Oregon's experiment to curb overdoses
August 3, 2023 6:26 AM Subscribe
“At four in the afternoon the streets can feel like dealer central,” Funding for Measure 110’s promise of increased services comes from Oregon’s marijuana tax revenues. After a slow start, more than $265 million has flowed to programs that try to make drug use safer by providing clean needles and test strips, offer culturally specific peer support and provide shelter for people newly in recovery. But residential treatment for addiction has yet to be substantially expanded.
archive link
Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies.
Although postdecriminalization usage rates have remained roughly the same or even decreased slightly when compared with other EU states, drug-related pathologies — such as sexually transmitted diseases and deaths due to drug usage — have decreased dramatically. Drug policy experts attribute those positive trends to the enhanced ability of the Portuguese government to offer treatment programs to its citizens — enhancements made possible, for numerous reasons, by decriminalization.
archive link
Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies.
Although postdecriminalization usage rates have remained roughly the same or even decreased slightly when compared with other EU states, drug-related pathologies — such as sexually transmitted diseases and deaths due to drug usage — have decreased dramatically. Drug policy experts attribute those positive trends to the enhanced ability of the Portuguese government to offer treatment programs to its citizens — enhancements made possible, for numerous reasons, by decriminalization.
how much housing would a quarter of a billion dollars buy. fuck these half measures. get folks off the street so they can get safe, clean, and start to build a life again.
posted by seanmpuckett at 7:11 AM on August 3, 2023 [16 favorites]
posted by seanmpuckett at 7:11 AM on August 3, 2023 [16 favorites]
Decrim without funding substantial (and mandatory) treatment doesn’t seem like it’s reducing human suffering.
I think it’s moving the human suffering from the shadows and prisons to in front of peoples faces.
Also mandatory treatment doesn’t work. People have to chose to quit. They need a better alternative than being high / numb to the world. They need help available but forcing help on somebody doesn’t make things better.
posted by Uncle at 7:14 AM on August 3, 2023 [30 favorites]
I think it’s moving the human suffering from the shadows and prisons to in front of peoples faces.
Also mandatory treatment doesn’t work. People have to chose to quit. They need a better alternative than being high / numb to the world. They need help available but forcing help on somebody doesn’t make things better.
posted by Uncle at 7:14 AM on August 3, 2023 [30 favorites]
WaPo: Once hailed for decriminalizing drugs, Portugal is now having doubts
posted by gwint at 7:46 AM on August 3, 2023 [1 favorite]
posted by gwint at 7:46 AM on August 3, 2023 [1 favorite]
If you fancy a review of some of the recent national gawking at Portland, our local alt-weekly has you covered. Since the NYT piece came out after that article was published they made an update.
posted by Dr. Twist at 8:09 AM on August 3, 2023 [13 favorites]
posted by Dr. Twist at 8:09 AM on August 3, 2023 [13 favorites]
NY Times: The Hard-Drug Decriminalization Disaster
But the sticky fact that proponents of decriminalization rarely confront is that addicts are not merely sick people trying to get well, like cancer sufferers in need of chemotherapy. They are people who often will do just about anything to get high, however irrational, self-destructive or, in some cases, criminal their behavior becomes. Addiction may be a disease, but it’s also a lifestyle — one that decriminalization does a lot to facilitate.
I call bullshit on this and also on the revision of the Portugal story. The problems in Portugal are nothing like what they were before decriminalization. There has definitely been a reduction of governmental funds for the support programs, and of course it is no longer the shiny thing of the day, and of course there are still drug users and addicts, and of course Portugal is a hub for drug trafficking thanks to its location & coastline, but no, there's really no national reconsideration of the policy on the horizon, because it seems to work, better than the alternatives.
Harm reduction – the current situation in Europe (European Drug Report 2023)
20 years of Portuguese drug policy - developments, challenges and the quest for human rights
posted by chavenet at 8:12 AM on August 3, 2023 [18 favorites]
But the sticky fact that proponents of decriminalization rarely confront is that addicts are not merely sick people trying to get well, like cancer sufferers in need of chemotherapy. They are people who often will do just about anything to get high, however irrational, self-destructive or, in some cases, criminal their behavior becomes. Addiction may be a disease, but it’s also a lifestyle — one that decriminalization does a lot to facilitate.
I call bullshit on this and also on the revision of the Portugal story. The problems in Portugal are nothing like what they were before decriminalization. There has definitely been a reduction of governmental funds for the support programs, and of course it is no longer the shiny thing of the day, and of course there are still drug users and addicts, and of course Portugal is a hub for drug trafficking thanks to its location & coastline, but no, there's really no national reconsideration of the policy on the horizon, because it seems to work, better than the alternatives.
Harm reduction – the current situation in Europe (European Drug Report 2023)
20 years of Portuguese drug policy - developments, challenges and the quest for human rights
posted by chavenet at 8:12 AM on August 3, 2023 [18 favorites]
They need a better alternative than being high / numb to the world. They need help available but forcing help on somebody doesn’t make things better.
Homelessness and drug addiction are symptoms of despair.
Can we have a war on despair? I don’t know how that would work but son-of-a-gun I’d sure like to try.
posted by neuracnu at 8:14 AM on August 3, 2023 [36 favorites]
Homelessness and drug addiction are symptoms of despair.
Can we have a war on despair? I don’t know how that would work but son-of-a-gun I’d sure like to try.
posted by neuracnu at 8:14 AM on August 3, 2023 [36 favorites]
The human condition is not pretty and Portland's (and ODOT's) policies of sweeps and adversarial architecture barely qualify as half-measures. House people! Bring services to them instead of concentrating them around downtown!
I grew up in Portland when the heroin crisis was starting to get really visible, but housing was a lot more affordable back then. It got worse when more and more people on the margins were forced out of their homes. Does anyone else remember walking around huge piles of orange needle caps on the MUPs? I think that really started in 2017/2018. It feels like the intention behind government policy is always to make the addicted person feel guilt/shame for the burden they're imposing or whatever vs. finding ways to humanize them. You know what really drives home that feeling of shame? Being treated like the 'other'.
posted by tmt at 8:14 AM on August 3, 2023 [5 favorites]
I grew up in Portland when the heroin crisis was starting to get really visible, but housing was a lot more affordable back then. It got worse when more and more people on the margins were forced out of their homes. Does anyone else remember walking around huge piles of orange needle caps on the MUPs? I think that really started in 2017/2018. It feels like the intention behind government policy is always to make the addicted person feel guilt/shame for the burden they're imposing or whatever vs. finding ways to humanize them. You know what really drives home that feeling of shame? Being treated like the 'other'.
posted by tmt at 8:14 AM on August 3, 2023 [5 favorites]
I voted for 110; and I still stand by it. I would rather our governments fix this under that framework, than to return to the alternate punitive criminalization. I agree treatment, housing, and more government support should be of utmost urgency and funding. I believe harm reduction supplies and narcan (and jesus christ, just garbage cans and toilets unhoused folks) should be everywhere and widely available. Once we solve the housing for everyone issue, then we can start tackling these problems much more effectively. We really can't do one without the other; without solving housing, neither criminalization or decriminalization will 'work' well.
I'd also like to say, that it's been really popular to just bag on Portland for how 'bad things have gotten,' since decriminalization, but this doesn't reflect the full reality. It's still a vibrant place with good folks. I live in a highish crime (I guess?), white-minority, high visible-homeless population area of the city, but even just this weekend, while I was walking my dogs at a local park (with lots of unhoused people living nearby, many of whom were doing hard drugs openly), and had to pass a couple mutual aid food stations set up by private citizens. A neighbor had set up a block party closing the road to have a DIY lofi opera. A huge family was celebrating a quinceañera, and getting down! Folks were walking their dogs and playing pickle-ball. A volunteer group was giving out narcan, and making sure that everyone living near the park had access to life saving meds. It's not a perfect place, nowhere is, but it is still a good place.
And again, I'd rather my home and city fix these problems than the problem of incarceration and repeated police involvement. I haven't seen a cop in my neighborhood in months; that's not a bad thing.
posted by furnace.heart at 8:29 AM on August 3, 2023 [59 favorites]
I'd also like to say, that it's been really popular to just bag on Portland for how 'bad things have gotten,' since decriminalization, but this doesn't reflect the full reality. It's still a vibrant place with good folks. I live in a highish crime (I guess?), white-minority, high visible-homeless population area of the city, but even just this weekend, while I was walking my dogs at a local park (with lots of unhoused people living nearby, many of whom were doing hard drugs openly), and had to pass a couple mutual aid food stations set up by private citizens. A neighbor had set up a block party closing the road to have a DIY lofi opera. A huge family was celebrating a quinceañera, and getting down! Folks were walking their dogs and playing pickle-ball. A volunteer group was giving out narcan, and making sure that everyone living near the park had access to life saving meds. It's not a perfect place, nowhere is, but it is still a good place.
And again, I'd rather my home and city fix these problems than the problem of incarceration and repeated police involvement. I haven't seen a cop in my neighborhood in months; that's not a bad thing.
posted by furnace.heart at 8:29 AM on August 3, 2023 [59 favorites]
Can we have a war on despair? I don’t know how that would work but son-of-a-gun I’d sure like to try
I am having a hard time finding the exact studies or articles on this, but OHSU just started straight up housing their 'frequent fliers' in their ER, because it was cheaper. They now invest in low-income housing, because (let's not mince this shit; it isn't charity) it is good for their bottom line. They found that this lowers their costs of treating uninsured unhoused folk in an ER setting repeatedly, instead giving wrap-around services to them.
It is cheaper for governments, taxpayers, and private business to just fuckinghouse folks, than to punish them for being homeless. Once that is dealt with, actual treatment of addiction can even be approached. This is one of those hill's I'll pretty much die on.
posted by furnace.heart at 8:41 AM on August 3, 2023 [41 favorites]
I am having a hard time finding the exact studies or articles on this, but OHSU just started straight up housing their 'frequent fliers' in their ER, because it was cheaper. They now invest in low-income housing, because (let's not mince this shit; it isn't charity) it is good for their bottom line. They found that this lowers their costs of treating uninsured unhoused folk in an ER setting repeatedly, instead giving wrap-around services to them.
It is cheaper for governments, taxpayers, and private business to just fuckinghouse folks, than to punish them for being homeless. Once that is dealt with, actual treatment of addiction can even be approached. This is one of those hill's I'll pretty much die on.
posted by furnace.heart at 8:41 AM on August 3, 2023 [41 favorites]
While this isn't quite as egregious as some of the NYT's other parachute disaster reporting about Oregon, it still leaves the reader with the idea that the fentanyl epidemic is unique or even especially severe in Portland. It isn't. Wherever you live, people are suffering and dying. Here it's just happening in public.
There have been several stories about Oregon's addiction crisis and decriminalization experiment in the past month. I thought Jack Holmes' story in Esquire painted a fuller picture than the Times' disaster tourism. Curiously, the Times is also publishing some of the best reporting on addiction and homelessness out there, by Eli Saslow, who happens to live in Portland. No idea why they haven't had him cover his home turf. Our local public radio station and alt-weekly have also published good reporting on the crisis.
I don't want to minimize the severity of the situation in Oregon. I work in downtown Portland, and I often pass a dozen passed-out users in the five short blocks between my bus stop and the front door. Last week there was a huge blood stain at the bus stop. Yesterday I saw a man with his pants around his ankles lying on the ground, his legs in the street, screaming. People just walked around him. A block away, in a public square, there were a mix of people eating lunch from trucks, people participating in a public yoga class, and people smoking fentanyl off tinfoil. Our office admin, a small woman, has been chased by shouting men twice so far this year. She recently skipped lunch because the front door was blocked by a woman slashing her head with a razor.
I don't believe for a moment that people are using and dying from fentanyl in Oregon because we decriminalized addiction. The crisis was already in motion before Measure 110 was even on the ballot. But the lack of criminal penalties has made the situation more visible than it is most places.
The same misery is happening in every city. If Oregon is unique, it is in the baffling failure of our public institutions to get so much as a single detox center up and running in the past 3 years. As a result, public opinion of decriminalization is extremely poor, and the experiment is likely to end soon. Last month, the Oregon legislature recriminalized possession of fentanyl. I expect other punitive measures will come next year.
posted by Just the one swan, actually at 8:46 AM on August 3, 2023 [25 favorites]
There have been several stories about Oregon's addiction crisis and decriminalization experiment in the past month. I thought Jack Holmes' story in Esquire painted a fuller picture than the Times' disaster tourism. Curiously, the Times is also publishing some of the best reporting on addiction and homelessness out there, by Eli Saslow, who happens to live in Portland. No idea why they haven't had him cover his home turf. Our local public radio station and alt-weekly have also published good reporting on the crisis.
I don't want to minimize the severity of the situation in Oregon. I work in downtown Portland, and I often pass a dozen passed-out users in the five short blocks between my bus stop and the front door. Last week there was a huge blood stain at the bus stop. Yesterday I saw a man with his pants around his ankles lying on the ground, his legs in the street, screaming. People just walked around him. A block away, in a public square, there were a mix of people eating lunch from trucks, people participating in a public yoga class, and people smoking fentanyl off tinfoil. Our office admin, a small woman, has been chased by shouting men twice so far this year. She recently skipped lunch because the front door was blocked by a woman slashing her head with a razor.
I don't believe for a moment that people are using and dying from fentanyl in Oregon because we decriminalized addiction. The crisis was already in motion before Measure 110 was even on the ballot. But the lack of criminal penalties has made the situation more visible than it is most places.
The same misery is happening in every city. If Oregon is unique, it is in the baffling failure of our public institutions to get so much as a single detox center up and running in the past 3 years. As a result, public opinion of decriminalization is extremely poor, and the experiment is likely to end soon. Last month, the Oregon legislature recriminalized possession of fentanyl. I expect other punitive measures will come next year.
posted by Just the one swan, actually at 8:46 AM on August 3, 2023 [25 favorites]
In the last year I have seen Vancouver and Portland's issues as a tourist from Los Angeles. I thought I was
"tough" enough to not be shocked. I was wrong. Vancouver FLOORED me when I walked through an open drug market with people openly smoking heroin/ fentanyl everywhere.
It reminded me of being in New York City during the late 80s / early 90s with crack.
