Despite having deleted X from my phone, my partner hasn’t. Today, while he was screaming into the void, he brought to my attention this tweet (or post as Musk renamed them) from Elon Musk: “In most cases, the word ‘homeless’ is a lie. It’s usually a propaganda word for violent drug addicts with severe mental illness.” As someone who was homeless for nearly three years, this couldn’t be further from the truth.
My story isn’t unlike that of many others. I left home as soon as I graduated from college and tried to make a name for myself in the big city. I was working in the film industry and couldn’t make enough money to support myself. So, I often would crash on the couches of my friends. When that failed, I would sleep on the subway and ride it back and forth to the end of the line or sleep in a quiet corner of Port Authority. I never sought out the shelter system or services because I didn’t consider myself to be homeless at the time. I was your typical starving artist trying to make something of themselves. My story isn’t that unusual; contrary to popular belief, substance use does not rank among the top causes of homelessness. According to a study conducted by the National Law Center on Homelessness and Poverty, the primary causes are Lack of affordable housing, Insufficient income, and Family crises, such as domestic violence, divorce, or the death of a breadwinner.
These issues account for over 75% of homelessness. Addiction, while a contributing factor for some, is often the result—not the cause—of losing stable housing. Multiple studies corroborate this finding, including the California Statewide Study of People Experiencing Homelessness, which found that 50% of homeless individuals had not used drugs in the six months prior to the survey.
The overlap between homelessness and addiction often stems from the trauma and stress of living unhoused. Research shows that many homeless individuals turn to substances as a way to cope with the harsh realities of street life, including physical danger, hunger, and exposure to the elements. 40% of homeless individuals who use illicit substances reported starting or increasing use after becoming homeless, according to the California study. Substance use among homeless individuals is often correlated with the length of time spent homeless and the severity of their living conditions rather than being the initial cause.
The widespread belief that addiction causes homelessness confuses correlation with causation. While substance use and alcohol misuse may exacerbate a person’s vulnerability, the structural causes—such as unaffordable housing markets—are far more significant. For example, if addiction were a leading cause, we would expect states with the highest overdose rates also to have the highest homelessness rates. Instead, states with the most expensive housing markets, like California and New York, report the highest rates of homelessness.
A Case that Sparked National Debate
A part of what led the controversial Tesla CEO to send out that tweet was the verdict in the Daniel Penny case on December 9th. The case involved the death of Jordan Neely, a 30-year-old homeless transman, on a New York City subway on May 1, 2023. Neely, known for his Michael Jackson impersonations, was experiencing a mental health crisis when he boarded the F train, shouting about his desperation and hunger. Although witnesses felt threatened, they noted he had not physically harmed anyone. Daniel Penny, a 24-year-old Marine Corps veteran, restrained Neely with a chokehold, assisted by two other passengers. Video footage showed Penny maintaining the hold even after Neely became unresponsive. Neely was pronounced dead shortly after police arrived.
The medical examiner ruled Neely’s death a homicide by neck compression, leading to charges of second-degree manslaughter and criminally negligent homicide against Penny. His trial in late 2024 ignited a national debate about vigilantism, race, and systemic failures in addressing homelessness and mental health. Penny was ultimately acquitted of all charges, with a jury deadlock leading to the dismissal of manslaughter and a not-guilty verdict on negligent homicide. The case divided public opinion and sparked protests, raising questions about subway safety, mental health resources, and the ethics of civilian intervention in crises. A wrongful death lawsuit filed by Neely’s father remains pending.
Neely’s tragic death highlights the systemic neglect of vulnerable populations. His struggles stemmed from profound trauma, including his mother’s murder when he was fourteen, which led to foster care, homelessness, and untreated mental illnesses such as depression and schizophrenia. On that subway, his cries for help were met with fear and violence instead of compassion and support. The chokehold that ended Neely’s life epitomizes society’s failure to address root causes like inadequate mental health care and housing policies. Penny’s acquittal underscores troubling societal attitudes, normalizing the dehumanization of marginalized individuals and raising urgent questions about collective responsibility and empathy.
