Kathryn Burgum, the White House Senior Advisor for Addiction Recovery, has issued a stark warning. Housing without treatment does not save lives. In fact, she says, it can end them.

Her comments follow the death of a former patient. He received housing, then died soon afterwards from a fentanyl overdose.

A Familiar Face in the Emergency Department

Burgum practised emergency medicine in downtown San Diego for thirty years. During that time, she came to know a man named Alex Soto well. Alex was homeless. He also lived with schizophrenia and struggled with methamphetamine addiction. Consequently, his visits to the emergency department became a weekly occurrence, and at times a daily one.

According to Burgum, she and her colleagues tried various approaches to break the pattern. They wanted to stop the revolving door between the streets and the hospital. Nothing worked for long. Nevertheless, hope arrived when Alex finally received a place of his own.

Housing Without Treatment Proved No Cure at All

Housing without treatment, however, proved to be no cure at all. Soon afterwards, Alex died in his new home from fentanyl poisoning.

“Housing without treatment is not compassionate. It’s deadly. And we learned that the hard way,” Burgum said, reflecting on a case that has stayed with her ever since.

“Housing killed Alex. We failed him and may his memory be a blessing,” she added.

Why a Housing First Approach Cannot Stand Alone

The story challenges a widely held assumption in homelessness policy, namely that a roof alone can turn a life around. Burgum’s account, however, suggests otherwise. Someone managing serious mental illness and active addiction needs more than four walls. Otherwise, an empty flat with no support can quickly become an isolated place to use drugs unseen. There is no emergency team nearby to notice, and no one checking in day to day.

That is precisely why, in Burgum’s view, a housing first approach must never stand alone. Housing paired with treatment, mental health care and ongoing supervision gives people a genuine chance at recovery. By contrast, a front door key alone does not equal compassion, nor does it remove the danger of addiction left untreated.

A Call to Rethink How Support Is Delivered

Burgum’s remarks arrive as officials across the United States reassess how they tackle homelessness and addiction together. Her account of Alex Soto stands as a reminder. Real compassion, in other words, means walking alongside someone through recovery, not merely handing them a set of keys and hoping for the best.

For Burgum, Alex’s death did not reflect an isolated failure of one programme. It points to a broader pattern. A housing led response, offered without treatment, leaves vulnerable people to face addiction entirely alone. As a result, housing without treatment can quietly undo years of care built up in emergency rooms like hers.

Consequently, Burgum is now urging policymakers to rethink how they deliver support, so that no one else slips through the way Alex did. Ultimately, she says, may his memory be a blessing. May his story also change how the country responds to those still caught between the streets and the emergency room.

Source: dbrecoveryresources