More than 120 people who were homeless died in Ireland in 2020, new data shows.
The Health Research Board (HRB) has published analysis on the number of deaths and cause of death among people who were homeless when they died.
It shows that 121 people who were homeless died in 2020 - the equivalent to 10 deaths per month, and an increase on the 2019 figure of 92.
The report shows that those who died while homeless were much younger than the average Irish person at the time of their death, with a median age of 36.5 for women and 42 for men.
A person wrapped in a sleeping bag in Dublin city centre in January 2021. Image: Leah Farrell / RollingNews.ieAlmost all who died had a history of substance abuse or dependency, and there was a high prevalence of mental health and medical conditions.
Over half of the deaths occurred in Dublin. Over two in three were among people who were homeless and in temporary or crisis accommodation.
A total of 23 people who died were known to have been sleeping rough.
Almost half of deaths occurred in specific accommodation for those who were homeless, with a further one in three happening in a public place.
Of those who died, one in five women and one in 10 men were known to have spent time in prison.
Substance abuse
Almost all (91%) who died had a history of substance abuse, with high levels of polydrug use.
Heroin (61%) was the most common drug used by those with a history of drug use, followed by cocaine (56%), and benzodiazepines (36%).
Of those that had used substances, over four in 10 were alcohol dependent.
There was a high proportion of people who injected drugs, especially among men, and a high prevalence of hepatitis C.
Almost half of those who died had ever accessed substance use treatment.
Cause of death
Poisoning was the cause of nearly six in 10 deaths.
The most common drugs implicated in poisoning deaths were opioids - mainly heroin and methadone - followed by benzodiazepines and cocaine.
There were 52 non-poisoning deaths recorded among people who were homeless, with the majority (85%) among men.
Deaths due to cardiovascular conditions accounted for one in four non-poisoning deaths, with the majority occurring among men.
'Coordinated approach'
HRB Chief Executive Dr Mairead O'Driscoll said behind each of these numbers is a life lost.
"The findings of this report highlight the very difficult situation faced by some of the most vulnerable people in our community," she said.
"The Health Research Board's aim in capturing and analysing data on the nature and circumstances of these deaths is to provide evidence that can inform harm reduction strategies and future policies to support those experiencing homelessness."
In addition to demographic data, the research includes information on the circumstances and cause of death. Figures were largely similar to those recorded for 2019.
A man prepares to inject heroin in Portlaoise, Co Laois in this 2008 file photo. Image: Julien Behal/PA Archive/PA ImagesHRB Senior Researcher Dr Suzi Lyons said there needs to be a coordinated approach between drug and alcohol treatment services.
"In 2020 we see the impact of problem substance use and mental health conditions, with the majority of those who died dealing with one or both of these issues at the time of their death.
"Our findings show that these cases are complex, and that a coordinated approach is needed between drug and alcohol treatment services, mental health supports and approaches to harm reduction," she added.
There were 11 deaths among people who were homeless and who had no recorded history of drug or alcohol use.
The report comes amid concerns for those sleeping rough as temperatures plummet.
As well as record high homeless figures, the death of a rough sleeper was recorded in Dublin city centre last week, with homeless groups and charities saying their fears are growing as the weather deteriorates.
