Submitted by SnortingCoffee t3_118eh0l in washingtondc
SnortingCoffee OP t1_j9gt1rh wrote
Reply to comment by celj1234 in Two-thirds of McPherson Square homeless remain on street, D.C. says by SnortingCoffee
>Plenty of people want to remain homeless so they can keep doing drugs and drinking as they please.
Give them shelter without preconditions and they're more likely to get sober. In other words, the whole "no help until you're sober" rule actually makes it less likely for people to get there.
TastesLike762 t1_j9gtex2 wrote
I mean “hey come on in and slam heroin in front of a bunch of people trying to get sober” doesn’t seem like a great plan.
frappeyourmom t1_j9h6wfv wrote
Going from “slamming heroin” every day to sober overnight has numerous studies to back up that that’s not a way to be sober sustainably long term. The most long term sustainable sober option is medication assisted treatment, that people still clutch their pearls about.
Like if any of you who are hardcore against drugs and would do any amount of research to see why harm reduction is the model that helps more people get sober and healthy with the assistance of MAT and able to get into housing and jobs long term like many of you claim to want them to get into, perhaps the policy failures that keep plaguing DC would get somewhere.
TastesLike762 t1_j9hf8tp wrote
I’m not hardcore against drugs. I’m suggesting that maybe the “hey you’re not coming in if you’re actively using dope” rule isn’t without merit and that it’s ok for a place to create and enforce rules.
Tuymaadaa t1_j9hjntb wrote
I hear your point about harm reduction, but from a budgetary perspective the ‘no conditions housing’ won’t make sense. Right or wrong, these programs are funded by foundations, cities, donations, and other good will and these stakeholders are interested in helping the most people the most cost effective way. That means help the ones who want it, don’t help the ones that don’t. Moreover, you can’t force a lifestyle change on a person who doesn’t want it. Also- what about harm reduction for people trying to avoid drugs, alcohol, and unstable, untreated addicts? It’s also not like it’s possible to create addicts/mentally unwell only housing.
No matter how much time, patience, resources, therapy (assuming they want it), and money are given to some people it won’t bring them to a base level of functional in mainstream society. This isn’t to say they’re undeserving of sympathy and support, but to say that in a society with limited resources and money services are going to go to the ones who stand to gain the most benefit.
frappeyourmom t1_j9hlgdt wrote
So I volunteer with one of the harm reduction organizations and I personally have made inroads with drug users who want help and to get sober. The one thing that’s stopping them is DC’s requirement that they have to be sober first. They don’t have the health insurance to be able to get sober because the main reason they use is pain management and they got addicted because of the opioid crisis. They don’t have a reliable address for Medicaid and they can’t use mine because I live in Virginia.
There IS money for programs, but DC has used more of that money to do sweeps and evictions than they have to get people into housing. LA has way more of a population to house and has been successful with a housing first model. So count up how many policy failures DC has and estimate how much money they could potentially save on sweeps if they prioritized housing instead of abstinence sobriety?
Tuymaadaa t1_j9hyz0w wrote
I hear you on that. I had multiple family members dealing with addiction. Some are doing extremely well, living their best clean life. Some are dead but while they were alive talked all about how they wanted to beat their addiction. The best support systems in the whole didn’t save them. So Im cynical when people say a lack of housing is their only barrier, especially when some people are primed to take what they can get. Addiction really is something that needs to be dealt with on an individual to individual basis.
More to your point though, I’m 100% in agreement that addiction is more of a health crisis and would be fine with methadone clinics being added to hospitals, which would be great harm reduction and a good use of city funds. Realistically though I don’t see that happening in downtown DC because what would people prefer- clearing of a tent city or establishment of a treatment center plus housing for addicts?
twenty-six-sixty-six t1_j9h28tm wrote
i mean the alternative is what you have now, with people shooting up on the street -- is that any better?
i don't think harm reduction programs solve these problems easily, but they're at least worth exploring
frappeyourmom t1_j9ha5bc wrote
Harm reduction isn’t easy, but usually when someone got addicted, it wasn’t easy either. Most of the people I speak to when I’m supporting them with fresh supplies say that they want to get clean, but they don’t know where to find support. The folx who can find MAT clinics and stay supported eventually do get sober. Sobriety isn’t an overnight thing. LA I believe has a housing first model that does get people housed and slowly weans them off of whatever they’re using on the streets and gets them onto a MAT regimen. There’s also a program in North Carolina that does the same thing. The main block to those programs being implemented nationwide are policy changes and funding.
Atar4xis t1_j9i4fg2 wrote
Nah, not worth exploring. What should happen is the homeless should be allowed to sleep in the v downtown botanist business at night. As for them shouting up, what business is it of anyone else?
SnortingCoffee OP t1_j9gtr25 wrote
What we're doing now is not working. Housing first has worked many times in many different places. Sure, when you phrase it as "hey come on in and slam heroin in front of a bunch of people trying to get sober" it doesn't sound like the right thing to do, but just because it sounds bad in the most cynical possible framing doesn't mean it's not a huge step up from the patchwork nonsense we're trying now.
Does anyone think our current strategy is working well?
IndependentYoung3027 t1_j9gz4bp wrote
So who should have to shelter people who do drugs and likely won’t take care of their space. You willing to rent out a room to one?
I’d rather not have city paid drug dens.
spince t1_j9h9g91 wrote
>I’d rather not have city paid drug dens.
Tbh I'd prefer this over a city subsidized open air homeless encampment where presumably the same activity happens.
frappeyourmom t1_j9h5ryx wrote
You know what actually helps prevent drug deaths and exposure to needles?
Safe use facilities, which cities like DC refuse to legalize.
