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Comment by ihaveajob | Hacker News Reader

SF doesn't rank anywhere near the top in terms of drug use/overdoses, a title merited by some Midwest cities such as Omaha. This would clearly invalidate the drug-addiction -> homelessness cause and effect.

The data I've seen points in the other direction: A majority of homeless drug addicts started using AFTER they became addicts. I imagine once you're at the bottom and have little hope to improve, it's easy to give in to abandon.

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In other words: In cities with cheap housing, even the drug addicts can afford a home, which is a GOOD thing IMO. For everybody, homeless and housed.

Agreed! It’s not like none of the homeowners or folks in luxury apartments in SF are using recreational drugs, they are just doing it in private because they can.

Yep, this is what I saw when I moved from the worst schooling filter district in GA to the best in the state. AFAICT wealthy people use drugs more than poor people, as drugs cost nontrivial amounts of money. Wealthy people just have safety nets that allow them to take greater risks.

Wealthy people can also avoid the cheap crappy fentanyl that is in mass circulation right now. Fentanyl is a huge problem for the unhoused here in Seattle, many of them are probably beyond rehabilitation and will require lots of help for the rest of their lives, it is really sad.

To some degree. More and more coke is being cut with fent. The dealers cutting coke with some other upper still want it to numb your nose, so they add something like lidocaine or increasingly fent as well.

Rich people are abusing opioids, Ritalin, Aderall, ecstasy. They are more likely to avoid meth and fent, and pay for quality (though you are right, they can be cheated). The homeless are much more vulnerable to bad drugs that have worse long term effects, especially conditions that are often associated with mental illness.

I've actually seen rich people go out of their way to get fent more than poor people. Once they know what it is, they appreciate the purity of the opioid. Additionally more and more MDMA sold actually isn't but is instead some analog that happens to pass reagent tests with unknown long term effects, which hits rich people as well.

Spokane used to be like that, it still is to some extent. My grandfather used to own/run what would be called a flop house (we called it "the empty arms"). Definitely this makes some neighborhoods very sketchy, but not that many homeless around (the ones that can't get housing get on the bus to Seattle or Portland since you can't really live outside in Spokane in the winter).

But even Spokane has been changing...the flop houses of old are mostly being redeveloped, housing is becoming not so cheap anymore.

San Francisco has the second highest overdose rate in the US behind Harris County. Please be more careful when sharing information.

https://www.sfchronicle.com/projects/2021/san-francisco-drug...

That article only looks at 10 counties: "Of the 10 places we examined, San Francisco had the second highest overdose rate in 2020 after Harris County, which contains the city of Houston."

If you look at more data, you see that even in California (https://www.countyhealthrankings.org/app/california/2021/mea...), SF is not at the top (Lake, Mendocino and Inyo rank higher). I'm not saying drug use is not a problem in SF. I'm just saying it's not the primary reason why we have a big homeless problem.

That said, compare with Ohio (https://www.countyhealthrankings.org/app/ohio/2021/measure/f...) where there are dozens of counties that more than double SF's overdose rate. And still, their homelessness rate is a fraction of California's.

looks like there must be some serious differences in methodology between these 2 sources.

sfchronicle has the overdose death rate for:

SF at 61 per 100k

Humboldt at 31 per 100k

Cited from Cali Dept of public health

CountryHealthRankings has:

SF at 23 per 100k

Humboldt at 32 per 100k

It's possible, I haven't looked into the details. But so far I'm yet to see a national study that puts SF anywhere near the top. It's just more visible because addicts are on the street, compared to other metros.

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