At what point do we realize that most of the great, noble ideas don't work against such a highly addictive drug. There is no harm reduction when a dose can easily kill you. When one puff in and your brain chemistry has been rewired. Theory is no match for anything this powerful.
There has to be policy, enforcement, and participation from landlords -
-Policy such as Janet Yellen's attempts to stop money laundering (Gift link NYT - read for the part on ending shell companies buying real estate)
-re-Criminalize opiate drug dealing and seize assets on a syndicate level
-Create programs that keep people in their current housing instead of allowing them to fall through to the streets
I think the "decriminalization of addiction" is an awesome concept but it doesn't work for opiates. There is MASSIVE proof that allowing the decriminalization of addiction leads to a situation of humans living in absolute hellish squalor that lacks any sort of dignity. True dignity is to create a non-criminal addiction legal class code that "sentences" people to a rehab we haven't invented yet/ doesn't exist if they have fallen below the
posted by Word_Salad at 9:15 AM on August 3, 2023 [6 favorites]
"tough" enough to not be shocked. I was wrong. Vancouver FLOORED me when I walked through an open drug market with people openly smoking heroin/ fentanyl everywhere.
It reminded me of being in New York City during the late 80s / early 90s with crack.
At what point do we realize that most of the great, noble ideas don't work against such a highly addictive drug. There is no harm reduction when a dose can easily kill you. When one puff in and your brain chemistry has been rewired. Theory is no match for anything this powerful.
There has to be policy, enforcement, and participation from landlords -
-Policy such as Janet Yellen's attempts to stop money laundering (Gift link NYT - read for the part on ending shell companies buying real estate)
-re-Criminalize opiate drug dealing and seize assets on a syndicate level
-Create programs that keep people in their current housing instead of allowing them to fall through to the streets
I think the "decriminalization of addiction" is an awesome concept but it doesn't work for opiates. There is MASSIVE proof that allowing the decriminalization of addiction leads to a situation of humans living in absolute hellish squalor that lacks any sort of dignity. True dignity is to create a non-criminal addiction legal class code that "sentences" people to a rehab we haven't invented yet/ doesn't exist if they have fallen below the
posted by Word_Salad at 9:15 AM on August 3, 2023 [6 favorites]
Sounds like "scared straight" programs worked on people, what with the shocking amount of forced treatment boosterism in this thread?
posted by sagc at 9:22 AM on August 3, 2023 [6 favorites]
posted by sagc at 9:22 AM on August 3, 2023 [6 favorites]
When one puff in and your brain chemistry has been rewired
This is not how drugs, even heroin or fentanyl, work. I would encourage you to dig deeper into how addiction and these drugs do actually function. These drugs do not immediately change you or turn you into an addict when you first take these drugs.
posted by furnace.heart at 9:23 AM on August 3, 2023 [38 favorites]
This is not how drugs, even heroin or fentanyl, work. I would encourage you to dig deeper into how addiction and these drugs do actually function. These drugs do not immediately change you or turn you into an addict when you first take these drugs.
posted by furnace.heart at 9:23 AM on August 3, 2023 [38 favorites]
There is MASSIVE proof that allowing the decriminalization of addiction leads to a situation of humans living in absolute hellish squalor that lacks any sort of dignity.
Also, please cite this proof.
posted by furnace.heart at 9:29 AM on August 3, 2023 [14 favorites]
Also, please cite this proof.
posted by furnace.heart at 9:29 AM on August 3, 2023 [14 favorites]
Homelessness and drug addiction are symptoms of despair.
Much of the despair comes from an economic situation where there’s not really much to do or strive for. If your drug use is self medicating for existing in a world where you already don’t have good options, getting clean to go work in an Amazon warehouse or drive for DoorDash isn’t exactly a dream of a better life.
posted by Jon_Evil at 9:32 AM on August 3, 2023 [25 favorites]
Much of the despair comes from an economic situation where there’s not really much to do or strive for. If your drug use is self medicating for existing in a world where you already don’t have good options, getting clean to go work in an Amazon warehouse or drive for DoorDash isn’t exactly a dream of a better life.
posted by Jon_Evil at 9:32 AM on August 3, 2023 [25 favorites]
jesus christ, just garbage cans and toilets unhoused folks
Yes. I think much coverage of Portland's challenges, especially in the national news, mostly serve to distract from the abject failure that is the City of Portland in doing almost anything a local government is supposed to do. (For those unfamiliar, the Portland metro area is governed by a patchwork of multiple county, city, and regional governments, and arguably two state governments. I am focusing narrowly and specifically on the City of Portland, although all of them have significant problems. )
It isn't just that there's a housing crisis, or a drug crisis. City of Portland leaders (the mayor and council members who run the city's bureaus) have abdicated all responsibility for any of the work needed to actually run a city (and there's no shortage of other administrative organizations for them to blame.) Trash stays on the streets for months. The police are effectively on strike (but still getting hefty raises). There are major streets and ramps in need of repair that have simply been closed for years. Countless public bathrooms have been closed for years for "maintenance." Water is more abundant and yet more expensive than almost anywhere. CoP politicians actively sabotage evidence-based policies of partner governments to pander to their base, which in a city with all at-large elections effectively means wealthy west siders and real estate developers.
110 had nothing to do with these failures. But drug use is so visibly jarring, and there's much more mass appeal in demanding incarceration for suffering people than in demanding the leaders (many of whom have substantial inherited wealth) be bothered to do their jobs and pick up the damn trash, that the narrative has become all about that. It's yet another effective way to shift blame away from those in power.
posted by dsword at 9:40 AM on August 3, 2023 [18 favorites]
Yes. I think much coverage of Portland's challenges, especially in the national news, mostly serve to distract from the abject failure that is the City of Portland in doing almost anything a local government is supposed to do. (For those unfamiliar, the Portland metro area is governed by a patchwork of multiple county, city, and regional governments, and arguably two state governments. I am focusing narrowly and specifically on the City of Portland, although all of them have significant problems. )
It isn't just that there's a housing crisis, or a drug crisis. City of Portland leaders (the mayor and council members who run the city's bureaus) have abdicated all responsibility for any of the work needed to actually run a city (and there's no shortage of other administrative organizations for them to blame.) Trash stays on the streets for months. The police are effectively on strike (but still getting hefty raises). There are major streets and ramps in need of repair that have simply been closed for years. Countless public bathrooms have been closed for years for "maintenance." Water is more abundant and yet more expensive than almost anywhere. CoP politicians actively sabotage evidence-based policies of partner governments to pander to their base, which in a city with all at-large elections effectively means wealthy west siders and real estate developers.
110 had nothing to do with these failures. But drug use is so visibly jarring, and there's much more mass appeal in demanding incarceration for suffering people than in demanding the leaders (many of whom have substantial inherited wealth) be bothered to do their jobs and pick up the damn trash, that the narrative has become all about that. It's yet another effective way to shift blame away from those in power.
posted by dsword at 9:40 AM on August 3, 2023 [18 favorites]
@furnace.heart
Ok, instead of one puff, we can say five days. So less than a week. Although everyone has different levels of sensitivity.
And as proof "that allowing the decriminalization of addiction leads to a situation of humans living in absolute hellish squalor that lacks any sort of dignity." How about the article we just read? Perhaps you could cite your assertion that open-air opioid drug markets such as the one described in the article is an awesome, uplifting place to live that helps residents move towards stable housing and lives of basic human dignity?
posted by Word_Salad at 9:42 AM on August 3, 2023 [1 favorite]
Ok, instead of one puff, we can say five days. So less than a week. Although everyone has different levels of sensitivity.
And as proof "that allowing the decriminalization of addiction leads to a situation of humans living in absolute hellish squalor that lacks any sort of dignity." How about the article we just read? Perhaps you could cite your assertion that open-air opioid drug markets such as the one described in the article is an awesome, uplifting place to live that helps residents move towards stable housing and lives of basic human dignity?
posted by Word_Salad at 9:42 AM on August 3, 2023 [1 favorite]
That wasn't a cite, Word_Salad. Try again.
posted by seanmpuckett at 9:43 AM on August 3, 2023 [19 favorites]
posted by seanmpuckett at 9:43 AM on August 3, 2023 [19 favorites]
I've heard friends here in Portland half-seriously say we should start executing fentanyl dealers, the ones who bring it into the city in the first place.
posted by gottabefunky at 9:43 AM on August 3, 2023 [1 favorite]
posted by gottabefunky at 9:43 AM on August 3, 2023 [1 favorite]
Anyone advocating for the dignity of drug users on one hand and the forced treatment of drug users on the other... You do see the incompatibilities there, right? Or are you just working on a definition of dignity that is more about what you want to see around you?
posted by sagc at 9:44 AM on August 3, 2023 [3 favorites]
posted by sagc at 9:44 AM on August 3, 2023 [3 favorites]
Vancouver (Canada) perspective here. And I'm currently living right on the edge of our "problem area". I've very probably contributed to saving at least three lives in the past eight months or so (ie: dialed 911).
Above all, this issue is complex. By which I mean, the resolution to all of this is magnitudes beyond complicated, no single individual knows what to do. That's the definition of complex -- for me anyway. That said, there is a lot of experience and expertise to work with. And one overall strategic approach that makes sense to me is what's been termed as the multi-pillar approach. That is, addiction etc is a complex human problem which means the resolution to it is also complex and human. It will require coordinated pillars of:
- political will
- policing
- detox
- treatment
- social welfare
- education
- even PR
I'm sure there are more.
A friend whose dad was a military guy recently compared it to a military level of organization being required. Not the organized violence part, but very much the big, well funded, well supplied and well organized part, working a complex strategy that, like any realistic military operation, knows that this strategy will have to evolve as it moves deeper into "enemy territory".
posted by philip-random at 9:50 AM on August 3, 2023 [3 favorites]
Above all, this issue is complex. By which I mean, the resolution to all of this is magnitudes beyond complicated, no single individual knows what to do. That's the definition of complex -- for me anyway. That said, there is a lot of experience and expertise to work with. And one overall strategic approach that makes sense to me is what's been termed as the multi-pillar approach. That is, addiction etc is a complex human problem which means the resolution to it is also complex and human. It will require coordinated pillars of:
- political will
- policing
- detox
- treatment
- social welfare
- education
- even PR
I'm sure there are more.
A friend whose dad was a military guy recently compared it to a military level of organization being required. Not the organized violence part, but very much the big, well funded, well supplied and well organized part, working a complex strategy that, like any realistic military operation, knows that this strategy will have to evolve as it moves deeper into "enemy territory".
posted by philip-random at 9:50 AM on August 3, 2023 [3 favorites]
arguably two state governments
I'm not familiar with Oregon local politics -- what does this mean?
posted by Theiform at 9:50 AM on August 3, 2023
I'm not familiar with Oregon local politics -- what does this mean?
posted by Theiform at 9:50 AM on August 3, 2023
There is MASSIVE proof that allowing the decriminalization of addiction leads to a situation of humans living in absolute hellish squalor that lacks any sort of dignity
Regardless of drug enforcement or lack thereof, this is a common end state for users.
posted by Dr. Twist at 9:51 AM on August 3, 2023 [2 favorites]
Regardless of drug enforcement or lack thereof, this is a common end state for users.
posted by Dr. Twist at 9:51 AM on August 3, 2023 [2 favorites]
I'm not familiar with Oregon local politics -- what does this mean?
A large part of the Portland metro area is across the Columbia river in Washington state.
posted by Dr. Twist at 9:52 AM on August 3, 2023 [1 favorite]
A large part of the Portland metro area is across the Columbia river in Washington state.
posted by Dr. Twist at 9:52 AM on August 3, 2023 [1 favorite]
The Portland Metro includes Vancouver, as we border Washington; Oregon and Washington do not always coordinate policy (they legalized weed before us, for example; leading to cannabis markets just a 10m drive away, before legalization occurred here). It just add's a layer of coordination that makes policy difficult here.
posted by furnace.heart at 9:52 AM on August 3, 2023 [1 favorite]
posted by furnace.heart at 9:52 AM on August 3, 2023 [1 favorite]
Government mandated squalor & isolation seems, then, like a shit option.
posted by MonsieurPEB at 9:52 AM on August 3, 2023
posted by MonsieurPEB at 9:52 AM on August 3, 2023
I'm not familiar with Oregon local politics -- what does this mean?
Portland's right on the Columbia river which is the border between Oregon State and Washington State, and Vancouver, Washington is essentially a suburb of Portland.
posted by Zalzidrax at 9:53 AM on August 3, 2023 [1 favorite]
Portland's right on the Columbia river which is the border between Oregon State and Washington State, and Vancouver, Washington is essentially a suburb of Portland.
posted by Zalzidrax at 9:53 AM on August 3, 2023 [1 favorite]
@sagc "Anyone advocating for dignity on one hand and forced treatment on the other... You do see the incompatibilities there, right?" Well yeah, duh. Perhaps one of the most basic conundrums in society. If it was that easy it would be done already.
@seanmpuckett I am not going to cite research papers on Fetanyl and opiate addiction. I will leave that to the professionals. But I hear, and occasionally surmise, that opiates and fetanyl are pretty darn addictive. Maybe? Or do I have to cite that?
I don't feel there is an opportunity for nuanced conversation on this topic if you can't look firsthand (ie not a research study) at people smoking opiates on the street and not have the flashbulb moment that perhaps the drug is more powerful than even the users' best intentions for themselves. What I see, firsthand, is people who are in such deep addiction they are not experiencing dominion over themselves. Which asks the question, are these people experiencing liberty?
posted by Word_Salad at 10:00 AM on August 3, 2023 [1 favorite]
@seanmpuckett I am not going to cite research papers on Fetanyl and opiate addiction. I will leave that to the professionals. But I hear, and occasionally surmise, that opiates and fetanyl are pretty darn addictive. Maybe? Or do I have to cite that?
I don't feel there is an opportunity for nuanced conversation on this topic if you can't look firsthand (ie not a research study) at people smoking opiates on the street and not have the flashbulb moment that perhaps the drug is more powerful than even the users' best intentions for themselves. What I see, firsthand, is people who are in such deep addiction they are not experiencing dominion over themselves. Which asks the question, are these people experiencing liberty?
posted by Word_Salad at 10:00 AM on August 3, 2023 [1 favorite]
Wherever you live, people are suffering and dying. Here it's just happening in public.
