How to Fix Homelessness and Addiction When Housing Alone Doesn’t Work: The TRIP Program Explained

Why I Created TRIP: A Plan for People Who’ve Lost the Ability to Choose Care

In January 2023, while working on a nursing contract in downtown Edmonton, I saw firsthand how badly the system was failing people lost in psychosis and addiction (now called substance use disorder, or SUD). Stepping out onto Jasper Avenue was like walking into the Twilight Zone. Bodies stood frozen in the cold. Dealers rode by on bikes, handing off drugs outside the subway beside our condo.

That’s when I started writing TRIP, the Treatment and Reintegration Program for the homeless. It was an idea I researched and developed as a paper. I wrote it because the people I passed every day leaving the condo for my ICU shift weren’t capable of making safe decisions. They weren’t refusing help. They had lost the ability to recognize they needed it.

Free agency depends on a working mind. But SUD distorts decision-making, often narrowing focus to the next dose and nothing beyond it. There is no functioning system in place for people who’ve lost the ability to make safe decisions. These are individuals in the grip of deep psychosis brought on by SUD or mental illness, and trauma so severe it has destroyed their sense of reality.

Psychosis breaks down the connection between thoughts and reality. Trauma, especially when repeated, reshapes how a person perceives risk, relationships, and control. When these forces collide, the result is someone who appears resistant or unreachable, when in fact they’ve lost access to the part of themselves that could weigh realistic options, plan ahead, or ask for help.

You can’t reason with someone who won’t give up what they believe they need, or expect someone deep in withdrawal to navigate housing paperwork, line up for detox, sit through an intake interview, meet the timeline for ID recovery, book an appointment with a psychiatrist, and still make it back to shelter by curfew. These systems were designed for people who can wait, schedule, and advocate. The people most in crisis can’t.

That’s where TRIP fits. It was designed for people who can no longer navigate care on their own, people whose judgment, perception, and sense of self-preservation have broken down. It doesn’t wait for collapse on street or depend on motivation. It brings together medical care, legal authority, and stable supervised housing to create a way for those who’ve lost the capacity to find one themselves.

Why Housing Alone Can’t Solve Addiction, Homelessness, or Mental Illness

Since I wrote the TRIP proposal in 2023, the crisis in Edmonton has only deepened. By mid-2024, the number of homeless residents had climbed past 3,000. By the end of that year, it had reached 5,000. The shelters are full most nights but cleared out during the day, pushing people back into the streets. The waitlists for housing stretch endlessly, but anyone actively using drugs is screened out before they can even qualify.

Tent encampments shift from one vacant lot or park to another as the city clears them, knowing full well there’s nowhere else to go. Downtown storefronts continue to shutter because people can’t shop beside suffering they’ve been trained to ignore.

And it is not just Edmonton. Every major city has followed the same pattern. Toronto, Vancouver, Calgary, San Francisco, and Philadelphia all have different budgets and different climates, but the outcome is the same.

The response hasn’t changed. Cities expand shelters temporarily, roll out winter warming plans, open overdose prevention sites with no long-term plan, and and point to housing affordability as if that explains everything.

This crisis isn’t about housing alone. It’s about what happens when someone’s brain and body are overtaken by substances, trauma, and neglect. No number of shelters or outreach teams can help someone who has lost the ability to think clearly, stay safe, or care for themselves.

What’s missing is structure. That’s what TRIP delivers.

How the TRIP Program Brings People Into Treatment and Housing

TRIP begins on the street, where trained outreach teams possibly made up of nurses, mental health staff, and law enforcement engage individuals who are visibly unwell, intoxicated, or caught in psychosis. These teams can’t simply bring someone in without legal backing. That is where Parens Patriae comes in. This legal principle gives the state or province the authority to intervene when a person has lost the ability to make safe decisions. For that to happen, legislation must be passed by elected officials to authorize this type of care-based intervention for individuals with SUD.

Once the legal framework is in place, vagrancy laws can be enforced not as punishment, but as a way to move people into care. This applies to individuals who meet clear criteria such as repeated overdoses, visible psychosis, inability to care for themselves, or posing a risk to others. When those conditions are met, TRIP initiates the process for involuntary admission.

Inside the TRIP Model: Treating Addiction, Psychosis, and Trauma Together

TRIP facilities provide housing on-site. Some people need 24-hour supervised care and stay in secure units initially. Others may only need semi-independent housing when it’s safe to do so. No one’s rushed. No one’s discharged just to clear a bed. Each person gets the structure and environment they need to maintain whatever level of function they’re capable of.

Every person admitted involuntarily is entitled to legal representation, a hearing, and a medical evaluation by an independent provider. Their case is reviewed regularly to decide whether continued care is necessary. Once admitted, each person gets a full medical and psychiatric assessment. That includes a history of substance use, mental illness, and trauma, because a significant number of people entering TRIP have lived through childhood and adolescent trauma that was never addressed. They’ll have to deal with it.

Without unpacking the trauma that shaped how they think, trust, and respond, they’re not likely to stay well. That’s why therapy and trauma-informed care are built into every level of the institution. From there, they’re placed in a level of care that matches their stability and needs.

When they’re stabilized, have gone through withdrawal, and regained enough cognitive clarity, each person is given a role. That might mean cleaning floors, washing dishes, helping new arrivals, learning a skill, or supporting someone else’s recovery. The point is to create a sense of purpose, not replace drug dependency with a new kind of institutional dependence. Everyone has responsibilities based on what they’re capable of.

Although the goal isn’t to hold people indefinitely, though there are exceptions. Some people won’t be able to return to what most would call a “normal” life. The damage from years of SUD, psychosis, or trauma may be too extensive. If someone can’t function safely on their own, the TRIP institution becomes their home.