SnortingCoffee OP t1_j9h0r2c wrote
Currently the district is paying scummy landlords millions of dollars to game the system without actually helping any unhoused people. Take that money and just house people directly.
IndependentYoung3027 t1_j9h1agr wrote
So you are or are not willing to rent to a known drug user?
How would you feel if they lived next door and brought their drug user friends over all the time?
SnortingCoffee OP t1_j9h28zk wrote
I'm not a landlord, and I never said anything about private landlords, not sure where you're getting that idea from.
And I would have no problem living next to a formerly homeless person. If they were causing problems with noise, damage to the building, etc., I would deal with that the same way I deal with any neighbor causing those problems.
DrunkWoodchuck t1_j9h7c3l wrote
But there is no way to deal with a judgement proof tenant next door. What are you going to do about them? “The same way I deal with other neighbors” is as vague as can be.
walkandtalkk t1_j9ic54p wrote
How would you deal with them?
glopmod t1_j9h5qs4 wrote
I am fairly sure the vast majority of people under 40 that have lived next door to me while living in DC were drug users, and the people they had over were as well.
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I know because I have smoked or drank with them.
frappeyourmom t1_j9hlwry wrote
I live in Virginia and live next to drug users (I smell weed all the time) and I’m fine with it.
walkandtalkk t1_j9ickal wrote
That's fine, but most people aren't. And we're obviously not talking about potheads. I don't think we can consider it a solution to say, "Allow those with unmanaged, addiction-related psychosis to live independently in crowded neighborhoods."
You wrote elsewhere about residential harm-reduction programs. As far as I can tell, the big impediments there are cost and staffing, though I'm curious what such programs cost other cities per resident per year. $30,000? $100,000? You'll quickly run into a lot of opposition as they become unaffordable.
glopmod t1_j9h59lx wrote
I would confidently suggest that there is similar or higher percentages of drug use by those working on the hill and K St as those living in tents.
RockItGuyDC t1_j9hxun4 wrote
Yeah, but they wear nice clothes and their doctor prescribes their amphetamines and/or opioids, so it's all gravy.
celj1234 t1_j9gu7ln wrote
City paid crack houses? Who can’t get behind that idea?
SnortingCoffee OP t1_j9gugnk wrote
Instead you want people to remain living in parks and sidewalks? Or what is your alternative?
IndependentYoung3027 t1_j9gza93 wrote
That people who want help can get free rehab and then housing.
People who don’t want help can’t be helped. Not everything has a solution
SnortingCoffee OP t1_j9h0km9 wrote
If your goal is to get people sober, housing is the most effective first step. That's not an opinion, that's a repeatedly demonstrated fact. It's not the only step, but it's the first step. This is a classic case of "would you rather solve the problem, or would you rather be right"?
IndependentYoung3027 t1_j9h142e wrote
I mean it’s not. Giving housing to people who are active drug users has consequences too.
SnortingCoffee OP t1_j9h1knx wrote
Yes, one of those consequences is that they're more likely to get sober than if they were on the street. Another is that it's likely to save the city money on emergency services. Yes, it has its own problems, it's not a silver bullet. But it's far more effective than what we're doing with that same money now.
kstinfo t1_j9hlrfm wrote
You seem to be of the impression that homeless/drug user are a given combination. It's almost axiomatic that homeless folk don't have any money. So, who's giving away free drugs? Inquiring minds want to know.
IndependentYoung3027 t1_j9hnvfp wrote
We are talking about people who have refused aid from the city which is often because they don’t want drug testing
glopmod t1_j9h54b6 wrote
A lower percentage of homeless have drug or alcohol issues than the percentage who have used this program.
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Blue_5ive t1_j9h12n9 wrote
I’m not doubting you but do you have a source that housing + no rehab is effective?
SnortingCoffee OP t1_j9h4267 wrote
Oh I absolutely don't think it should be housing + no rehab. It's just housing first. Having people in a stable location makes it much easier to connect them with services like substance abuse treatment, mental health treatment, job training & placement, etc.
Here's one study that looked into it:
https://pubmed.ncbi.nlm.nih.gov/10737824/
Conclusion: "The program's housing retention rate over a five-year period challenges many widely held clinical assumptions about the relationship between the symptoms and the functional ability of an individual. Clients with severe psychiatric disabilities and addictions are capable of obtaining and maintaining independent housing when provided with the opportunity and necessary supports."
Here's another, this time with more mixed results:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448313/
"Participants in the Housing First program were able to obtain and maintain independent housing without compromising psychiatric or substance abuse symptoms."
People were more likely to remain stably housed with a housing first approach.
The most interesting highlight for me is that the housing first group had lower levels of engagement in substance abuse treatment, but basically the same levels of actual substance use. This shows that forcing people into substance abuse treatment in order to receive housing is ineffective.
glopmod t1_j9h4zt9 wrote
Did he state that?
Blue_5ive t1_j9h5i1q wrote
I took the linked and other comments as implying that housing was the better first step than rehab https://reddit.com/r/washingtondc/comments/118eh0l/_/j9gtr25/?context=1
I’m just looking for sources on the claims people make because this is a highly complicated issue. Any data or studies on it is interesting and people throwing out random facts in these threads should be able to back it up like op does.
celj1234 t1_j9gv27w wrote
I don’t have one. Homelessness will always exist for my lifetime in this city. But I deff don’t want my tax dollars going to fund crack house shelters.
SnortingCoffee OP t1_j9gv8hi wrote
what if it cost fewer tax dollars to house people than it does to let people live on the street?
Also why do you think the problem is unsolvable when so many other major cities around the world don't have this problem?
[deleted] t1_j9gyj8z wrote
[deleted]
glopmod t1_j9h4wkx wrote
"I don't have solutions but the problem can't be solved and I don't want my money-"
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It's not your money.
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