The Tweet that Sparked Stigma and Controversy
The tweet that sparked the controversy was from Jeremy Kauffman, a failed conservative politician from the Libertarian Party. He tweeted out his hot take on an article on homelessness published in the SF Chronicle two years ago on April 26th, 2022. The article discusses San Francisco’s ambitious $160 million annual investment in permanent supportive housing, which has become a stark example of systemic failure, with thousands of vulnerable residents left in dire conditions. Single-room occupancy (SRO) hotels, the program’s backbone, are plagued by crime, neglect, and chronic underfunding. Reports detail infestations, structural disrepair, and rampant overdoses—issues exacerbated by insufficient staffing and oversight. A quarter of tenants tracked by the city in 2020 died while in the program, and 21% returned to homelessness, underscoring a lack of meaningful progress. Despite these alarming trends, city leaders have focused on expanding new programs while leaving older buildings underfunded and mismanaged.
Key findings highlight structural flaws that perpetuate these failures. Case managers face caseloads up to five times higher than federal recommendations, often earning wages so low that they teeter on homelessness themselves—this lack of support forces crisis management over proactive care, with many tenants falling through the cracks. Violent incidents, unsanitary conditions, and unresolved maintenance issues are rampant, with city officials and nonprofits pointing fingers rather than implementing solutions. The city’s approach of relying on 100-year-old SROs, clustered in high-crime areas like the Tenderloin, offers little hope for residents trying to rebuild their lives.
Experts argue that supportive housing programs cannot succeed without substantial funding increases and systemic reform. Cities like Los Angeles and Seattle achieve better outcomes by prioritizing scattered-site housing, where individuals live in private apartments with tailored support. San Francisco’s heavy reliance on aging SROs limits tenant choice and perpetuates cycles of instability. Meanwhile, newly developed properties like the Kelly Cullen Community demonstrate what’s possible when residents are given dignified living spaces and adequate support, leading to significant improvements in health and stability.
To truly address homelessness, San Francisco must shift priorities. More significant investments in maintenance, staffing, and oversight of existing SROs are urgently needed, alongside broader adoption of scattered-site housing models. Ignoring these issues risks deepening the city’s homelessness crisis, perpetuating cycles of despair for residents like Pauline Levinson, who describe living conditions as hopeless. Sustainable solutions will require treating supportive housing not as a quick fix but as an opportunity to provide lasting change for those most in need.
Bringing it All Together: Stigma, The Most Deadly Disease in America
Stigma—against people experiencing homelessness, mental illness, and addiction—is not just a social ill; it is a lethal force. It perpetuates cycles of despair, prevents meaningful systemic change, and silences the voices of those who most need compassion and care. Elon Musk’s tweet dismissing the word “homeless” as a “lie” and equating it with “violent drug addicts with severe mental illness” encapsulates the toxic misconceptions that fuel this stigma. Such statements not only misrepresent the reality of homelessness but also dehumanize individuals, reinforcing harmful stereotypes that impede both public empathy and policy reform.
While addiction and mental illness often coexist with homelessness, they are frequently consequences, not causes, of being unhoused. The trauma of living without stable shelter can exacerbate existing vulnerabilities or lead individuals to turn to substances as a coping mechanism for the relentless stress, danger, and isolation they face daily.
Stigma’s Deadly Consequences
Stigma against the homeless and those with mental illnesses or addiction fuels discriminatory practices that worsen their conditions. Public stigma manifests in the form of social exclusion, discriminatory policies, and even violence. Structural stigma—embedded in policies and institutions—leads to underfunded mental health services, criminalization of homelessness, and inadequate housing solutions. For example, let’s think back to the article published in the SF Chronicle on San Francisco’s $160 million investment in permanent supportive housing. It showed how that effort was undermined by neglect, underfunding, and mismanagement, leaving thousands in unsafe conditions. These systemic failures are compounded by societal indifference, driven in part by stigmatizing beliefs.