I was driving home from a show late Sunday night and saw someone stopped crookedly in the bus lane slumped over their steering wheel. It didn't occur to me until I got home it might've been someone ODing. (I also saw some other weird shit on the way home that night.)
posted by slogger at 10:04 AM on August 3, 2023 [1 favorite]
I was driving home from a show late Sunday night and saw someone stopped crookedly in the bus lane slumped over their steering wheel. It didn't occur to me until I got home it might've been someone ODing. (I also saw some other weird shit on the way home that night.)
posted by slogger at 10:04 AM on August 3, 2023 [1 favorite]
"These people don't have dominion over themselves... I know, we'll further remove their agency! That'll help."
posted by sagc at 10:06 AM on August 3, 2023 [5 favorites]
posted by sagc at 10:06 AM on August 3, 2023 [5 favorites]
I don't feel there is an opportunity for nuanced conversation on this topic
OK, we can just keep it at hysteria then.
posted by Dr. Twist at 10:07 AM on August 3, 2023 [12 favorites]
OK, we can just keep it at hysteria then.
posted by Dr. Twist at 10:07 AM on August 3, 2023 [12 favorites]
dsword's comment needs to be emphasized.
Opiate overdose rates in states is different. Addiction rates, and overdose rates, do not correlate with visibility. Oregon is in the middle of the pack for overdose rates. We're probably leading the pack in visibility; that cannot be verified.
More people die, in states where drugs are criminalized. Please look at this information from the CDC. Using opiate OD rates in various states, you can track the problem's severity fairly well. Oregon is not unique in this; we are unique because we are not locking folks up for using drugs. They are visible because of housing issues that were isolated to the west coast, but now exist in more areas of the nation.
This is happening in your state. It is being hidden. Just because it is not happening in an open air market does not mean it is not happening.
posted by furnace.heart at 10:08 AM on August 3, 2023 [34 favorites]
Opiate overdose rates in states is different. Addiction rates, and overdose rates, do not correlate with visibility. Oregon is in the middle of the pack for overdose rates. We're probably leading the pack in visibility; that cannot be verified.
More people die, in states where drugs are criminalized. Please look at this information from the CDC. Using opiate OD rates in various states, you can track the problem's severity fairly well. Oregon is not unique in this; we are unique because we are not locking folks up for using drugs. They are visible because of housing issues that were isolated to the west coast, but now exist in more areas of the nation.
This is happening in your state. It is being hidden. Just because it is not happening in an open air market does not mean it is not happening.
posted by furnace.heart at 10:08 AM on August 3, 2023 [34 favorites]
Word_Salad I'm going to say respectfully you don't have a good understanding of either addiction or harm reduction principles or treatment which is why you're getting some pushback here.
posted by flamk at 10:13 AM on August 3, 2023 [28 favorites]
posted by flamk at 10:13 AM on August 3, 2023 [28 favorites]
... people smoking opiates on the street and not have the flashbulb moment that perhaps the drug is more powerful than even the users' best intentions for themselves. What I see, firsthand, is people who are in such deep addiction they are not experiencing dominion over themselves.
Well, I think this is people choosing the least worst option available. As the Times article explains, treatment resources aren't really there, so the options are continue to use the drugs or be violently, miserably ill without sanitary facilities, and with high probability begin using again at some point, since it's notoriously hard to stay off opioids without support.
It's not really unique to opioid users (a huge percentage of tobacco smokers want to quit, but struggle to do so, for example) or to homeless people (lots of opioid users have housing but still limited access to affordable treatment), but it's more visible, of course, on the street.
posted by smelendez at 10:14 AM on August 3, 2023 [7 favorites]
Well, I think this is people choosing the least worst option available. As the Times article explains, treatment resources aren't really there, so the options are continue to use the drugs or be violently, miserably ill without sanitary facilities, and with high probability begin using again at some point, since it's notoriously hard to stay off opioids without support.
It's not really unique to opioid users (a huge percentage of tobacco smokers want to quit, but struggle to do so, for example) or to homeless people (lots of opioid users have housing but still limited access to affordable treatment), but it's more visible, of course, on the street.
posted by smelendez at 10:14 AM on August 3, 2023 [7 favorites]
I think all of this can be pointed at the housing crisis and at our continual inability to address income inequality. As the housing prices skyrocketed here in Portland (and Vancouver, and Seattle, and San Francisco) we saw more and more people hitting the streets. Nobody wants a drug rehab center, a mental institution, a soup kitchen, a crisis center in their neighborhood. Poor to rich, nobody wants it. The housing crisis sent scores of tenuously housed people (couch surfers, 3+-to-a-bedroom apartments, backyard campers) out into the streets and their cars and campers. Think about the drifter young dude who stays with his Aunt who has a small apartment who is housing her kid and their kids and there's a little space in the front room where he can crash. Aunt loses her job or they get kicked out of their apartment and suddenly you've got three, four people looking for alternative living arrangements, no room for dude. Being on the streets sucks. It's scary, and uncomfortable, and you can't sleep and it's hard to wash-up or stay charged up to make phone calls and people look at you like you suck. The more you are on the street, the harder it is to get back. The various options for help are full to bursting. Portland has lots of systems and services that are working and working hard everyday and they do make an impact but the demand far exceeds what is on offer.
Housing is now a rich man's game. We are truly fucked for the past generation's obsession with hoarding wealth and toys and bullshit. SNAP for kids was just cut. We need a national policy because people will drift for wherever they can live the most sane life. There's loads of these issues in all major and minor cities. I think some contingent in Portland is grasping for punitive measures because the compassionate thing isn't working. But the fantasy that we can just jackboot thug our way through this is untenable to most people even the assholes. Criminalize it! Okay. Criminalized. Now what? People are still going to fall off the housing rung with this bullshit. Our services are still overrun for the "good poor" and we still aren't reigning in unfettered wealth hoarding. It's called a sh*tshow and I think that it is mostly due to the recalcitrance of the wealthy to do anything that might cause them any loss whatsoever even if it makes no material difference to their quality of life. We also have a lot of people trying to do things the right way, compassionately, and it absolutely works for some and has no effect on others. The last time I did a downtown Portland wander with my daughter, I felt like we were encountering a different societal breaking point on every block. But we didn't get panhandled or approached or have anything happen to us at all other than witness this breakdown of humanity. It's unsettling, it's uncomfortable, it's grievously unfair and I want to fix it, too, and it's sad how tempting it is to want to just throw it all in a big hole and cover it up. But, guess what, the hole is coming for you next if we don't demand the wealthiest and most privileged to fix this.
posted by amanda at 10:14 AM on August 3, 2023 [47 favorites]
Housing is now a rich man's game. We are truly fucked for the past generation's obsession with hoarding wealth and toys and bullshit. SNAP for kids was just cut. We need a national policy because people will drift for wherever they can live the most sane life. There's loads of these issues in all major and minor cities. I think some contingent in Portland is grasping for punitive measures because the compassionate thing isn't working. But the fantasy that we can just jackboot thug our way through this is untenable to most people even the assholes. Criminalize it! Okay. Criminalized. Now what? People are still going to fall off the housing rung with this bullshit. Our services are still overrun for the "good poor" and we still aren't reigning in unfettered wealth hoarding. It's called a sh*tshow and I think that it is mostly due to the recalcitrance of the wealthy to do anything that might cause them any loss whatsoever even if it makes no material difference to their quality of life. We also have a lot of people trying to do things the right way, compassionately, and it absolutely works for some and has no effect on others. The last time I did a downtown Portland wander with my daughter, I felt like we were encountering a different societal breaking point on every block. But we didn't get panhandled or approached or have anything happen to us at all other than witness this breakdown of humanity. It's unsettling, it's uncomfortable, it's grievously unfair and I want to fix it, too, and it's sad how tempting it is to want to just throw it all in a big hole and cover it up. But, guess what, the hole is coming for you next if we don't demand the wealthiest and most privileged to fix this.
posted by amanda at 10:14 AM on August 3, 2023 [47 favorites]
That WaPo article on Portugal is bizarre:
posted by Gerald Bostock at 10:17 AM on August 3, 2023 [17 favorites]
A newly released national survey suggests the percent of adults who have used illicit drugs increased to 12.8 percent in 2022, up from 7.8 in 2001, though still below European averages. Portugal’s prevalence of high-risk opioid use is higher than Germany’s, but lower than that of France and Italy. But even proponents of decriminalization here admit that something is going wrong.To put it another way: Party drug use has increased but overall drug use is lower than in other European countries. Overdose rates have increased, which the article implies is due to decriminalization even though similar trends elsewhere in the world are being driven by an increasingly toxic drug supply. Most of the article is actually about street crime and visibility of drug use. And it's only towards the end of the article that you find out that key elements of the decriminalization policy (such as rehabilitation) aren't actually being used/enforced because the relevant programs have been defunded or outsourced. I don't know what's actually going on in Portugal but I don't think I trust this article to tell me about it.
Overdose rates have hit 12-year highs and almost doubled in Lisbon from 2019 to 2023. Sewage samples in Lisbon show cocaine and ketamine detection is now among the highest in Europe, with elevated weekend rates suggesting party-heavy usage. In Porto, the collection of drug-related debris from city streets surged 24 percent between 2021 and 2022, with this year on track to far outpace the last. Crime — including robbery in public spaces — spiked 14 percent from 2021 to 2022, a rise police blame partly on increased drug use.
posted by Gerald Bostock at 10:17 AM on August 3, 2023 [17 favorites]
I work with some people who do harm reduction and addition treatment; I've had several friends who have beaten heroin addictions. Their perception is that for many people, it's homelessness first and then addiction, or else disability/medical crisis and then addiction. Then they can't keep getting opiates and switch to fentanyl.
All the people I've known well who used heroin kept their addictions hidden. They had employment and stable housing and that enabled them to manage their addictions. Collapsing into street-level use, etc, is caused by something else, not just the fact of addiction.
The best way to cut down on drug use right now would be to house the people who are on the street and keep people who are addicted and housed from losing their housing. The rest can be dealt with by harm reduction and treatment.
Treatment is really difficult and usually not successful the first time or two - everyone I know who kicked heroin had at least two rounds of treatment. People have to have all the other stuff in their life more or less stable first, and then they still need lots of support.
Getting people stable first is the only way any of this is going to work.
The least expensive way to deal with this expensive social problem is going to be spending money on housing, but we live in a society where the police union, etc, would rather have an ongoing problem and pay the cops a lot instead.
posted by Frowner at 10:26 AM on August 3, 2023 [52 favorites]
All the people I've known well who used heroin kept their addictions hidden. They had employment and stable housing and that enabled them to manage their addictions. Collapsing into street-level use, etc, is caused by something else, not just the fact of addiction.
The best way to cut down on drug use right now would be to house the people who are on the street and keep people who are addicted and housed from losing their housing. The rest can be dealt with by harm reduction and treatment.
Treatment is really difficult and usually not successful the first time or two - everyone I know who kicked heroin had at least two rounds of treatment. People have to have all the other stuff in their life more or less stable first, and then they still need lots of support.
Getting people stable first is the only way any of this is going to work.
The least expensive way to deal with this expensive social problem is going to be spending money on housing, but we live in a society where the police union, etc, would rather have an ongoing problem and pay the cops a lot instead.
posted by Frowner at 10:26 AM on August 3, 2023 [52 favorites]
Amanda's got it right. I could give very similar stories to a lot of the Portland ones living in Seattle - only difference is people are doing their drugs inside their tents instead of outside - and the state hasn't decriminalized anything.
What happened was covid wiping out low level service jobs while housing prices continuing to skyrocket. Things started getting visibly worse the instant federal support ran out. Decriminalization in Oregon just had bad timing, and it lets people blame that.
You want to solve the drug problem, don't criminalize drug dealers, criminalize landlords.
posted by Zalzidrax at 10:27 AM on August 3, 2023 [27 favorites]
What happened was covid wiping out low level service jobs while housing prices continuing to skyrocket. Things started getting visibly worse the instant federal support ran out. Decriminalization in Oregon just had bad timing, and it lets people blame that.
You want to solve the drug problem, don't criminalize drug dealers, criminalize landlords.
posted by Zalzidrax at 10:27 AM on August 3, 2023 [27 favorites]
@flamk The next time I think about my stint working in a rehab, or I vote, or give money to charity, or work at a food bank, or come across one of the many, many unhoused in my neighborhood I will remember that I "don't have a good understanding of either addiction or harm reduction principles or treatment."
I understand that the real political question here is whether harm reduction works for fentanyl. I honestly don't know, but my intuition and personal experience (which belay my ignorance) are saying no.
posted by Word_Salad at 10:34 AM on August 3, 2023 [1 favorite]
I understand that the real political question here is whether harm reduction works for fentanyl. I honestly don't know, but my intuition and personal experience (which belay my ignorance) are saying no.
posted by Word_Salad at 10:34 AM on August 3, 2023 [1 favorite]
The state lost nearly 150 during the pandemic—a “staggering” number, a top official admitted last year. Before that, in early 2020, Portland lost its only sobering center, where cops could drop off people intoxicated on booze or narcotics. City, county and state officials have failed, despite years of discussions, to open a replacement.
That's from the WWeek link that Just one swan, actually posted. This type of language makes it sound like the beds and the sobering center just sort of got misplaced or drifted away, when presumably it was the funding that was cut. We don't need to lose beds and centers.
posted by Frowner at 10:34 AM on August 3, 2023 [12 favorites]
That's from the WWeek link that Just one swan, actually posted. This type of language makes it sound like the beds and the sobering center just sort of got misplaced or drifted away, when presumably it was the funding that was cut. We don't need to lose beds and centers.
posted by Frowner at 10:34 AM on August 3, 2023 [12 favorites]
We're getting to eponysterical levels of discourse here, but do you just not believe that any research has been done? Word_Salad, why on earth would your observations and intuitions be prioritized over research?
posted by sagc at 10:38 AM on August 3, 2023 [9 favorites]
posted by sagc at 10:38 AM on August 3, 2023 [9 favorites]
The same misery is happening in every city. If Oregon is unique, it is in the baffling failure of our public institutions to get so much as a single detox center up and running in the past 3 years. As a result, public opinion of decriminalization is extremely poor, and the experiment is likely to end soon. Last month, the Oregon legislature recriminalized possession of fentanyl. I expect other punitive measures will come next year.
