With great fanfare, Secretary of Health and Human Services (HHS) Robert F. Kennedy, Jr., announced on August 12 a new Best Practices Toolkit, a publication that lays the groundwork for a “treatment first” approach to homelessness and addiction.

How embarrassing it must be for Housing and Urban Development (HUD) Secretary Scott Turner to sign off on a document that takes a “treatment first” approach to homelessness. Isn’t the treatment for homelessness providing housing? I don’t think that’s what Secretary Turner had in mind.

It begs the question: What is the treatment for homelessness, if not housing? Half of the homeless population in the U.S. is disabled and cannot work. What is the treatment for them? I argue that it is housing. The other half are employed but can’t afford proper housing. Is the “treatment” they receive going to be an increase in the minimum wage? Not likely.

And what about the drug addicts? Well, first of all, drug addiction and homelessness are two very different problems not subject to the same set of “best practices,” unless best practice means to love your neighbor. The majority of drug addicts are not homeless and are not unemployed. The Best Practices Toolkit says almost nothing about them.

Lev Facher, long-time addiction reporter for STAT News, writes of the Best Practices Toolkit:

The strategy makes only passing mention of two medications known to vastly reduce one’s odds of dying of opioid overdose, methadone and buprenorphine. In recent months, a number of federal government actions have cast doubt on the administration’s support for medication-assisted treatment, also known as medications for opioid use disorder.

It is the widespread distribution of naloxone (Narcan) that is credited with bending down the curve on overdose deaths since 2024, and not the disruption of drug cartels. The funding for this widespread distribution was essentially terminated by Secretary Kennedy. The Best Practices Toolkit refers to the new “treatment first” strategy as “the warm handoff.” It’s more like a back-of-the-hand approach.

From top to bottom, the Best Practices Toolkit is a backhanded approach to fighting either homelessness or addiction. The “treatment first” subtitle is a reactionary rebuke of the Biden administration’s “housing first” approach.

Just for the record, that wasn’t the Biden administration’s approach but the approach of several governors and mayors. As Facher points out, “in Houston, the city moved 25,000 people from the streets into homes over the course of a decade.” That is a housing-first approach to homelessness.

The Best Practices Toolkit indicates that 75% of the homeless are addicted to drugs. That is more than double the highest credible evidence that roughly 33% have substance use disorders. It states that 78% of the homeless are “mentally ill,” an insulting exaggeration equivalent to saying 78% of Congress is mentally ill.

The housing-first strategy for addiction treatment came about because addicted people will not stay in treatment long enough unless they have stable housing. Again, most people in addiction treatment do not need housing. But for those who do, it is an essential element of recovery. One might even call it a “best practice.”

The administration has not completely turned its back on the addicted homeless. For methamphetamine addiction, it recommends contingency management, paying people to stay in treatment and deliver clean test results. The practice is both expensive and effective, and it is truly one of the best practices in addiction medicine.

For everyone other than methamphetamine addicts, however, the administration’s approach to homelessness and addiction is, “Here’s a pamphlet. Now get lost.”

Written by Steve O’Keefe. First published August 21, 2026.

Sources:

“HHS, ONDCP, and HUD Launch First-Ever ‘Treatment First’ Toolkit to Combat Homelessness and Addiction,” HHS Press Office, August 12, 2026.

“Trump administration’s new ‘treatment first’ addiction toolkit emphasizes faith, abstinence,” STAT News, August 12, 2026.

“The Trump administration wants ‘treatment first’ for homelessness and addiction, but San Diego has a capacity problem,” KBPS, August 12, 2026.