Background: Homelessness is a large problem within San Diego County, accounting for more than 8,500 Americans. Approximately one third of this population has a problem with substance abuse. Methods: A 20 question initial survey was administered to 2,460 clients of the San Diego Syringe Exchange between January 1st and December 31st, 2010. A logistic regression was created to assess the association of housing status and having ever sought a drug treatment or detox program. Results: Of 2,460 heroin users surveyed, 72% were male and the mean age was 40 (range 18-76) years old. About 76% (n = 1,864) report using heroin two or more times per day and approximately 76% (n = 1,870) of participants reported having ever been enrolled in a detox or drug treatment program. Housing status is not significantly associated with having sought drug treatment or detox for heroin (OR 1.168; CI .924, 1.474). Conclusion: There is no significant association between housing status and having been enrolled in a detox or drug treatment program, after controlling for age, heroin use, and having ever used a contaminated syringe from another within the past two months. Having ever sought heroin treatment or a detox program is positively associated to age, amount of heroin consumption, and having ever used a contaminated syringe from another within the past two months. The findings support the need for further research and interventions targeting different positive associations and factors known to lead IDUs into treatment so that may reduce the adverse effect of prolonged drug use.