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Comment by finexplained | Hacker News Reader

I really don't understand why this wasn't done years ago.

> is concerned that the emergency declaration is being used to support her plan for more policing in the neighborhood, which could criminalize people with substance use disorders before resources such as the supervised drug-use site or a planned drug sobering center open.

Honest question. Is a supervised drug-use site an effective approach for reducing drug use long term? Does it help get people into services that help them deal with addiction? Or is it just meant to supervise potential overdoes and intervene?

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The primary goal is harm reduction: fewer deadly overdoses, less disease (HIV) transmission due to needle sharing and less needles discarded on the street.

The site where I live can also provide some help for people who want to get off drugs and off the street, but the addict must want to do that.

I can’t speak to how effective that help actually is, but the harm reduction part certainly works.

Are there any estimates of the degree to which policies like these increase the rate of drug use as opposed to just reducing the danger for existing users?

Are people surprised that subsidizing drug use seems to attract more drug use?

>The first several years of evaluation have yielded an array of scientific outputs, including more than 30 peer-reviewed studies describing the program’s impacts. These publications indicate that Insite provides a range of benefits to its clients and the greater community, including a reduction in public injecting, lower levels of HIV risk behaviours (e.g., syringe sharing), and an increase in uptake of addiction treatment among the facility’s clients. Furthermore, studies seeking to identify potential harms of the facility found no evidence of negative impacts. Studies were independently peer-reviewed and published in top scientific periodicals, including the New England Journal of Medicine, The Lancet and the British Medical Journal.

Emphasis mine.

From https://www.bccsu.ca/wp-content/uploads/2016/10/insite_repor...

>the harm reduction part certainly works.

Certainly? Goals and outcomes are different though. Is there any evidence that SF's policies are having positive outcomes? It seems like all the statistics show it the opposite. Overdoses are up, crime is up--so who is this really helping? The skeptic in me thinks it's a nice way for the government to just give up on people even more but under a kinder veil of "harm reduction". SF is closer to Ancapistan than it is any progressive utopia.

Certainly. But I wasn't speaking about SF, I was speaking about Vancouver.

>The first several years of evaluation have yielded an array of scientific outputs, including more than 30 peer-reviewed studies describing the program’s impacts. These publications indicate that Insite provides a range of benefits to its clients and the greater community, including a reduction in public injecting, lower levels of HIV risk behaviours (e.g., syringe sharing), and an increase in uptake of addiction treatment among the facility’s clients. Furthermore, studies seeking to identify potential harms of the facility found no evidence of negative impacts. Studies were independently peer-reviewed and published in top scientific periodicals, including the New England Journal of Medicine, The Lancet and the British Medical Journal.

From https://www.bccsu.ca/wp-content/uploads/2016/10/insite_repor...

How could SF give up on people any more than it already has?

It had to get really bad first to manufacture popular consent for all the fun new surveillance we’re about to be subjected to :/

Nah, the existing ordinance already allows the surveillance she referred to and this is just theatre

Regan passed a bunch of bills as Governor that basically disbanded mental health care for the homeless.

Since it’s illegal to stick them in a drug rehab clinic, mandatory counseling sessions, or even force them back on their meds (with their prior written consent), all that’s left is putting them out of the public eye while they get high, I guess.

Or, maybe we could just switch the law back to what it was in 70’s.

> Regan

Reagan

> passed a bunch of bills as Governor

Governors don't unilaterally “pass bills”. They sign (or veto) bills passed by the legislator.

> that basically disbanded mental health care for the homeless.

Deinstitutionalization was a bipartisan, national phenomenon driven in large parts by abuse scandals in institutions.

>Reagan

This matters because Donald Regan was a guy who worked for Ronald Reagan.

>Deinstitutionalization was a bipartisan, national phenomenon driven in large parts by abuse scandals in institutions.

Not just scandals in the sense of individual acts, but changes in thinking about patient rights. For example, eugenic sterilization started as policy more than rogue abuse, and was still going on as late as the 1970s. I think the laws about institutionalizing people against their will were changed.

No doubt saving money was a factor, but lots of factors coincided, largely because people wanted to reform the system as society had changed.

> Not just scandals in the sense of individual acts, but changes in thinking about patient rights.

The two are linked, there was an absolute wave of scandals in the sense of abusive (often systematic rather than individual) acts in particular institutions that were instrumental in getting people to rethink patient rights; without them, the institutionalized would probably have remained out of sight and out of mind.

> legislator

legislature

Were these law irrevocable? If not, every governor and state legislature since then are also complicit.

The laws were not. The judicial decisions that made it far more difficult to hold people against their will - which ultimately drove a lot of deinstitutionalization; the asylums were closed mostly as a response, not a cause - are effectively irrevocable.

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