The NYT article somewhat predictably buries this fact halfway through the article and mentions it only in passing, despite the fact that this seems to be the major reason for Measure 110's failures. True investigative reporting would have spent most of the article delving into the reasons for this staggering level of bureaucratic malfeasance. Zero questions whatsoever as to who's responsible, just straight into convincing their readers that this is all down to the bleeding hearts who want Those People to invade your downtowns and suburbs and destroy your way of life.
And of course people are happy to lap it up.
posted by Glegrinof the Pig-Man at 10:39 AM on August 3, 2023 [8 favorites]
The NYT article somewhat predictably buries this fact halfway through the article and mentions it only in passing, despite the fact that this seems to be the major reason for Measure 110's failures. True investigative reporting would have spent most of the article delving into the reasons for this staggering level of bureaucratic malfeasance. Zero questions whatsoever as to who's responsible, just straight into convincing their readers that this is all down to the bleeding hearts who want Those People to invade your downtowns and suburbs and destroy your way of life.
And of course people are happy to lap it up.
posted by Glegrinof the Pig-Man at 10:39 AM on August 3, 2023 [8 favorites]
Harm reduction and mutual aid are killing more addicts and homeless than any misguided justice program could.
Its even worse when you compare the daily overdose deaths to covid fatalities, they are about to get lapped in the PNW.
Harm reduction used to be about ending criminal sentences for drugs like pot, people being able to test drugs for adulterants, and being able to check people into the hospital without fear of arrest, but it really lost its way and became enablement handing out rainbow pipes with candy wrappers, and pushing narcan as a catch all.
Housing first sounds egalitarian, until the housing gets burnt down, contaminated by drugs, or becomes a shooting gallery of competing drug dealers.
Fentanyl went way past unintended consequences, I don' think people grasp that blues cost pennies, and sell for dollars.
I don't think progressive proposals can handle or even grasp the current inertia of drugs -> homeless -> mentally ill -> death.
posted by vincentmeanie at 10:39 AM on August 3, 2023 [2 favorites]
Its even worse when you compare the daily overdose deaths to covid fatalities, they are about to get lapped in the PNW.
Harm reduction used to be about ending criminal sentences for drugs like pot, people being able to test drugs for adulterants, and being able to check people into the hospital without fear of arrest, but it really lost its way and became enablement handing out rainbow pipes with candy wrappers, and pushing narcan as a catch all.
Housing first sounds egalitarian, until the housing gets burnt down, contaminated by drugs, or becomes a shooting gallery of competing drug dealers.
Fentanyl went way past unintended consequences, I don' think people grasp that blues cost pennies, and sell for dollars.
I don't think progressive proposals can handle or even grasp the current inertia of drugs -> homeless -> mentally ill -> death.
posted by vincentmeanie at 10:39 AM on August 3, 2023 [2 favorites]
Ah, yes, that is the only and inevitable path, and nothing outside of drugs has any influence on it! Seems like a well-rounded argument for conservative... What, exactly? The War on Drugs?
posted by sagc at 10:41 AM on August 3, 2023 [6 favorites]
posted by sagc at 10:41 AM on August 3, 2023 [6 favorites]
Sorry word_salad, after reading what I wrote maybe I felt like it comes off as dismissive which is not my intention... I do think there's value in people's first-hand experiences of witnessing street drug use and addiction and what that might tell us about the problem. I think sometimes the liberal powers-that-be and the comfortable upper middle class in certain big blue cities turn a blind eye to obvious suffering happening out in the streets citing "harm reduction" and "compassion" while at the same time also enacting or turning a blind eye to harsh carceral approaches, anti-housing/NIMBYism and all the rest of what contributes or exacerbates the problem.
On preview: what does "harm reduction work for fentanyl" mean to you? If one less person dies from an OD that might mean "work" or does "work" mean no visible suffering on the streets? Or does it mean a specific individual has no addiction and is a functional member of society? Or maybe it means someone lives an additional 6 months but dies anyway of an OD?
posted by flamk at 10:42 AM on August 3, 2023 [2 favorites]
On preview: what does "harm reduction work for fentanyl" mean to you? If one less person dies from an OD that might mean "work" or does "work" mean no visible suffering on the streets? Or does it mean a specific individual has no addiction and is a functional member of society? Or maybe it means someone lives an additional 6 months but dies anyway of an OD?
posted by flamk at 10:42 AM on August 3, 2023 [2 favorites]
I understand that the real political question here is whether harm reduction works for fentanyl.
Not a political question, an actual question, which to the answer is yeah, Harm reduction for all opiate use prevents people from dying. It keeps them alive. That is the goal of harm reduction, to reduce the harm they are causing to themselves.
Cite, cite, cite.
Testing drugs is harm reduction; it prevents death by overdose.
Widespread use of narcan is harm reduction; it prevents death by overdose.
Providing paraphanilia is harm reduction; it prevents serious illness resulting from drug use.
Ideally, we would have safe injection cites, (BIG OL' FUCKIN CITE) leading to less overdoses (uh, none overdoses at such sites), less HIV transmission, cutting OD ambulance trips more than in half, among other benefits
An addict can't get treatment, or get sober if they are dead from an overdose. you cannot force someone into treatment.
posted by furnace.heart at 10:46 AM on August 3, 2023 [31 favorites]
Not a political question, an actual question, which to the answer is yeah, Harm reduction for all opiate use prevents people from dying. It keeps them alive. That is the goal of harm reduction, to reduce the harm they are causing to themselves.
Cite, cite, cite.
Testing drugs is harm reduction; it prevents death by overdose.
Widespread use of narcan is harm reduction; it prevents death by overdose.
Providing paraphanilia is harm reduction; it prevents serious illness resulting from drug use.
Ideally, we would have safe injection cites, (BIG OL' FUCKIN CITE) leading to less overdoses (uh, none overdoses at such sites), less HIV transmission, cutting OD ambulance trips more than in half, among other benefits
An addict can't get treatment, or get sober if they are dead from an overdose. you cannot force someone into treatment.
posted by furnace.heart at 10:46 AM on August 3, 2023 [31 favorites]
Just for a crazy long term idea, how about research into safer and less addictive recreational drugs?
posted by Nancy Lebovitz at 10:46 AM on August 3, 2023 [9 favorites]
posted by Nancy Lebovitz at 10:46 AM on August 3, 2023 [9 favorites]
If there's anything that half-executed plans carried out in the midst of police sick-outs because they may eventually face accountability for cracking heads tells us, it's that we should reverse track & give police even more budget & less oversight.
After all, we're seeing it play out so well up in Seattle where even a compromised "don't go on risky high-speed chases if you can't at least come up with an excuse that someone's life is at risk" bill has led to SPD stonewalling after an officer pasted an international student going 76 in a 25mph zone without sirens, for a drug call where the patient was awake & already being treated by a medic.
posted by CrystalDave at 10:50 AM on August 3, 2023 [12 favorites]
After all, we're seeing it play out so well up in Seattle where even a compromised "don't go on risky high-speed chases if you can't at least come up with an excuse that someone's life is at risk" bill has led to SPD stonewalling after an officer pasted an international student going 76 in a 25mph zone without sirens, for a drug call where the patient was awake & already being treated by a medic.
posted by CrystalDave at 10:50 AM on August 3, 2023 [12 favorites]
As I get older and more jaded and see the world in less black-and-white terms, it seems clearer that there are some people who can take care of themselves, and some who just will not or cannot take care of themselves. I don't know the solutions, but am beginning to have doubts that open-air, mostly consequence-free drug markets are working to reduce harm. At the very least, giving people with a drug habit a $100 fine seems ridiculous, on the surface, when that $100 is going straight to a dealer five minutes later. And it seems almost as ridiculous as not acknowledging that people with substance abuse problems are moving to Portland (and Seattle) precisely because hard drugs are sold open-air and mostly without consequences. No answers to any of these problems, but lots of questions about the premises underlying this shift in policy and the resulting outcomes, so far.
posted by They sucked his brains out! at 10:51 AM on August 3, 2023 [6 favorites]
posted by They sucked his brains out! at 10:51 AM on August 3, 2023 [6 favorites]
So they should... Die of overdoses on their home cities, with drugs bought from markets that are even less safe?
posted by sagc at 10:53 AM on August 3, 2023 [3 favorites]
posted by sagc at 10:53 AM on August 3, 2023 [3 favorites]
I am still waiting for that study on how many people who use narcan go on to recover from being an addict or homeless, and don't just use again and again till they die.
posted by vincentmeanie at 10:55 AM on August 3, 2023 [2 favorites]
posted by vincentmeanie at 10:55 AM on August 3, 2023 [2 favorites]
Asked and answered vincentmeanie.
posted by furnace.heart at 10:57 AM on August 3, 2023 [14 favorites]
posted by furnace.heart at 10:57 AM on August 3, 2023 [14 favorites]
Honestly, my most cynical take on the most-visible harm reduction chatter here in Portland is that there is a hope that these folks will die off faster if we just give them all the tools they need. And loads of people who are stressed (have we come to terms with a global pandemic and the last seven years of political madness? I don't think so) would be happy to see that happen. This is stressful. This is awful. This is uncomfortable. From what I hear, the jails and beds are full. So, what dear folks railing against "liberal compassion", would you have us do? What's on offer? What is exactly is the plan? What's the bright idea?
posted by amanda at 10:58 AM on August 3, 2023 [3 favorites]
posted by amanda at 10:58 AM on August 3, 2023 [3 favorites]
So they should... Die of overdoses on their home cities, with drugs bought from markets that are even less safe?
In Seattle, at least, I see no evidence that functionally open-air markets are leading to fewer deaths. The statistics, in fact, point to increased overdose deaths over time.
I don't have answers for your hypothetical, but I think those of us who live in more progressive regions may have to ask ourselves some hard questions about what we're proposing and implementing, as it doesn't seem to be having the desired outcomes.
posted by They sucked his brains out! at 11:00 AM on August 3, 2023 [2 favorites]
In Seattle, at least, I see no evidence that functionally open-air markets are leading to fewer deaths. The statistics, in fact, point to increased overdose deaths over time.
I don't have answers for your hypothetical, but I think those of us who live in more progressive regions may have to ask ourselves some hard questions about what we're proposing and implementing, as it doesn't seem to be having the desired outcomes.
posted by They sucked his brains out! at 11:00 AM on August 3, 2023 [2 favorites]
@sagc
" Word_Salad, why on earth would your observations and intuitions be prioritized over research?"
I don't believe my personal and direct experience should be prioritized over research (which I am not seeing you provide, am I?) and I never wrote that - so not sure where that is coming from except a bit of Whataboutism ? I think the two together can actually create a much deeper, more nuanced view of an issue.
While I realize that RESEARCH is a big happy power word (and granted, I love it too) there are serious limitations to any study, which their authors would probably communicate with humility.
@Flamk - thank you for your thoughtful response. I don't know the success metrics of Harm Reduction working (for opiates) but I think you can be pro-safe injection site, pro-needle exchange, pro-safer supply and naxolone distribution and still recognize that these programs do create secondary effects in communities that need to be mitigated (more supply in the open socializes use).
I was listening to a news report on the Vancouver homeless drug-using population and the homeless man interviewed literally said he wished the government would provide a safe supply. The idea of going so far as to get your opiates from the Canadian government seemed...well...yet another conflict of interest?
posted by Word_Salad at 11:03 AM on August 3, 2023
" Word_Salad, why on earth would your observations and intuitions be prioritized over research?"
I don't believe my personal and direct experience should be prioritized over research (which I am not seeing you provide, am I?) and I never wrote that - so not sure where that is coming from except a bit of Whataboutism ? I think the two together can actually create a much deeper, more nuanced view of an issue.
While I realize that RESEARCH is a big happy power word (and granted, I love it too) there are serious limitations to any study, which their authors would probably communicate with humility.
@Flamk - thank you for your thoughtful response. I don't know the success metrics of Harm Reduction working (for opiates) but I think you can be pro-safe injection site, pro-needle exchange, pro-safer supply and naxolone distribution and still recognize that these programs do create secondary effects in communities that need to be mitigated (more supply in the open socializes use).
I was listening to a news report on the Vancouver homeless drug-using population and the homeless man interviewed literally said he wished the government would provide a safe supply. The idea of going so far as to get your opiates from the Canadian government seemed...well...yet another conflict of interest?
posted by Word_Salad at 11:03 AM on August 3, 2023
But is "asking ourselves some hard questions" an actual exercise of nuanced reflection done in good faith or does it become a sneaky avenue for "moderates" to enact harsh antihuman policies that sweep it out of sight but only contributes to worsening the problem (thereby kicking the can down the road and necessitating ever harsher antihuman policies until we basically get fascism)?
posted by flamk at 11:04 AM on August 3, 2023 [6 favorites]
posted by flamk at 11:04 AM on August 3, 2023 [6 favorites]
And this is why people aren't taking you seriously - a safe supply would be a massive step toward harm reduction.
posted by sagc at 11:05 AM on August 3, 2023 [10 favorites]
posted by sagc at 11:05 AM on August 3, 2023 [10 favorites]
A blog post on heroin users a decade ago, with no citations isn't an answer.
People on here talking about safe supplies of fentanyl are a wild ride, the street price for pure blues is 3 dollars a pill, give or take.
its not an issue with adulteration, people are just totally lost to addiction.
posted by vincentmeanie at 11:05 AM on August 3, 2023
People on here talking about safe supplies of fentanyl are a wild ride, the street price for pure blues is 3 dollars a pill, give or take.
its not an issue with adulteration, people are just totally lost to addiction.
posted by vincentmeanie at 11:05 AM on August 3, 2023
Again, it's taking 2-3 years for the proposed treatment centers to get up and running, or for those already functioning to see any sort of help from the state government. This is a failure of implementation, not policy, and the world's "paper of record" almost didn't even mention it at all.
posted by Glegrinof the Pig-Man at 11:05 AM on August 3, 2023 [4 favorites]
posted by Glegrinof the Pig-Man at 11:05 AM on August 3, 2023 [4 favorites]
does it become a sneaky avenue for "moderates"
Huh, okay. I can assure you that I am no centrist or moderate, but I do now regret even saying and citing as much as I have, despite living and working in a major metropolitan area in the PNW and being able to speak from my lived experience. Best of luck.
posted by They sucked his brains out! at 11:07 AM on August 3, 2023 [2 favorites]
Huh, okay. I can assure you that I am no centrist or moderate, but I do now regret even saying and citing as much as I have, despite living and working in a major metropolitan area in the PNW and being able to speak from my lived experience. Best of luck.
posted by They sucked his brains out! at 11:07 AM on August 3, 2023 [2 favorites]
A blog post on heroin users a decade ago, with no citations isn't an answer.
