In San Francisco, where I am most familiar, SROs which are used to house homeless junkies are the primary location of overdose deaths, even though they house fewer junkies than the streets surrounding them.
While it's true that shelter placement has some advantages for high needs folks (e.g. older, women, or disabled), those themselves don't correlate with opioid overdose deaths. There was a randomized trial of permanent supportive housing, which is a stronger intervention than simple housing, in Santa Clara (DOI 10.1111/1475-6773.13553) where those who received PSH died at slightly higher rates than those did not and never found housing of their own.
Thanks for finding that, looks like it might indeed increase risks.
> We enrolled 423 participants (199 intervention; 224 control). Eighty-six percent of those randomized to PSH received housing compared with 36 percent in usual care.
> We found a similar high mortality rate in both treatment and control groups. Individuals experiencing homelessness have a greater age-adjusted mortality rate than housed counterparts.25 Among those who died, 89 percent of those in the intervention group had been housed compared with 28 percent in the control group.
I really want to pattern match, but it’s just not enough data. Worse they may have undercounted deaths in the control group. “Abode provided data on death for all participants who died while living in Abode housing. We queried County death certificate data on all participants who did not appear in any source of study data for 6 or more months.”