The same thing has been happening in SF with homelessness. A lot of people think they should go to prison or be displaced somewhere else. It’s like refusing to accept that there’s a root cause.
See: https://www.sfchronicle.com/projects/2021/rescuing-jessica-s...
This person has no interest in treatment. They want to do drugs and take advantage of what’s provided to keep doing that.
You can’t fix that with hotels. You either need to require treatment or imprison (paired with arresting dealers).
On the more progressive end, maybe drug clinics that administer drugs to addicts for free onsite (to crash the dealer market while you’re going after them). Eventually you have to force a choice. The do drugs openly while living in a tent on the street can’t be an option.
What happens when you bust a drug ring and arrest some big players? You immediately create a power vacuum, which leads to a turf war where other players (in the gang or between gangs) start jockeying for power, spreading their mayhem across the area.
The only solution here is legalization, treatment, and general social welfare.
That last one is what makes the gang bangers go away, but it's a long process.
Arrest the dealers and administer the drug to addicts for free at clinics? I think that would be an interesting approach.
I'm not a policy expert. I used to agree with you, but I think part of the issue is trivial access to drugs (see the tenderloin). It's harder for addicts to quit when it's very easy to get the drug (whether that's via dealers or legalization) and the city helps to enable you (hotel shelters, etc.) I understand the good intent and compassion, but a lot of bad policy on the left starts with good intent and ends with unanticipated bad consequences. Cities with arguably crueler enforcement don't have these issues (San Mateo). SF attracts addicts because they know it's lax and drug access is easy. Pair that with NIMBY housing policy and it's very hard to get housed and off of drugs.
I'd argue the SF approach to this has been a failure, London Breed's recent speech on the topic is something I agree with. The equilibrium we're trapped in is bad. We need to force a choice and that choice is likely either treatment or prison.
I mean, it's a national crisis. It's easy to point the zits on my face but the problem is in what I eat.
Most people don't develop debilitating drug addictions without underlying problems. Even most people with drug addictions don't get to a point where they can't hold down a job or have a need to carry out crime to fund it, but of those who do it's worth considering why when e.g. a typical heroin addict can hold down a job and could have funded their addiction for ~$20/day if they had access to clean, medical grade heroin (we know the price, because e.g. the UK NHS buys medical grade heroin for use for post-operative pain management - under the generic name diamorphine).
So there's a long path there from failure to address mental health issues and other social problems, via failure to provide safe, clean supplies and early intervention for those who still get addicted to drugs, failure to regulate healthcare properly (e.g. the prescription oxy -> black market oxy -> heroin recruitment path), and failure to ensure availability of jobs, and lacking welfare options, before worrying about treatment and emergency housing is even in the picture.
Start addressing root causes and a lot of the problems later in that chain would either go away or at least be substantially diminished.
Here are some pages covering various uses by the NHS
Most relevant to the point I made, here is a pricing page for diamorphine for the NHS[1].
Use during birth: [2]
"This is an injection of a medicine called pethidine into your thigh or buttock to relieve pain. It can also help you to relax. Sometimes, less commonly, a medicine called diamorphine is used."
Use in NHS Scotland [3]: "Unlicensed intranasal diamorphine has been used in the NHS in Scotland for the treatment of severe pain in children in the emergency setting. The availability of diamorphine hydrochloride nasal spray (Ayendi®) provides a licensed preparation."
Article on recent-ish supply problems[4] due to a problem at one of the manufacturers:
"NHS trusts forced to use ‘expensive’ pre-filled diamorphine syringes to manage ongoing supply issues
Exclusive: Birmingham Women’s and Children’s NHS Foundation Trust has had to source pre-filled diamorphine syringes from other NHS trusts to meet demand."
NICE advice on diamorphine use [5] lists indications and doses for acute pain, chronic pain not currently treated with a strong opioid analgesic, acute pulmonary oedema, myocardial infarction.
NHS patient information (word doc) [6] on the shortage: "Diamorphine is licensed to treat severe pain associated with surgery, heart attack or a terminal illness. It is also used for the relief of shortness of breath in severe heart conditions. In addition, a small number of people in the UK may be receiving diamorphine to manage heroin addiction."
So while I have no idea about the actual volume of use, as you can tell the NHS has suppliers, and NICE has a price list.
[1] https://bnf.nice.org.uk/medicinal-forms/diamorphine-hydrochl...
[2] https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/p...
[3] https://pharmaceutical-journal.com/article/news/nhs-trusts-f...
[4] https://www.scottishmedicines.org.uk/medicines-advice/diamor...
[5] https://bnf.nice.org.uk/drug/diamorphine-hydrochloride.html#...
[6] https://www.england.nhs.uk/south/wp-content/uploads/sites/6/...
We need to clean up the mess and prevent more being added at the same time.
It is not like we can only do either preventive or reactive.
You want to arrest people for being homeless?
That is an interesting idea. All kinds of ethical issues for handing out free heroin, but why not take all the confiscated drugs, test them for safety and hand them out for free at clinics with some damage-reduction safe guards like daily per-person limits, offer rehab and mental health services, etc? Turn addicts into informants without even trying, because if they rat out dealers, the dope is free. I doubt users have the long-term awareness to see that it eventually reduce supply.
Making it harder for addicts to get heroin or a replacement will only increase the energy they will spend on getting it. This makes it nearly impossible to get to a better place in their life. It is mostly getting the drug that has a negative effect on holding down a job, not the drug itself.
My sister was a functional alcoholic for 25 years. When she started heroine, everything changed, and she overdosed within 2.
She couldn't have been a functional alcoholic for 25 year if alcohol were an illegal substance.
There are plenty of people who have a normal life on methadone or heroin if it is provided to them.
As already stated, if you are an addict, getting the substance is the highest priority. Making it harder to get just makes them use more of their resources to get them.
It depends on the definition of "worse". If cell death over time, then maybe alcohol is worse. If it's how much a recreational/entertaining dose disturbs the workings of the mind, the operation/rational/ability to live a normal life, which is the purpose of the mind, then I would say heroin is worse.
I would assume the amount of dopamine a drug releases is directly related to its ability to disrupt someones life.
“Why do they do it? Radical anti-system ideology. “There’s a San Francisco Coalition on Homelessness hat which says, ‘Coalition on Homelessness: On The Frontlines of Class Warfare,’” said the insider. “They feel like they’re fighting class warfare. They tell people to not take shelter.””
https://michaelshellenberger.substack.com/p/san-francisco-ho...
Didn't seem like that bad of a life while it lasted, being in the tourist areas crime was never bad enough to be afraid for your safety, you had bleeding heart church groups that would regularly come by the camps to hand out food and clothing. All the while you can sell and doing drugs in the open.
out of sight out of mind
Later in life I was a missionary, and we saw a dude in homeless attire get out of a nice Mercedes. He saw us as well and told us his story about making bank begging in front of a bank, showed us the $$$ suits stashed in his trunk, told us about his high end "compound" where he lived.
Then of course there was the guy who would block the sidewalk in front of a previous workplace in SF and harass any people passing by who didn't give him money.
There are many cases of people either straight up abusing the system, or acting in ways that will destroy the system.
The more of this there is -- the visible, abusive begging and taking over of shared public spaces -- the less empathy people will have for the invisible homeless who aren't causing trouble and will actually benefit from help.