The study cited in the article showed no change in consumption due to narcan use. Please try harder.
posted by furnace.heart at 11:07 AM on August 3, 2023 [7 favorites]
The study cited in the article showed no change in consumption due to narcan use. Please try harder.
posted by furnace.heart at 11:07 AM on August 3, 2023 [7 favorites]
Crime — including robbery in public spaces — spiked 14 percent from 2021 to 2022, a rise police blame partly on increased drug use.
Well if the police say it's true. JFC we have the internet. It enables communication with most anyone on the planet. Why the fuck would a journalist ask the people with no vested interest in the war on some drugs and who are famously well reasoned and approach all issues with compassion and nuance (/hamburger) about this rather than, idk, scientists would research these issues.
They are people who often will do just about anything to get high, however irrational, self-destructive or, in some cases, criminal their behavior becomes. Addiction may be a disease, but it’s also a lifestyle — one that decriminalization does a lot to facilitate.
Which is why famously alcohol prohibition was the high point of rational behaviour free of crime and harm in American history. We proven repeatedly that the substance isn't the issue, addiction is. I am so fricken tried of this hobby horse being trotted out for substance after substance by people who think pepper on their potatoes are a mite too spicy.
posted by Mitheral at 11:08 AM on August 3, 2023 [9 favorites]
Well if the police say it's true. JFC we have the internet. It enables communication with most anyone on the planet. Why the fuck would a journalist ask the people with no vested interest in the war on some drugs and who are famously well reasoned and approach all issues with compassion and nuance (/hamburger) about this rather than, idk, scientists would research these issues.
They are people who often will do just about anything to get high, however irrational, self-destructive or, in some cases, criminal their behavior becomes. Addiction may be a disease, but it’s also a lifestyle — one that decriminalization does a lot to facilitate.
Which is why famously alcohol prohibition was the high point of rational behaviour free of crime and harm in American history. We proven repeatedly that the substance isn't the issue, addiction is. I am so fricken tried of this hobby horse being trotted out for substance after substance by people who think pepper on their potatoes are a mite too spicy.
posted by Mitheral at 11:08 AM on August 3, 2023 [9 favorites]
Mod note: Couple of comments removed. Let's avoid trollish comments and be considerate and respectful of others.
Also, please move on from the back and forth derail, thanks!
posted by Brandon Blatcher (staff) at 11:21 AM on August 3, 2023 [2 favorites]
Also, please move on from the back and forth derail, thanks!
posted by Brandon Blatcher (staff) at 11:21 AM on August 3, 2023 [2 favorites]
Homelessness and drug use, when it is visible to people who are not homeless or users of drugs* are topics that folks seem to feel a lot of confidence in their ideas about, based on looking at people on the street and drawing conclusions, rather than reviewing the avaiable evidence or poling experts - or talking to people experiencing homelessness and/or frequent substance use.
*What we even consider a drug is socially and legally constructed since daily wine drinkers, who do it in their own homes, are not pathologized or criminalized or consider 'drug addicts'. I am interested to check out this recent book that explores this stuff from the perspective of an addiction psychiatrist and anthropologist, a sociologist and policy advocate, and a historian.
posted by latkes at 11:22 AM on August 3, 2023 [10 favorites]
*What we even consider a drug is socially and legally constructed since daily wine drinkers, who do it in their own homes, are not pathologized or criminalized or consider 'drug addicts'. I am interested to check out this recent book that explores this stuff from the perspective of an addiction psychiatrist and anthropologist, a sociologist and policy advocate, and a historian.
posted by latkes at 11:22 AM on August 3, 2023 [10 favorites]
its not an issue with adulteration, people are just totally lost to addiction.
Love to cite things while dehumanizing the people I want to "help" (make disappear)
posted by Uncle at 11:23 AM on August 3, 2023 [2 favorites]
Love to cite things while dehumanizing the people I want to "help" (make disappear)
posted by Uncle at 11:23 AM on August 3, 2023 [2 favorites]
I'm not going to be able to participate in this thread anymore, because it's clearly devolving, and the level of callousness is really difficult to face. I could cite all the evidenced based treatment options, all of the ways that we could address this problem with proven tactics, but that is clearly not going to sway anyone who doesn't hold those as valid already.
People in the throes of addiction are still people with consciousness, (souls if you belive that) and are a part of this universe looking back on itself experiencing a lot of pain.They still have the spark of life and creativity that makes you, YOU, and me, ME. And to remind all of us that they are suffering. Reducing their suffering (all of our suffering, actually) should be a goal of everyone.
If you are not advocating for the reducing your fellow sibling human's suffering, I would really ask that you take a break from this thread, and take a moment to reflect on why that may be.
posted by furnace.heart at 11:27 AM on August 3, 2023 [27 favorites]
People in the throes of addiction are still people with consciousness, (souls if you belive that) and are a part of this universe looking back on itself experiencing a lot of pain.They still have the spark of life and creativity that makes you, YOU, and me, ME. And to remind all of us that they are suffering. Reducing their suffering (all of our suffering, actually) should be a goal of everyone.
If you are not advocating for the reducing your fellow sibling human's suffering, I would really ask that you take a break from this thread, and take a moment to reflect on why that may be.
posted by furnace.heart at 11:27 AM on August 3, 2023 [27 favorites]
Also, if you are so inclined and have the chance and can talk with a number of unhoused people, your mind will change. It can be frustrating, scary and gross to deal with people in the throes of a serious public addiction. Some addicts are horrible people, some addicts act horribly if they are desperate for drugs. But of course, there are many shitty people who aren't addicts
But as a broad, broad generality what always strikes me is the incredible waste of human potential that happens when these sick systems arise, and that makes it much easier to...I guess be frustrated or angry the way you would be frustrated or angry with a friend, at worst. It's like, I can't think of unhoused people or addicted people - or even people who steal bikes or are otherwise not very pro-social - without thinking of the real, specific people I've met and how it always strikes me as garbage and unfair that their life chances are much worse than mine.
I also can't think of "addicts" as a group without thinking of certain specific smart, charming and talented people I've talked to on the street. I don't want anything bad to happen to them, and I don't want systems in place that are going to hurt them. Like, it really brings home why I wouldn't want forced treatment or aggressive policing, because I can picture it happening to people I have met and talked to, and I hate to think of it.
You meet someone and you think, "if we were meeting under less high-pressure and weird circumstances, we would be regular friends, not just people who see each other once a week at the Helping People event" and then you think of them being marched off to some treatment camp or thrown in jail or otherwise disposed of and it is horrible.
posted by Frowner at 11:44 AM on August 3, 2023 [32 favorites]
But as a broad, broad generality what always strikes me is the incredible waste of human potential that happens when these sick systems arise, and that makes it much easier to...I guess be frustrated or angry the way you would be frustrated or angry with a friend, at worst. It's like, I can't think of unhoused people or addicted people - or even people who steal bikes or are otherwise not very pro-social - without thinking of the real, specific people I've met and how it always strikes me as garbage and unfair that their life chances are much worse than mine.
I also can't think of "addicts" as a group without thinking of certain specific smart, charming and talented people I've talked to on the street. I don't want anything bad to happen to them, and I don't want systems in place that are going to hurt them. Like, it really brings home why I wouldn't want forced treatment or aggressive policing, because I can picture it happening to people I have met and talked to, and I hate to think of it.
You meet someone and you think, "if we were meeting under less high-pressure and weird circumstances, we would be regular friends, not just people who see each other once a week at the Helping People event" and then you think of them being marched off to some treatment camp or thrown in jail or otherwise disposed of and it is horrible.
posted by Frowner at 11:44 AM on August 3, 2023 [32 favorites]
Truly. And the idea that these problems can't come for you is a just-world fallacy and that presumes a moral failing on the part of the addict or the houseless person or whomever we consider the wretches. For every un-reachable lost cause addict there's someone that is getting just that bit of help and compassion they need to save their lives. We don't see them anymore because their problem has been fixed. You don't see the success stories, you see the failure but the failure on the streets is our failure as a society. We should not have hungry children. We should be able to house everyone. America is really way behind the other advanced countries. Go anywhere in the world with our kind of wealth and you see some amazing stuff. We won't ever have it because our politics is entrenched in the whims of the wealthy who are more secure in power the more we fight each other.
But, back to Portland, this is a small city with a big city jacket on and it's never really been able to get to the next level. We have some taxation problems that are holding us back and for all that people have moved here to have a nice lifestyle and escape their even more expensive home locations, it's all been sucked up by housing costs.
posted by amanda at 11:44 AM on August 3, 2023 [13 favorites]
But, back to Portland, this is a small city with a big city jacket on and it's never really been able to get to the next level. We have some taxation problems that are holding us back and for all that people have moved here to have a nice lifestyle and escape their even more expensive home locations, it's all been sucked up by housing costs.
posted by amanda at 11:44 AM on August 3, 2023 [13 favorites]
I think most if not all of us would agree that a major obstacle here is the inaccessibility of drug treatment. Ages ago, I had an interesting informal conversation with a prominent expert on addiction and the brain. She shared an anecdote about someone she knew who had struggled with substance use disorder and had access to socialized medicine. This person had received drug treatment but after a while, they realized it was getting more difficult not to relapse so they were going back to rehab. They weren’t in a dire situation. They just needed help, not in a this-is-a-crisis way but they needed it enough to know they couldn’t just white-knuckle their way through it.
That stuck with me. It should be that easy, because that’s actually not easy. Recognizing and seeking help is not easy. But the getting help shouldn’t be the hard part.
posted by kat518 at 12:05 PM on August 3, 2023 [13 favorites]
That stuck with me. It should be that easy, because that’s actually not easy. Recognizing and seeking help is not easy. But the getting help shouldn’t be the hard part.
posted by kat518 at 12:05 PM on August 3, 2023 [13 favorites]
amanda's point bears repeating : Being on the streets sucks. It's scary, and uncomfortable, and you can't sleep and it's hard to wash-up or stay charged up to make phone calls and people look at you like you suck. The more you are on the street, the harder it is to get back.
I have heard more than once, both from acquaitances who volunteer with unhoused people and people whose social circle includes the same, that a nonzero number of homeless addicts are doing drugs not because that's how they got there, but because that's the only way to cope with how much it sucks ass being homeless. It is fucking terrible, and frankly I don't know how long I--who have never had a substance issue in my life--would stay sober in the kind of conditions I regularly see when I visit my home town on the west coast. Knowing that I would probably never be able to get out of it. Sweet fucking Jesus.
A beloved relative suffered for many years with addiction; the only reason they didn't literally die in a gutter in Pioneer Square at some point in the early 90s, and in fact were able to stay sober for a couple years at the very end, is that they had a family member who was affluent, caring and, idk, pragmatic/savvy/intuitive enough to ensure that they stayed housed--because he knew perfectly well that if that person wound up sleeping rough it was game over. Every time I see a woman pushing a pug down 2nd Avenue in a stroller (happened), or see some guy screaming in a bus shelter surrounded by filth (regular occurrence), or drive past one of those cursèd fucking encampments on the side of I-5, I think of them.
I 100% agree that all Portland's decriminalization law is really doing is bringing all this grotesque suffering--and it IS disgusting, morally, to see people forced to exist like this--out into the open, which no other city in the US (to my knowledge) has had the guts to do. That the law is insufficient to bring about its stated aims in the current environment is painfully clear, but the previous solution, and the one most municipalities use, is simply throwing these people in jail to rot. A ruling class which cannot or will not construct an alternative to either of these approaches deserves every single one of the consequences it whines about, and more besides.
posted by peakes at 12:24 PM on August 3, 2023 [23 favorites]
I have heard more than once, both from acquaitances who volunteer with unhoused people and people whose social circle includes the same, that a nonzero number of homeless addicts are doing drugs not because that's how they got there, but because that's the only way to cope with how much it sucks ass being homeless. It is fucking terrible, and frankly I don't know how long I--who have never had a substance issue in my life--would stay sober in the kind of conditions I regularly see when I visit my home town on the west coast. Knowing that I would probably never be able to get out of it. Sweet fucking Jesus.
A beloved relative suffered for many years with addiction; the only reason they didn't literally die in a gutter in Pioneer Square at some point in the early 90s, and in fact were able to stay sober for a couple years at the very end, is that they had a family member who was affluent, caring and, idk, pragmatic/savvy/intuitive enough to ensure that they stayed housed--because he knew perfectly well that if that person wound up sleeping rough it was game over. Every time I see a woman pushing a pug down 2nd Avenue in a stroller (happened), or see some guy screaming in a bus shelter surrounded by filth (regular occurrence), or drive past one of those cursèd fucking encampments on the side of I-5, I think of them.
I 100% agree that all Portland's decriminalization law is really doing is bringing all this grotesque suffering--and it IS disgusting, morally, to see people forced to exist like this--out into the open, which no other city in the US (to my knowledge) has had the guts to do. That the law is insufficient to bring about its stated aims in the current environment is painfully clear, but the previous solution, and the one most municipalities use, is simply throwing these people in jail to rot. A ruling class which cannot or will not construct an alternative to either of these approaches deserves every single one of the consequences it whines about, and more besides.
posted by peakes at 12:24 PM on August 3, 2023 [23 favorites]
They sucked his brains out!, I wasn't implying you were being sneaky, but I think it's safe to say there's a certain type of blue big city Democrat "moderate" that basically draws their sustenance on picking over the failed or semi-failed or less than perfect policies of the progressive left (such as harm reduction or social welfare programs) and rather than try and solve and improve upon those failures or less-than-perfect outcomes instead uses them to hippie-bash/punch leftward and advocate for draconian and harsh punitive measures that just-so-happen to align basically with the rightwing in a manner that ratchets everything rightward over time. When people say things like "we really need to ask ourselves the hard questions" they almost never mean anything that might harm or challenge the wealthy, the powerful or the connected. It's always used to begin a project of justifying going after the disempowered.
posted by flamk at 12:37 PM on August 3, 2023 [13 favorites]
posted by flamk at 12:37 PM on August 3, 2023 [13 favorites]
In Seattle, at least, I see no evidence that functionally open-air markets are leading to fewer deaths. The statistics, in fact, point to increased overdose deaths over time.
