The phrase “down and out” means something like as low as you can get. No money, no friends, and probably struggling with an addiction.
But what sense of “down” and what sense of “out?”
“Down” could be “down on your luck,” “down on the ground,” “down the cash,” depressed, or “coming down.”
“Out” could be “Out of luck,” “out of money,” “out of style,” “out of drugs,” or “out on the street.”
Maybe the only way to settle this is by finding the origin of the phrase. But maybe there is some segment of society that actually knows what the words mean when they are saying “down and out?”
Apologies if this has been done – I had no luck searching for “down” and “out.”