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Comment by stubybubs | Hacker News Reader

West Coast city stuff then. It's everywhere.

I'm convinced there isn't any kind of immediate solution to these problems. Not that we should give up on mental health and addictions treatment. I just think the solution is way broader. Reduce income inequality, improve schools, keep up the drug treatment so the children of people with drug problems stand a chance, better research about when opiate prescriptions are appropriate (like 24 hours post surgery at most then just acetaminophen), universal healthcare and childcare to stop people falling into poverty... Then wait a good 20 years for those things to ripple through society.

I know HN loves solutioning and grand projects, but at least consider that this isn't always the way. Consider the article from a couple of days ago about letting ACL tears heal on their own rather than doing surgery. You cannot engineer your way out of everything and often it makes things worse.

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> keep up the drug treatment so the children of people with drug problems stand a chance

The current "treatment" is to hand out free drug paraphernalia and what has been proposed in cities like SF and Seattle are taxpayer-funded "safe injection sites" fully staffed with nurses. An analogy would be to try and cure a rat problem by sitting on a park bench tossing them pieces of bread. It's irrational and it doesn't work.

The obvious solution with rats is just to kill them, but people aren't rats, so the analogy doesn't work. Safe injection sites are intended to stop people from dying and reduce the spread of communicable diseases, because people are worth trying to save.

The problem being inherently human, you have to come up with solutions that at the very least treat them as such.

This approach sounds a lot like treating a heart attack with diet and exercise. Sure diet and exercise are great, but they’re not what’s indicated while you’re keeling over. First fix the acute problem and then look work on reducing recurrence afterwards.

And of course there is an immediate solution: remove the people violating the social contract from society at large. It’s up to the people of San Francisco to either find a politically palatable way to do that or continue to live in a kind of fecal anarchy.

Edit: in case it’s not clear I’m not euphemistically suggesting incarceration as the only option, although it is one. Some kind of supervised halfway house SRO type thing would be another option among many. Drug rehabilitation also.

That's just it, I don't think you can do that. The equivalent of acute treatment for an MI in homelessness would be coralling them elsewhere or removing them from the city and replacing them with known good humans harvested from elsewhere.

Probably how NYC recovered from the 70s and 80s is instructive, or the decades long overall decline in violent crime in major cities. SF for all the crap it gets is still near an all time low in violent crime. Was it acute treatments, or did general conditions just change?

San Francisco also needs to make housing a lot cheaper by building way more of it, including marginal options like SROs. So much of the disorder you see on streets of wouldn't be happening in public if housing wasn't insanely expensive to the point of people needing a good steady job lest they become homeless.

Not heart attacks, but the issue with CPR is that outcomes after it are really bad. You can do interventions, but the five-year outlook isn't good for ~90% of people needing CPR.

In other words, it's a lot of work to get the a homeless addict to be a net-neutral for society, if that's even possible.

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