Is there evidence that the increase in overdose deaths is a result of "open-air markets," though? Isn't it the result of an increasingly toxic drug supply, which could be addressed by providing a safe supply, which would presumably reduce the demand for open-air markets in the first place?
I live in Vancouver. I see the problem. I feel less safe downtown than I used to. The last time I helped out someone in a potential OD situation was five days ago. I agree that we need to think critically rather than being dogmatic about the solutions we propose. And the evidence I've seen so far, from research and my own lived experience, is that criminalization and stigmatization may make the problem less visible but they don't actually help people. Harm reduction helps people, and we keep doing it in half-assed (or intentionally sabotaged) ways that make it less effective than it could be.
What I also see -- not here on Metafilter, thankfully, but elsewhere -- is a whole lot of calls for police violence, vigilantism, and eliminationist rhetoric against drug users, and that really scares me because I think it's becoming a significant recruitment tool for fascists. Again, no one on Metafilter is doing this! But I think it's super important to see drug users, homeless folks, etc. as our neighbors first and foremost -- as members of our community, not as undesirable others -- and to be very very careful and thoughtful about how the lines between "us" and "them" are being drawn.
posted by Gerald Bostock at 12:44 PM on August 3, 2023 [26 favorites]
Is there evidence that the increase in overdose deaths is a result of "open-air markets," though? Isn't it the result of an increasingly toxic drug supply, which could be addressed by providing a safe supply, which would presumably reduce the demand for open-air markets in the first place?
I live in Vancouver. I see the problem. I feel less safe downtown than I used to. The last time I helped out someone in a potential OD situation was five days ago. I agree that we need to think critically rather than being dogmatic about the solutions we propose. And the evidence I've seen so far, from research and my own lived experience, is that criminalization and stigmatization may make the problem less visible but they don't actually help people. Harm reduction helps people, and we keep doing it in half-assed (or intentionally sabotaged) ways that make it less effective than it could be.
What I also see -- not here on Metafilter, thankfully, but elsewhere -- is a whole lot of calls for police violence, vigilantism, and eliminationist rhetoric against drug users, and that really scares me because I think it's becoming a significant recruitment tool for fascists. Again, no one on Metafilter is doing this! But I think it's super important to see drug users, homeless folks, etc. as our neighbors first and foremost -- as members of our community, not as undesirable others -- and to be very very careful and thoughtful about how the lines between "us" and "them" are being drawn.
posted by Gerald Bostock at 12:44 PM on August 3, 2023 [26 favorites]
I live in Vancouver as well and agree with everything Gerald Bostock has to say above.
I was forced into a treatment centre in November of '21 after undergoing a mandatory assessment because my government workplace found out about my alcohol use disorder from an honest doctor when I needed time off to address a relapse.
I had been trying to quit but I got caught up in an incredibly corrupt system and the doctor who did my assessment was the most vile human being I have ever met in the medical system.
She also owns a substance testing company so I have to do random substance tests for 2 years. A massive conflict of interest. I mention this because ash lied and lied and lied in her report whose main goal was to build a case for substance testing.
This is the elephant in the room here; the massive amounts of profit to be had in the Addictions Industrial Complex.
In western Canada the addictions industry has ties to the right wing; and the doctor did my assessment appears at addiction conferences pushing a hard core abstinence only treatment model.
My treatment centre was hardcore true believer AA and even they said that 95% of us would relapse in a year.
Rehab really helped me, but only because I wanted so bad to quit.
So yeah, profit has to be addressed as well; the last figure I came across is that dealing with addiction is a 46 billion dollar business in the US and that has to change.
Anyways, my 2 cents, this is very rushed because I have to go to work, thank you for this and the ensuing discussion.
posted by Phlegmco(tm) at 1:05 PM on August 3, 2023 [33 favorites]
I was forced into a treatment centre in November of '21 after undergoing a mandatory assessment because my government workplace found out about my alcohol use disorder from an honest doctor when I needed time off to address a relapse.
I had been trying to quit but I got caught up in an incredibly corrupt system and the doctor who did my assessment was the most vile human being I have ever met in the medical system.
She also owns a substance testing company so I have to do random substance tests for 2 years. A massive conflict of interest. I mention this because ash lied and lied and lied in her report whose main goal was to build a case for substance testing.
This is the elephant in the room here; the massive amounts of profit to be had in the Addictions Industrial Complex.
In western Canada the addictions industry has ties to the right wing; and the doctor did my assessment appears at addiction conferences pushing a hard core abstinence only treatment model.
My treatment centre was hardcore true believer AA and even they said that 95% of us would relapse in a year.
Rehab really helped me, but only because I wanted so bad to quit.
So yeah, profit has to be addressed as well; the last figure I came across is that dealing with addiction is a 46 billion dollar business in the US and that has to change.
Anyways, my 2 cents, this is very rushed because I have to go to work, thank you for this and the ensuing discussion.
posted by Phlegmco(tm) at 1:05 PM on August 3, 2023 [33 favorites]
just garbage cans and toilets unhoused folksPublic restrooms and porta potties get trashed really quickly in Portland. They will quickly be graffitied, filled with garbage and then set on fire. I mean that literally. Porta potties are routinely thrashed and then set ablaze here. I don’t know what that’s about or how to stop it, but it’s made it more difficult than you’d expect to provide basic facilities.
posted by chrchr at 1:14 PM on August 3, 2023 [2 favorites]
Fentanyl went way past unintended consequences
It was an unintended consequence alright - of the crackdown on prescription drugs, and of the globalization of chemical manufacture.
I show people these graphs a lot. Figure 2 especially.
posted by atoxyl at 1:34 PM on August 3, 2023 [7 favorites]
It was an unintended consequence alright - of the crackdown on prescription drugs, and of the globalization of chemical manufacture.
I show people these graphs a lot. Figure 2 especially.
posted by atoxyl at 1:34 PM on August 3, 2023 [7 favorites]
If anyone wants to know, a tolerable alternative to porta potties is repeatedly setting up camping/portable toilets - the kind that are just a bucket in a cheap tiny tent, basically. They are not ideal, but they are usable and replaceable and can be set up at encampments on an as-needed basis. You need the city, encampment support or someone to take care of this and you need to understand that it's something that has to be re-upped, but people tend to be appreciative.
One thing that happens around encampments: people arrive to prey on the unhoused. Pimps, drug dealers, thieves, gang members asserting territory, people looking to rape and victimize. This escalates problems and then the problems are blamed on the unhoused people. Another advantage to getting people into housing is that, when everyone has a door they can close, it is much harder to prey on people. You need a certain amount of security and a light touch so that you aren't just creating a housing prison, but no one can troll around encampments looking to steal people's shit if people actually have their own lockable rooms. Pimps can't roam around looking for people to victimize. Drug sales is separated from where people live, so even if it is chaotic and terrible it can't escalate into burning people's tents or attacking them while they sleep. Also, you have the opportunity to create more space between people, which deescalates things.
Furthermore, and I cannot stress this enough, people are extremely volatile when they don't get enough sleep, which you don't when you're sleeping with one eye open in a tent under a highway overpass. My belief is that just putting people in lockable rooms where they can sleep deeply and feeding them regular, reasonably nutritious meals will have a very substantial deescalating effect after six weeks or so. (On the street most of the time you get crappy food - people are surviving almost entirely on, like pop tarts and cheetos, because that is cheap, portable, predictable and gives you a little sugar boost when you're feeling low. Think about how you'd feel after a few months of scanty bad sleep and a diet of ultraprocessed food for almost every meal - cheetos might cheer you up a bit in the moment but play hell with your stomach over the longer term.)
posted by Frowner at 1:42 PM on August 3, 2023 [33 favorites]
One thing that happens around encampments: people arrive to prey on the unhoused. Pimps, drug dealers, thieves, gang members asserting territory, people looking to rape and victimize. This escalates problems and then the problems are blamed on the unhoused people. Another advantage to getting people into housing is that, when everyone has a door they can close, it is much harder to prey on people. You need a certain amount of security and a light touch so that you aren't just creating a housing prison, but no one can troll around encampments looking to steal people's shit if people actually have their own lockable rooms. Pimps can't roam around looking for people to victimize. Drug sales is separated from where people live, so even if it is chaotic and terrible it can't escalate into burning people's tents or attacking them while they sleep. Also, you have the opportunity to create more space between people, which deescalates things.
Furthermore, and I cannot stress this enough, people are extremely volatile when they don't get enough sleep, which you don't when you're sleeping with one eye open in a tent under a highway overpass. My belief is that just putting people in lockable rooms where they can sleep deeply and feeding them regular, reasonably nutritious meals will have a very substantial deescalating effect after six weeks or so. (On the street most of the time you get crappy food - people are surviving almost entirely on, like pop tarts and cheetos, because that is cheap, portable, predictable and gives you a little sugar boost when you're feeling low. Think about how you'd feel after a few months of scanty bad sleep and a diet of ultraprocessed food for almost every meal - cheetos might cheer you up a bit in the moment but play hell with your stomach over the longer term.)
posted by Frowner at 1:42 PM on August 3, 2023 [33 favorites]
I have some pretty strong feelings about this whole issue, coming from personal experience, although my experience was a long time ago and I knows that there are others with experience with addiction who disagree. Here I’ll just say:
There obviously are externalities of drug addiction, there’s obviously associated crime and public nuisance, especially when there’s a concentrated population of serious users, and it’s not wrong for people to be concerned about it! A lot of “tough love” talk that’s framed in terms of concern for the drug users, though, is out of touch at best and at worst comes off as disingenuous cover for people who are more concerned with the public nuisance but want to say something more “compassionate” and I honestly can’t stand it.
posted by atoxyl at 1:47 PM on August 3, 2023 [14 favorites]
There obviously are externalities of drug addiction, there’s obviously associated crime and public nuisance, especially when there’s a concentrated population of serious users, and it’s not wrong for people to be concerned about it! A lot of “tough love” talk that’s framed in terms of concern for the drug users, though, is out of touch at best and at worst comes off as disingenuous cover for people who are more concerned with the public nuisance but want to say something more “compassionate” and I honestly can’t stand it.
posted by atoxyl at 1:47 PM on August 3, 2023 [14 favorites]
It’s not that supply is not part of the problem when it comes to things like fentanyl but if you want to talk about that let’s talk about true internationally coordinated effort to reduce supply.
posted by atoxyl at 1:49 PM on August 3, 2023 [4 favorites]
posted by atoxyl at 1:49 PM on August 3, 2023 [4 favorites]
I am still waiting for that study on how many people who use narcan go on to recover from being an addict or homeless, and don't just use again and again till they die.
I’m sure the long-term success rate for involuntary participation in a treatment program is, in comparison, stunningly good…
(Okay, enough for now)
posted by atoxyl at 1:53 PM on August 3, 2023 [3 favorites]
I’m sure the long-term success rate for involuntary participation in a treatment program is, in comparison, stunningly good…
(Okay, enough for now)
posted by atoxyl at 1:53 PM on August 3, 2023 [3 favorites]
Porta potties are routinely thrashed and then set ablaze here. I don’t know what that’s about or how to stop it, but it’s made it more difficult than you’d expect to provide basic facilities.
I would guess that it's the most insulting possible solution to very real problems. We won't actually help, and will tsk, tsk, as we walk past, but for the love of god shit in this bucket. What do you mean you're not grateful?
posted by Uncle at 1:53 PM on August 3, 2023 [1 favorite]
I would guess that it's the most insulting possible solution to very real problems. We won't actually help, and will tsk, tsk, as we walk past, but for the love of god shit in this bucket. What do you mean you're not grateful?
posted by Uncle at 1:53 PM on August 3, 2023 [1 favorite]
I think if we want to help people.... Any people, ever... The most important and lasting benefit would be to smash the general hate or dehumanizing based world view of the average fascist, colonizers, right wing, judgmental religionist, or even patriarchal type.
Once we actually get everyone on board that humans all deserve the best life possible, then there can be debates about best options and practices. But far too many people think that any kind of safety net is a sin or heresy and that crushing people is more profitable.
System working as intended, no errors found.
posted by Jacen at 2:02 PM on August 3, 2023 [3 favorites]
Once we actually get everyone on board that humans all deserve the best life possible, then there can be debates about best options and practices. But far too many people think that any kind of safety net is a sin or heresy and that crushing people is more profitable.
System working as intended, no errors found.
posted by Jacen at 2:02 PM on August 3, 2023 [3 favorites]
As others have said in this thread, it’s really frustrating that our local governments don’t seem to be able to do basic government type of stuff. An especially infuriating example: recently it came to light that Multnomah County is sitting on $100 million in a fund for homeless services that they haven’t decided how to spend. They’ve been underspending from that fund for years.
posted by chrchr at 2:06 PM on August 3, 2023 [4 favorites]
posted by chrchr at 2:06 PM on August 3, 2023 [4 favorites]
I am still waiting for that study on how many people who use narcan go on to recover from being an addict or homeless, and don't just use again and again till they die.
Narcan is not a treatment for addiction. It's a treatment for overdose. It keeps you from dying. The alternative to not administering Narcan, in many instances, is death. I find it difficult to understand this sentence to have any other meaning than "there's no point in saving them in the moment, because they're just going to kill themselves at some point." (Also, homelessness is not a disease.)
People with substance abuse disorders can be unbelievably frustrating and angering and heart-breaking to deal with. They can combine infinite need with infinite antisociality, which pushes many people's buttons (I'm not exempt from this). Their (visible) presence in large numbers in one spot do indeed pose real challenges to neighborhood infrastructure and can be exceptionally discomfiting. But, damn, the "tough questions" people so often seem to be coming from the fundamental position of "if they can't stop being visibly needy, they might as well die as fast as possible and save us the agita."
posted by praemunire at 2:53 PM on August 3, 2023 [32 favorites]
Narcan is not a treatment for addiction. It's a treatment for overdose. It keeps you from dying. The alternative to not administering Narcan, in many instances, is death. I find it difficult to understand this sentence to have any other meaning than "there's no point in saving them in the moment, because they're just going to kill themselves at some point." (Also, homelessness is not a disease.)
