kent ISD, Homeless Resource for families with children – Homeless Liaison available – Free transportation to and from school for children – Free meals – Free education www.fcomi.org/kent.html – Free medical and dental in Kent County Thekentcenter.org – Free substance abuse/addiction recovery help

6. Strengths Recognize the issue at hand Recognize need for change Have government policy and support to make the change Second largest city in Michigan (Grand Rapids) Weaknesses The past action plan was a 10 year plan that ends in 2014 and the issue still exists. Lack of personal resources for the homeless Lack of ability to access the resources for the homeless population Kent County http://blog.mlive.com/grpress/news_impact/2009/03/large_gods-kitchen- line.jpg

7. Diagnosis Risk of substance abuse among homeless individuals in Kent County, Michigan related to homelessness Risk of homelessness among substance abusers in Kent County, Michigan related to substance abuse As demonstrated by substance abuse more prominent in the homeless population than the general population; 38% homeless population dependent on alcohol and 26% abuse other drugs (National Coalition for the Homelessness, 2009). National Coalition for the Homeless. (2009, July). Substance abuse and homelessness. Retrieved from http://www.nationalhomeless.org/factsheets/addiction.pdf

8. Diagnosis Individual Diagnosis: Risk of ineffective coping skills. Risk for self or other-directed injury. Risk for dysfunctional family dynamics. Risk for financial burdens. Risk for powerlessness. Risk for denial. Risk for sleep-deprivation. Risk for poor health. Ackley, B. J. & Ladwig, G. B. (2014). Nursing diagnosis handbook (10 ed.). Maryland Heights, MO: Elsevier. Image from: http://www.mlive.com/news/grand-rapids/index.ssf/2012/02/grand_rapids_metro_area_gets_b.html

9. Diagnosis Community Diagnosis Risk for financial burdens to community. Risk for increase in medical expenses relating to overdoses, communicable diseases, and risky behaviors. Risk for community violence and crime. Risk for child abuse and neglect requiring Child Protective Services involvement (National Institute on Drug Abuse, 2014). National Institute on Drug Abuse. (2014). Drug abuse and addiction: one of America's most challenging public health problems. Retrieved from http://archives.drugabuse.gov/about/welcome/aboutdrugabuse/magnitude/

10. Planning Target Population: Homeless Substance Abusers in Kent County, MI. Planning Group: Community Health Nurses Program Goal/Objective: Assist homeless substance abusers in Kent County, MI with obtaining resources to end their substance abuse and homelessness. Resources needed: Community health nurses, volunteers, general community members, homeless shelters, AA & NA programs, substance abuse programs, educational centers, mental health services, government agencies, health department, churches.

11. Interventions: Who The Dwelling Place Guiding Light for Men Mel Trotters Ministry Dwelling Place, (2014) Mel Trotters Ministry, (2014)

12. Who: Interurban Transit “Riding the Rapids” The Rapid, (2014)