Abstract

Experiences of housing - or lack of (e.g., experiencing homelessness, living in unstable housing, and controlled environments as temporary shelter) - impact experiences of and attempts at healing for those with a history of problematic substance use. Formally recognized as addiction in medical literature, the concept of problematic substance was used to broadly describe experiences of drug and alcohol use that results in severe consequences and did not necessitate diagnosis. Definitions of different housing environments, provided by Pan et al. (2020), are absent of nuance in determining what is “stable” and frequently fail to recognize the impact of relationships, geographic location, living conditions (i.e. heat and air conditioning, rodent infestation), and autonomy as components of stable or unstable housing. Healing from problematic substance use in each of the explored housing environments comes with unique facilitators and barriers to healing processes. Given the opportunity to define these concepts for themselves, participants were asked questions such as, “What does stable housing look like to you?” and “What does it mean to heal from problematic substance use?” The central research question guiding this study was: “How does housing impact people’s healing from problematic substance use?” Sixteen semi-structured qualitative interviews took place over the course of 18 months. Thematic analysis was used to examine the data, and the findings informed the development of a conceptual framework titled The House of Healing. This framework metaphorically links elements of healing from problematic substance use - as identified by participants - to structural components of housing (e.g., relationships as electricity, trust as walls). It theorizes that these elements of healing from problematic substance use function as critically as the corresponding housing components to which they are metaphorically related when considering what defines stable versus unstable housing.