How Albuquerque helped its homeless population and saved money in the process

If I check my comments frequently enough I sometimes notice oscillations. That one was voted up once, then down twice, then I didn't check for a while. 2 people have since appeared to cancel out those two downvotes.

After I posted that comment I thought about editing it to say something about how the nicer weather is "in addition to the state's services...".

Perhaps some of the downvoters thought I was disagreeing with the comment I was replying to, whereas I actually meant to supplement his/her good points with my experiences.

Edit: changed his to his/her.

I know it's anecdata, but my experience is that there are a fair number of borderline cases where they can't hold it together sporadically, but the meds definitely lower the quality of the "good days" to fix that. Sometimes there's a fast acting med that can work; often there's not and patients are faced with a stark choice.

I think we see a lot more homelessness in that group of people than we should, because we basically trap them there after one or two episodes, even though if we fixed it and got them some help (usually better coping techniques; occasionally meds), we'd see a lot less homelessness.

I do think that meds have become a substitute for real coping technique teaching, and that in many of those cases, the caregiver isn't making the optimal choice for the patient, because they're optimizing cost or time invested, rather than long-term quality of life.

There are obviously things like hardcore schizophrenia where that isn't the case, but even for more sporadic delusion disorders, it can be.

The term for psychosis which is worsened by its treatment is Supersensitivity psychosis, or tardive psychosis [0]. I think it originated in the early 1980's. Whitaker references some of the early studies in 'The Case Against Antipsychotics' (link in several of my earlier comments).

[0] https://en.wikipedia.org/wiki/Tardive_psychosis

There is no controversy that some psychotic presentations are caused by alcohol, cocaine and meth amphetamine, and other substances [1]. Emergency departments typically test for substances, and also for urinary tract infections.

[1] https://en.wikipedia.org/wiki/Substance-induced_psychosis

When the cause of a psychotic presentation is determined, the psychosis is said to be 'secondary' to its cause. If no cause is determined, the psychosis is said to be 'idiopathic' [2]:

  Finally, we discuss how careful studies of secondary 
  psychotic disorders can help elucidate the 
  pathophysiology of primary, or idiopathic, psychotic 
  disorders such as schizophrenia.

> but when you look at a persons total ability to function and their global quality of life, antipsychotic medications are helpful.

When I met my friend, I figured she was "high as a kite", because she fluttered from topic to topic like a butterfly. I gradually learned that she really was supplementing her methadone (an opiate) with cocaine, and a constant dose of alcohol.

At the time, I didn't know anything about psychosis. But looking back, I now recognize that were times that she became psychotic due to cocaine, and that she recovered with sobriety.

Methadone is known to cause sugar cravings, but I think it also contributed to the 2-bottle-a-day liquor habit she developed after a month on the drug.

When my friend ran out of alcohol, she became profoundly psychotic. The hospital she was taken to used anti-psychotics. But these drugs were not indicated because they do not treat the cause of the presenting symptom (they found cocaine metabolites, and ought to have found evidence of alcohol use, which I think can be detected at up to 3 days).

There was a story submission here about how cocaine destroys mitochondria. I think this is fairly well-established. Today there's this:

Frequent sauna bathing can reduce the risk of dementia (sciencebulletin.org) - https://news.ycombinator.com/item?id=13204396

Dementia is the name for a type of psychosis, when it is experienced by old people [3]. Sauna bathing is good for dementia because it supports the metabolism. Old people frequently become cold, which indicates poor metabolism, and reduced ATP (energy molecule used by cells to power everything).

[3] http://www.medscape.com/viewarticle/564899_3

From my observations, anything that helps the metabolism is also good for psychosis.

Neuroleptics (so-called "Anti-psychotics") are palliative medications that just slow people down to match their reduced energy capacity. They hurt people, and should all be withdrawn from use, in favor of treating the cause of their condition.

Edit: Adding a link to "Psychosurgery as Brain-disabling Therapy" [4], for my own future reference:

  Psychosurgery merits special attention 
  because, as the prototype of brain-
  damaging therapeutics, it can shed
  light on the clinical effects of other
  brain-disabling treatments such as
  electroconvulsive therapy (ECT) and
  the major tranquilizers [aka neuroleptics -tcj_phx].

One gets the feeling that it's a more egalitarian city than other US metro areas. I didn't feel like it was that racist of a city, certainly nothing compared to Pittsburgh, where I now live.

And there are very few establishments that are designed exclusively for the wealthy. The Frontier restaurant near UNM is a great example of what I'm talking about. You would regularly see news anchors, professors, doctors, etc. dining there in the same room as people who were homeless.