People with substance abuse disorders can be unbelievably frustrating and angering and heart-breaking to deal with. They can combine infinite need with infinite antisociality, which pushes many people's buttons (I'm not exempt from this). Their (visible) presence in large numbers in one spot do indeed pose real challenges to neighborhood infrastructure and can be exceptionally discomfiting. But, damn, the "tough questions" people so often seem to be coming from the fundamental position of "if they can't stop being visibly needy, they might as well die as fast as possible and save us the agita."
posted by praemunire at 2:53 PM on August 3, 2023 [32 favorites]
I get it. I find living with human misery to be.. miserable! I'm currently fantasizing about leaving my lifelong home in the Bay Area to escape it. It's perfectly human to not want to see other humans living in piles of garbage, taking drugs on this street, having mental health crises in front of you, defecate in public, etc! (Obviously much more miserable to be actually experiencing these things.)
But I think the problem is with where we identify the problem! Diseases of despair can't be cured by hiding them in poor neighborhoods or locking them up in prison. Places that have less misery have less poverty, more access to meaningful work and healthy leisure. Clean air, walkable cities, public parks, recreation programs, easy to access healthcare, and abundant housing for people at all income levels are all ingredients in a healthy society where fewer people live on the streets, have frequent mental health crises or use dangerous drugs to excess.
Harm reduction measures like decriminalization and ready access to buprenorphine and narcan are like, the minimum required for mitigating death - so in my opinion - a moral imperative. But they neither worsen nor solve the crisis. They're almost irrelevant to solving the crisis.
posted by latkes at 2:55 PM on August 3, 2023 [9 favorites]
But I think the problem is with where we identify the problem! Diseases of despair can't be cured by hiding them in poor neighborhoods or locking them up in prison. Places that have less misery have less poverty, more access to meaningful work and healthy leisure. Clean air, walkable cities, public parks, recreation programs, easy to access healthcare, and abundant housing for people at all income levels are all ingredients in a healthy society where fewer people live on the streets, have frequent mental health crises or use dangerous drugs to excess.
Harm reduction measures like decriminalization and ready access to buprenorphine and narcan are like, the minimum required for mitigating death - so in my opinion - a moral imperative. But they neither worsen nor solve the crisis. They're almost irrelevant to solving the crisis.
posted by latkes at 2:55 PM on August 3, 2023 [9 favorites]
I would guess that it's the most insulting possible solution to very real problems. We won't actually help, and will tsk, tsk, as we walk past, but for the love of god shit in this bucket. What do you mean you're not grateful?Well, I disagree. I think it’s unlikely that destroying public facilities is smart, actually. I find that notion extremely offensive. I think it’s way more likely that, rather than these been principled acts of protest by rational actors, a very small number of people are setting things on fire for fun and ruining it for a much larger number of people that would like a clean, private restroom.
I mean, another thing here is that there’s a huge shortage of public defenders, though just this week new funding was added to hire more. If you can’t assign a public defender to a crime suspect, they can’t be prosecuted and the case gets dropped and they’re back on the streets, and that’s what’s happening. A lot of the issues people have with the addiction/homelessness omnicrisis in Portland aren’t with the addiction or the homelessness but really just the sense of filth and lawlessness. Assault is illegal! Theft is illegal! As the Times article notes, it’s still illegal to use drugs in public. It’s definitely illegal to destroy a public restroom. You don’t really need to make possession of fentanyl illegal to charge drug users who cause problems with crimes. Being a drug user shouldn’t license a person to antisocial behavior. So, I continue to support measure 110, but please, please can the rest of our legal system function at least a little bit?
posted by chrchr at 3:19 PM on August 3, 2023 [5 favorites]
Seconding frowner’s comment wrt housing (and food).
Until the late 80’s/early 90’s most bigger cities had many options of SRO (single-room-occupancy) housing, with shared bathrooms. This was cheap, often poorly maintained but the residents had something they could afford, a door that locked, a place to shit/shower/shave, a roof that kept out the elements and it wasn’t the street.
As this sort of housing went away, I think we saw more couch-surfing and folks living in cars (even short-term).
Now, anyone on the edge is one crisis (of any kind) away from the street. I agree with others that I would not have the fortitude to stay sober very long, were I forced to live on the street. It’s miserable, and does indeed open one up to exploitation by all manner of criminals.
I am sick to death of people “blaming the victim” - these are humans, where is our compassion, and our collective will to help?
posted by dbmcd at 3:47 PM on August 3, 2023 [19 favorites]
Until the late 80’s/early 90’s most bigger cities had many options of SRO (single-room-occupancy) housing, with shared bathrooms. This was cheap, often poorly maintained but the residents had something they could afford, a door that locked, a place to shit/shower/shave, a roof that kept out the elements and it wasn’t the street.
As this sort of housing went away, I think we saw more couch-surfing and folks living in cars (even short-term).
Now, anyone on the edge is one crisis (of any kind) away from the street. I agree with others that I would not have the fortitude to stay sober very long, were I forced to live on the street. It’s miserable, and does indeed open one up to exploitation by all manner of criminals.
I am sick to death of people “blaming the victim” - these are humans, where is our compassion, and our collective will to help?
posted by dbmcd at 3:47 PM on August 3, 2023 [19 favorites]
Until the late 80’s/early 90’s most bigger cities had many options of SRO (single-room-occupancy) housing, with shared bathrooms.
There was another post about SROs here recently and yes, absolutely. I often feel like this is mostly invisible to people who never had a reason to visit these sort of places or spend time around their inhabitants, like most people don’t even really have a concept of what life looks like one or two rungs up from sleeping on the street, like it doesn’t even compute for them that this niche could exist.
You reference the 80s and 90s but even in the last ten years a lot of them have gone away.
posted by atoxyl at 4:06 PM on August 3, 2023 [5 favorites]
There was another post about SROs here recently and yes, absolutely. I often feel like this is mostly invisible to people who never had a reason to visit these sort of places or spend time around their inhabitants, like most people don’t even really have a concept of what life looks like one or two rungs up from sleeping on the street, like it doesn’t even compute for them that this niche could exist.
You reference the 80s and 90s but even in the last ten years a lot of them have gone away.
posted by atoxyl at 4:06 PM on August 3, 2023 [5 favorites]
I think it’s way more likely that, rather than these been principled acts of protest by rational actors, a very small number of people are setting things on fire for fun and ruining it for a much larger number of people that would like a clean, private restroom.
Absolutely. Vigilantism and harassment of folks needing services by destroying those facilities to a) drive them away, b) express anger that any services are being handed out at all, c) make the situation look bad, d) harass and terrorize for fun is and has been a factor. Up until this last year I was on a board at one of our farmers market. At various times, we’ve had issues with our potty that we need to have on-site during market season. During pandemic the level of unauthorized use and vandalism was epic. But here’s the thing, it would get broken into so that people could sleep in it. Our market manager came one morning to open it up and two people were sleeping in it. And, yes, they’d done drugs in it and it was messed up from being broken into and they had done something so that they both sleep in there and it smelled horrendous. It was so frustrating to try to get a working potty before market opened, a gross mess to clean up, a potty for the company to repair and the promise that it would happen again and again. But damn, can you imagine sleeping in a port-a-potty WITH a second person? Let me tell you, some of the neighbors are HOSTILE about this situation and there’s any number of reasons a potty being used as shelter could burn including someone purposefully going after the people inside.
posted by amanda at 4:32 PM on August 3, 2023 [8 favorites]
Absolutely. Vigilantism and harassment of folks needing services by destroying those facilities to a) drive them away, b) express anger that any services are being handed out at all, c) make the situation look bad, d) harass and terrorize for fun is and has been a factor. Up until this last year I was on a board at one of our farmers market. At various times, we’ve had issues with our potty that we need to have on-site during market season. During pandemic the level of unauthorized use and vandalism was epic. But here’s the thing, it would get broken into so that people could sleep in it. Our market manager came one morning to open it up and two people were sleeping in it. And, yes, they’d done drugs in it and it was messed up from being broken into and they had done something so that they both sleep in there and it smelled horrendous. It was so frustrating to try to get a working potty before market opened, a gross mess to clean up, a potty for the company to repair and the promise that it would happen again and again. But damn, can you imagine sleeping in a port-a-potty WITH a second person? Let me tell you, some of the neighbors are HOSTILE about this situation and there’s any number of reasons a potty being used as shelter could burn including someone purposefully going after the people inside.
posted by amanda at 4:32 PM on August 3, 2023 [8 favorites]
Well, I disagree. I think it’s unlikely that destroying public facilities is smart, actually. I find that notion extremely offensive. I think it’s way more likely that, rather than these been principled acts of protest by rational actors, a very small number of people are setting things on fire for fun and ruining it for a much larger number of people that would like a clean, private restroom.
You misunderstand me. I don’t think it’s protest. I think it the actions of people driven to madness by having nowhere to sleep and no real hope of finding anything to change their situation other than drugs. When all you have to express yourself is shit and rage things are going to get covered in shit.
posted by Uncle at 6:01 PM on August 3, 2023
You misunderstand me. I don’t think it’s protest. I think it the actions of people driven to madness by having nowhere to sleep and no real hope of finding anything to change their situation other than drugs. When all you have to express yourself is shit and rage things are going to get covered in shit.
posted by Uncle at 6:01 PM on August 3, 2023
If your comment, Uncle, was some kind of dig at my comment about camping toilets, well, I suggested that because it is what encampment support has done here when the city stopped providing portapotties and there were no toilets nearby. Believe me, no one really likes using a camping toilet, but people like it quite a lot better than having absolutely zero privacy and no cleanable container for waste. If we were able to rent or build and maintain anything better we would, but for a number of reasons the camping toilets have been the best we could do. They get torn down by the cops every time the cops move people on, for one thing.
posted by Frowner at 6:53 PM on August 3, 2023 [3 favorites]
posted by Frowner at 6:53 PM on August 3, 2023 [3 favorites]
Sorry Frowner I was not trying to dismiss the vital need for toilets. Or the hard work that goes into getting them there. I was trying to express that it is a slightly insulting bandaid to many problems. We don’t provide housing or food or help. Only criminalization and, due to the hard work of underfunded good people, a bucket to shit in.
posted by Uncle at 7:30 PM on August 3, 2023
posted by Uncle at 7:30 PM on August 3, 2023
If your comment, Uncle, was some kind of dig at my comment about camping toilets, well, I suggested that because it is what encampment support has done here when the city stopped providing portapotties and there were no toilets nearby.
Even in these situations, there's a hierarchy. Full encampments like you are describing have options and possibilities that you don't have when it is a line of five tents about six inches from the commuter traffic on Naito Parkway. Portland has allowed (like people have said, due to total local government failure) living situations that you don't see in many places in North America.
That said, I agree agree agree with the comments above about how the gutting of the low end of the housing market (like SROs) and how even basic crummy housing (like a 1-bedroom in a dilapidated 8-unit built in 1967) costs way more than someone earning an entry-level wage can afford, has blocked people from having any other option. The drug use that is happening on the streets is more a response to the trauma of living in those conditions as it is a cause. People need a minimum basic level of dignity (like, a room that has a locking door; a place to shit that isn't a bus shelter) before there is any chance of healthy living.
And, these aren't problems that should be dumped in the lap of local government. Even a better functioning government than Portland has can't solve this. This represents a total abdication of federal responsibility, because these problems are national, and everywhere.
posted by Dip Flash at 7:49 PM on August 3, 2023 [8 favorites]
Even in these situations, there's a hierarchy. Full encampments like you are describing have options and possibilities that you don't have when it is a line of five tents about six inches from the commuter traffic on Naito Parkway. Portland has allowed (like people have said, due to total local government failure) living situations that you don't see in many places in North America.
That said, I agree agree agree with the comments above about how the gutting of the low end of the housing market (like SROs) and how even basic crummy housing (like a 1-bedroom in a dilapidated 8-unit built in 1967) costs way more than someone earning an entry-level wage can afford, has blocked people from having any other option. The drug use that is happening on the streets is more a response to the trauma of living in those conditions as it is a cause. People need a minimum basic level of dignity (like, a room that has a locking door; a place to shit that isn't a bus shelter) before there is any chance of healthy living.
And, these aren't problems that should be dumped in the lap of local government. Even a better functioning government than Portland has can't solve this. This represents a total abdication of federal responsibility, because these problems are national, and everywhere.
posted by Dip Flash at 7:49 PM on August 3, 2023 [8 favorites]
Which centers the people who drive through the neighborhood and don’t want to see shit on the sidewalk, not the people who need help.
Fuuuck that. Nobody is being “centered”. Nobody wins when people are denied basic sanitation. The status quo here benefits absolutely nobody. Why do you imagine a rich person in a car and not a kid walking on the sidewalk on their way to school, or a single mom waiting at the bus stop on her way home from work?
posted by chrchr at 8:30 PM on August 3, 2023 [6 favorites]
Fuuuck that. Nobody is being “centered”. Nobody wins when people are denied basic sanitation. The status quo here benefits absolutely nobody. Why do you imagine a rich person in a car and not a kid walking on the sidewalk on their way to school, or a single mom waiting at the bus stop on her way home from work?
posted by chrchr at 8:30 PM on August 3, 2023 [6 favorites]
is there any hope that fewer young people are not attracted to using fentanyl ?
posted by robbyrobs at 9:29 PM on August 3, 2023
posted by robbyrobs at 9:29 PM on August 3, 2023
Are these rehabilitation programs that these people are being directed to effective? Is there a level of relapse where we admit that the resources are failing people instead of people failing programs?
posted by Selena777 at 9:59 PM on August 3, 2023
posted by Selena777 at 9:59 PM on August 3, 2023
My spouse makes six figures. By any sane estimate we are wealthy.