This Homelessness and Addiction Program Was Sent Directly to Politicians Who Could Fund It

I didn’t write TRIP as a thought experiment, or to keep in a folder on my laptop. I sent it directly to elected officials and policymakers, people in a position to fund it, legislate it, or at the very least start a conversation about it. Emails went out to representatives in Alberta, Toronto, British Columbia, Saskatchewan, New Brunswick, California, and Pennsylvania. These weren’t anonymous submissions. They were addressed personally, with the proposal attached in full.

Some replied through assistants with vague acknowledgments. Most said nothing at all. Not one asked to read more or requested a conversation. No one said they were working on something similar or even offered a basic follow-up.

Politicians say they care about mental health, homelessness, SUD, and trauma, but that changes the moment a solution requires structure, legal authority, or any level of responsibility. TRIP would require complex decisions. It would mean changing how we define care for people who’ve lost the ability to choose it. It would call out the illusion that we’re making progress, when most responses are just Band-Aids covering bullet wounds.

Avoidance is easier. Shelters get funding. Housing-first initiatives get press conferences. But when a proposal addresses the full scope of what substance use disorder really is, very few want to go near it.

That’s what happened. They read it, or they didn’t. Either way, they said nothing. And the silence spoke for itself.

CARE Court vs. TRIP: California’s Mental Health Plan Compared

I had sent my TRIP proposal directly to Governor Gavin Newsom and San Francisco lawmakers in 2023. The state enacted major reforms: SB 43 expanded the definition of gravely disabled under the 1967 Lanterman–Petris–Short Act to include severe substance use disorder, enabling involuntary holds and conservatorships for those unable to care for themselves.

California introduced CARE Court in 2022 as a way to compel treatment for people with untreated schizophrenia and related psychotic disorders. It was signed into law in September 2022 and rolled out in October 2023 across seven counties: San Francisco, Los Angeles, Orange, Riverside, San Diego, Stanislaus, and Tuolumne. The plan was to expand statewide by the end of 2024.

CARE Court allows family members, first responders, and clinicians to petition a civil court to mandate care for someone showing signs of serious psychosis. The person is then brought into a structured plan, which can include mental health treatment, medication, and housing services. If they refuse the plan or don’t follow through, the court can initiate a conservatorship process.

On paper, this sounds like a step in the right direction. But in practice, CARE Court is a limited tool. It focuses on legal coordination, not full-spectrum care. There is no institution attached to the court itself. There’s no guarantee of detox, on-site housing, or long-term supervision. The person may get referred to services, but they still have to navigate the same fragmented system that already fails people who are severely unwell.

That’s where CARE Court and TRIP part ways. CARE Court creates a legal path to treatment, but TRIP builds the place where that treatment happens. TRIP doesn’t just refer people to care. It keeps them in it, safely and with structure, until they’re as stabilized as they’re going to get.

California’s CARE Court is a policy step while TRIP is a structural fix. One moves paper, the other moves people. And that’s the difference.

Alberta’s Forced Addiction Treatment Law vs. the TRIP Program

As I stated earlier, I sent the TRIP proposal to MPs and even to the Premiers of Alberta, Jason Kenney and later Danielle Smith, in 2023. Maybe they listened and used the idea.

Alberta’s Compassionate Intervention Act, introduced in 2025, comes closer than any other Canadian policy to what TRIP outlines. It allows involuntary treatment for adults with severe substance use disorder when they pose a danger to themselves or others and haven’t responded to voluntary care.

Family members, healthcare workers, or police can apply for a treatment order, and if approved by a commission, the person can be taken into custody and placed in a secure facility for up to three months, followed by up to six months in community care.

While this marks a major change in Canadian addiction policy, it still doesn’t match what TRIP delivers. Alberta’s model focuses on short-term stabilization, and the infrastructure for compassionate intervention centers isn’t expected to open until 2029. Alberta has been promoting affordable housing as a solution to the homelessness crisis since 2016, without recognizing that if they built it, many still wouldn’t come because they didn’t want to lose their autonomy.

TRIP is an idea around long-term institutional care, not as a last resort, but as a structured, early intervention system with legal safeguards, psychiatric care, housing, and purpose-driven rehabilitation under one roof. Alberta’s bill creates legal authority to detain and treat, but it lacks the full institutional design TRIP is based on. It’s a legal doorway, not a complete system.

TRIP Is the Long-Term Addiction and Homelessness Solution No One Wants to Fund

TRIP is more than a concept on paper. It’s reason-based, structured, and necessary to build. It offers what every paid task force and commissioned document has failed to deliver: a full system for people who can’t navigate care on their own.

The current model still cycles people with SUD who can’t function psychologically through short-term services, discharges them back to the street, and calls it progress. We’ve seen decades of studies, press releases, and ad hoc ideas. But we haven’t seen anything permanent for the people who need it most.

California introduced CARE Court. Alberta passed the Compassionate Intervention Act. These are important lurches in the right direction, but they don’t go far enough. Neither provides a single, integrated institution with care, housing, legal safeguards, and purpose built in. TRIP does.

The people with the power to act already have the plan in front of them, because I gave it to them for free. They’ve seen the crisis, and they’ve seen the outcomes of doing less. What’s left now is a choice.

TRIP wasn’t written to make headlines. It was written as a way to help the people politicians chose to ignore. The ones lying on subway grates, overdosing in kiddie parks, slumped over in doorways, and walking through traffic in full-blown psychosis.

If this isn’t the moment to build it out, then what exactly are we waiting for?