There’s also self-stigma—internalized shame and alienation—that further traps individuals into remaining homeless. When people internalize public stereotypes, they may avoid seeking help, fearing judgment or rejection. This is particularly devastating for those living with mental health or substance use, as it prevents them from accessing life-saving resources like treatment and housing.
How Misconceptions Impede Solutions
The widespread belief that addiction and mental illness drive homelessness shifts focus away from effective solutions. Housing-first models—prioritizing stable, permanent housing coupled with supportive services—have been proven to improve outcomes and reduce costs. Yet, stigma-driven narratives hinder their implementation. Misguided policies criminalize homelessness, as seen in states like Missouri, where sleeping on state-owned land is punishable by law. Such measures neither address the root causes of homelessness nor offer pathways to recovery.
Moreover, public and structural stigma undermine trust in and access to healthcare. Homeless individuals often face barriers like discriminatory attitudes from providers, lack of insurance, and logistical challenges such as transportation. These barriers are compounded for those with co-occurring mental health or substance use disorders, creating a vicious cycle of neglect and worsening health outcomes.
Toward a Stigma-Free Future
Society must confront its biases and embrace evidence-based solutions to dismantle the stigma that kills. Education campaigns can challenge stereotypes, replacing fear and judgment with understanding and compassion. Policies should focus on systemic causes, such as expanding affordable housing and providing trauma-informed, accessible mental health and addiction treatment.
Person-first language—referring to individuals as “people experiencing homelessness” rather than “homeless people”—can also shift perceptions, emphasizing their humanity over their circumstances. Additionally, decriminalizing homelessness and addiction can reduce the harms of stigma, reframing these issues as public health crises rather than moral failings.
The voices of those directly affected, like the author who shared their lived experience of homelessness, must lead these efforts. Their stories reveal the truth behind the stereotypes and inspire action rooted in empathy. As a society, we are morally obligated to reject stigma and create systems that uplift rather than punish. By addressing the structural drivers of homelessness and treating all individuals with dignity, we can build a future where no one is left behind.
My Take
I am deeply disappointed at the cesspool that Twitter has become. The stigmatizing language and memes being shared to perpetuate myths about people who I know and love is disheartening. What do I mean by that? As a person in long-term, sustained recovery for my mental health, I am proof that recovery from mental illness is possible and obtainable. We need compassion, not division and hatred. And if we don’t change how we view the most vulnerable population, we’ll end up like the self-fulfilling prophecy of “First They Came.”
We are not superior to our fellow man because we lack the understanding of their lived experience. And we can’t be shocked when “…they came for me / And there was no one left / To speak out for me.” As a society, we must do better.
SPEAK OUT! SPEAK LOUD! at The Sober Curator is a celebration of authentic voices in recovery—echoing Madonna’s call to “Express yourself!” Here, readers and contributors take the spotlight, sharing transformative sobriety journeys, creative talents, and new avenues of self-expression discovered along the way. Through videos, poems, art, essays, opinion pieces, and music, we break the silence that often surrounds addiction, replacing it with connection, hope, and inspiration.
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Call 988 to reach the National Suicide Prevention Lifeline. It provides free and confidential support 24 hours a day, seven days a week for people in suicidal crisis or distress. You can learn more about its services here, including its guide on what to do if you see suicidal language on social media. You can also call that number to talk to someone about how you can help a person in crisis. For crisis support in Spanish, call 1-888-628-9454.
For support outside of the US, a worldwide directory of resources and international hotlines is provided by the International Association for Suicide Prevention. You can also turn to Befrienders Worldwide.
Help is Available
If you or someone you love is living with substance use, alcohol misuse, a co-occurring, or a behavioral health disorder, there is hope. The Break Free Foundation aids individuals seeking recovery through the Break Free Scholarship Fund. It sends anyone who lacks the financial resources to attend a recovery center to do so at low to no cost.
Review our Treatment Locator Tool to find the right program near you, as well as our list of Hotlines and Helplines. Click here for a list of regional and national resources. On this road to recovery, no one is alone. We are all in this together.
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