We can, at the most extreme reach of monthly payments and a huge mortgage, just barely afford the most nightmarish disaster houses, ones that are in advanced decay or which have major structural problems or which are the half-finished fever dreams of a foolish would-be flipper and require tens of thousands in additional repairs to even be livable. Either that or moving to somewhere an hour away from the city into the middle of deep red Nazi territory, which as a spouse to a trans person I am not a fan of.
The houses. We need places for people to live who can't afford five hundred thousand dollars in loans. The chain doesn't go from drugs to homelessness to crisis. It goes from homelessness to crisis to drugs.
posted by Scattercat at 11:45 PM on August 3, 2023 [11 favorites]
We can, at the most extreme reach of monthly payments and a huge mortgage, just barely afford the most nightmarish disaster houses, ones that are in advanced decay or which have major structural problems or which are the half-finished fever dreams of a foolish would-be flipper and require tens of thousands in additional repairs to even be livable. Either that or moving to somewhere an hour away from the city into the middle of deep red Nazi territory, which as a spouse to a trans person I am not a fan of.
The houses. We need places for people to live who can't afford five hundred thousand dollars in loans. The chain doesn't go from drugs to homelessness to crisis. It goes from homelessness to crisis to drugs.
posted by Scattercat at 11:45 PM on August 3, 2023 [11 favorites]
I’m a firm proponent of Housing First and though I’m not homeless I’m on Medicaid and SNAP in Oregon. I’ve spent this week in detox being monitored every 4 hours around the clock, getting klonopin and diazepam for treatment with plenty of good food and kind staff and nurses as well as immediate access to emergency hospital care. Tomorrow I’m transferring to a 90-day women’s residential program. Both of these stays - as well as rides between Portland and Eugene - are fully covered by Medicaid and Medicaid will also pay my rent for those three months.
It took me several months and lots of phone calls to secure this place and I can guarantee-damn-tee you that if I were starting from being unhoused or had a debilitating mental illness I would have never arrived here.
Housing First and case managers won’t keep everyone from falling through the cracks but I’m positive that first mitigating the extreme stresses of living on the street would help a whole lot of addicts. They might not get clean and sober the first time through the program but they can always try again.
Are these rehabilitation programs that these people are being directed to effective?
I read The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry a couple weeks ago and 12-step programs generally have a 5-10% success rate, less so if the participant doesn’t want to rely on a higher power.
However there are several other treatment programs to treat addiction in rehab: Rational Recovery, SMART and others. Last night I went to a Refuge Recovery meeting which is Buhddism-related and includes meditation.
posted by bendy at 12:04 AM on August 4, 2023 [32 favorites]
It took me several months and lots of phone calls to secure this place and I can guarantee-damn-tee you that if I were starting from being unhoused or had a debilitating mental illness I would have never arrived here.
Housing First and case managers won’t keep everyone from falling through the cracks but I’m positive that first mitigating the extreme stresses of living on the street would help a whole lot of addicts. They might not get clean and sober the first time through the program but they can always try again.
Are these rehabilitation programs that these people are being directed to effective?
I read The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry a couple weeks ago and 12-step programs generally have a 5-10% success rate, less so if the participant doesn’t want to rely on a higher power.
However there are several other treatment programs to treat addiction in rehab: Rational Recovery, SMART and others. Last night I went to a Refuge Recovery meeting which is Buhddism-related and includes meditation.
posted by bendy at 12:04 AM on August 4, 2023 [32 favorites]
Fuuuck that. Nobody is being “centered”. Nobody wins when people are denied basic sanitation. The status quo here benefits absolutely nobody. Why do you imagine a rich person in a car and not a kid walking on the sidewalk on their way to school, or a single mom waiting at the bus stop on her way home from work?
Sorry this was responding to my deleted comment. I’m trying to express that porta potty’s aren’t basic sanitation. Basic sanitation includes water for washing and showering. Groups providing porta potty’s and camp toilets are providing a vital and important service that shouldn’t be needed.
I imagine a rich person driving through the neighborhood because those are the people setting and centering policy. That’s why so many of our laws and discourse are about not seeing the human misery capitalism causes. Those people don’t give a shit about the people who are dying on sidewalks or the young girl who has to walk past on her way to school. They just don’t want to see it. That’s why they ban “urban camping” and criminalize feeding people on the street. The same people that have to fight day and night to fund porta potty’s know how to actually solve the problems but the rich people who occasionally deign to give a slight amount of money don’t want to help the people on the streets, most of them would prefer that they just die and decrease the surplus population . They just don’t want to think about them on the way to dinner and a show.
posted by Uncle at 6:46 AM on August 4, 2023 [2 favorites]
Sorry this was responding to my deleted comment. I’m trying to express that porta potty’s aren’t basic sanitation. Basic sanitation includes water for washing and showering. Groups providing porta potty’s and camp toilets are providing a vital and important service that shouldn’t be needed.
I imagine a rich person driving through the neighborhood because those are the people setting and centering policy. That’s why so many of our laws and discourse are about not seeing the human misery capitalism causes. Those people don’t give a shit about the people who are dying on sidewalks or the young girl who has to walk past on her way to school. They just don’t want to see it. That’s why they ban “urban camping” and criminalize feeding people on the street. The same people that have to fight day and night to fund porta potty’s know how to actually solve the problems but the rich people who occasionally deign to give a slight amount of money don’t want to help the people on the streets, most of them would prefer that they just die and decrease the surplus population . They just don’t want to think about them on the way to dinner and a show.
posted by Uncle at 6:46 AM on August 4, 2023 [2 favorites]
@Nancy Lebovitz
I am struggling to find it, but, the Nature podcast had a great piece on how scientists were using AI and had found thousands of derivatives of Ketamine (I'm not a scientist so my terminology may be off). They are trying to find one that will have minimum psychoactive side effects. Somehow this deals with protein-folding models not being easily done with accuracy which has been advanced.
posted by zerobyproxy at 8:26 AM on August 4, 2023 [2 favorites]
I am struggling to find it, but, the Nature podcast had a great piece on how scientists were using AI and had found thousands of derivatives of Ketamine (I'm not a scientist so my terminology may be off). They are trying to find one that will have minimum psychoactive side effects. Somehow this deals with protein-folding models not being easily done with accuracy which has been advanced.
posted by zerobyproxy at 8:26 AM on August 4, 2023 [2 favorites]
My ideal would have psychoactive effects as a feature, not a bug, but thanks for looking and it will probably be interesting if you turn it up.
posted by Nancy Lebovitz at 10:12 AM on August 4, 2023 [1 favorite]
posted by Nancy Lebovitz at 10:12 AM on August 4, 2023 [1 favorite]
Oregon is shameless, it's a culture that was always based on getting the support to stay where you are not access services unless you really need them. Their approach to change is based on this formula, creating an alliance around conservative principles that stop a huge array of solutions to homelessness and addiction. The current sentiment is that the Portland experience cannot be effectively recreated in such a way that it can be sustained in a town that is not Portland.
I recommend Oregonians look at the Glebe Centre, founded by the United Reform Church and now run by the YMCA of the Black Country. It's not ostensibly religious. The goal is to have a safe, warm wet room and inexpensive diner serving small plates and specials day and night.
What is a wet room? It's a place to drink what you've bought or brought in a common communal room so you don't freeze to death or get beaten up. It diverts a lot of other crime through educational announcements made during the peak hours. The challenge for wet rooms is they are hard to implement in all but the poorest places. There are many places this kind of project could be staged. A community group could get a grant from the International YMCA to seed a program locally and active participants could transition into employment at the YMCA once the project qualifies for other funding.
Good luck!
posted by parmanparman at 12:04 PM on August 4, 2023 [6 favorites]
I recommend Oregonians look at the Glebe Centre, founded by the United Reform Church and now run by the YMCA of the Black Country. It's not ostensibly religious. The goal is to have a safe, warm wet room and inexpensive diner serving small plates and specials day and night.
What is a wet room? It's a place to drink what you've bought or brought in a common communal room so you don't freeze to death or get beaten up. It diverts a lot of other crime through educational announcements made during the peak hours. The challenge for wet rooms is they are hard to implement in all but the poorest places. There are many places this kind of project could be staged. A community group could get a grant from the International YMCA to seed a program locally and active participants could transition into employment at the YMCA once the project qualifies for other funding.
Good luck!
posted by parmanparman at 12:04 PM on August 4, 2023 [6 favorites]
I'll just drop a couple of thoughts here that might be helpful or give a little perspective:
#1. It's worth remembering that leading up to the 1980s there was remarkably little homelessness in the U.S. I mean, such a problem is never completely eradicated and we shouldn't pretend that it was, but the problem we have faced since that time became at least an order of magnitude or two worse when Saint Ronald graced us with his bright ideas of letting the private/charitable sector deal with poverty and homelessness, shutting down wholesale the system for housing and caring for the mentally ill, and turning HUD into a shell of its former self - all so that we could save a couple of nickles in the budget.
A few references for those interested: 1 2 3 4
The problem we are facing now is, to a very great degree, a problem of our own making that was created to save a couple of measly billion in the federal budget. For perspective: $2 billion would be 0.26% of the annual U.S. defense budget. This is something that we can, absolutely, as a nation afford to do, but we choose not to.
#2. I haven't been to any of the places you all have been discussing above recently - particularly, I know nothing specifically about the situation in Oregon. But everywhere I have traveled or visited in the past couple of years has seen an extremely dramatic increase in visible homelessness, tent cities, and such. I mean, EXTREMELY dramatic.
Around here, places where previously, maybe one or two homeless guys would live in their tents are now pretty huge tent cities. Other little "unused" green areas near a freeway interchange or behind a commercial development that previously had no visible homeless people are now literally bustling. I haven't seen anything like it in the 30 years I have lived here.
I took the time to look up some statistics on homelessness in the U.S. and the overall perspective is, the number of unhoused people increased a lot during the 2007-2009 recession era, then gradually decreased in ensuing years, but has been markedly increasing again since about 2019.
Nationwide the increased numbers are large but don't seem as dramatic as what I'm seeing with my eyes - my own estimate is that the number of unhoused people around here has grown by a factor of maybe 10 in the past 3-ish years. Some stats show the number of unhoused people has grown by maybe 10-20% each year since 2019. Others show less - maybe 10% growth in homeless overall in the past 3-4 years. Either way, there has been a clear increase after a definite low point.
And one thing that happens is that people without housing tend to collect in certain areas that have the things they need to survive. Those places very much tend to be near the center of big cities and in places with relatively good weather. Lots of smaller towns have literally ZERO unhoused people because if such people tried to stay there they would literally die, combined with the fact the law enforcement can more easily scare off (or literally send off) the occasional person they want to get rid of. And if you look at the data, certain areas - particularly west coast states and a few in the northeast - have much, much larger homeless populations.
Point is, even a 10% or 20% increase in unhoused people nationwide over the past 3-ish years might indeed mean an increase of 5-10-20X or other such large factors in those certain places.
And my point is, be very, very careful of blaming one particular factor for the problems you are seeing. Things are not going all so well on this front in many, many places including places that haven't made any particular changes in their drug decriminalization laws.
How much of the problem is due to changes in the laws regarding drug decriminalization, how much due to overall economic and social factors affecting the entire country, and how much is due to a variety of other factors is a very difficult thing to tease out.
posted by flug at 12:16 AM on August 5, 2023 [22 favorites]
#1. It's worth remembering that leading up to the 1980s there was remarkably little homelessness in the U.S. I mean, such a problem is never completely eradicated and we shouldn't pretend that it was, but the problem we have faced since that time became at least an order of magnitude or two worse when Saint Ronald graced us with his bright ideas of letting the private/charitable sector deal with poverty and homelessness, shutting down wholesale the system for housing and caring for the mentally ill, and turning HUD into a shell of its former self - all so that we could save a couple of nickles in the budget.
A few references for those interested: 1 2 3 4
The problem we are facing now is, to a very great degree, a problem of our own making that was created to save a couple of measly billion in the federal budget. For perspective: $2 billion would be 0.26% of the annual U.S. defense budget. This is something that we can, absolutely, as a nation afford to do, but we choose not to.
#2. I haven't been to any of the places you all have been discussing above recently - particularly, I know nothing specifically about the situation in Oregon. But everywhere I have traveled or visited in the past couple of years has seen an extremely dramatic increase in visible homelessness, tent cities, and such. I mean, EXTREMELY dramatic.
Around here, places where previously, maybe one or two homeless guys would live in their tents are now pretty huge tent cities. Other little "unused" green areas near a freeway interchange or behind a commercial development that previously had no visible homeless people are now literally bustling. I haven't seen anything like it in the 30 years I have lived here.
I took the time to look up some statistics on homelessness in the U.S. and the overall perspective is, the number of unhoused people increased a lot during the 2007-2009 recession era, then gradually decreased in ensuing years, but has been markedly increasing again since about 2019.
Nationwide the increased numbers are large but don't seem as dramatic as what I'm seeing with my eyes - my own estimate is that the number of unhoused people around here has grown by a factor of maybe 10 in the past 3-ish years. Some stats show the number of unhoused people has grown by maybe 10-20% each year since 2019. Others show less - maybe 10% growth in homeless overall in the past 3-4 years. Either way, there has been a clear increase after a definite low point.
And one thing that happens is that people without housing tend to collect in certain areas that have the things they need to survive. Those places very much tend to be near the center of big cities and in places with relatively good weather. Lots of smaller towns have literally ZERO unhoused people because if such people tried to stay there they would literally die, combined with the fact the law enforcement can more easily scare off (or literally send off) the occasional person they want to get rid of. And if you look at the data, certain areas - particularly west coast states and a few in the northeast - have much, much larger homeless populations.
Point is, even a 10% or 20% increase in unhoused people nationwide over the past 3-ish years might indeed mean an increase of 5-10-20X or other such large factors in those certain places.
And my point is, be very, very careful of blaming one particular factor for the problems you are seeing. Things are not going all so well on this front in many, many places including places that haven't made any particular changes in their drug decriminalization laws.
How much of the problem is due to changes in the laws regarding drug decriminalization, how much due to overall economic and social factors affecting the entire country, and how much is due to a variety of other factors is a very difficult thing to tease out.
posted by flug at 12:16 AM on August 5, 2023 [22 favorites]
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posted by ruddhist at 7:05 AM on August 3, 2023 [9 favorites]