I agree that opiates require a more comprehensive approach than just legalizing, but I wonder if the astronomical cost of housing in those cities contributes to making it hard to really get people off the streets and out of the system.
There is a serious opioid problem in the rural Midwest and Appalachia but most users there are housed because housing is affordable. Many also have roots like family in the area. Makes treatment way easier if people are safe and off the street already.
How do you get off the street when, at least in SF, the poverty line is upwards of $100k/year? You could leave but that’s a big leap for someone battling addiction with no resources and a very small world.
Don’t know.. it just seems like other places in the world have decriminalized to better effect and something else is wrong in West Coast cities. The cost of housing seems like one possibility.
Edit: could also be cultural. I know Vancouver has a deeply rooted opiate culture. Just go listen to some 90s industrial from that place. Every song is about smack or trying to kick smack or being back on smack. Good music though. There’s a whole thing about heroin and good music. Too bad it’s so addictive and toxic.
Most unhoused opioid users in SF are happy to remain homeless. Their base income is north of $12k tax free a year (SNAP and their SF homeless grant); one woman I’ve been trying to help for over two years makes north of $30k annually, tax free, with zero expenses other than fentanyl and food. Very few are willing to trade the amenable weather and lack of any behavioral restrictions for the (frankly quite minimal) requirements that come with temporary shelter, let alone those associated with a SRO or permanent long term housing.
Sounds like I am missing the most obvious thing: they literally pay people to be homeless.
It sounds like once you are in that lifestyle the incentive is very much to stay there. So no wonder.
Of course the high cost of real housing doesn’t help. Makes it that much harder to get truly out of poverty. It also makes a life off the street look unattainable. It’s telling a mentally ill addict there is no hope for them to truly get off the street unless they can somehow produce an engineering degree or gain equivalent experience.
Yes - and I think worse than that, they don’t pay people to get better. So they create a very real financial cliff for anyone who is determined to make a lifestyle change.
What is the probability of being able to get better once addicted to strong opioids, regardless of incentive? Is it possible the brain’s chemistry gets irreversibly broken at some point?
I have used opioids since the mid-2000s. I am on a low enough dose today that it treats my cancer/Crohns pain but I feel no noticeable psychological effects. I can and do easily taper off multiple times a year for tolerance resets.
Further, every year a number of people in my programme finally taper off methadone for good; the relapse rate is in the low single digits. This is similarly the case for patients in Switzerland’s heroin assisted treatment programme. (I live in Estonia and am on their methadone equivalent.)
There is a serious opioid problem in the rural Midwest and Appalachia but most users there are housed because housing is affordable. Many also have roots like family in the area. Makes treatment way easier if people are safe and off the street already.
How do you get off the street when, at least in SF, the poverty line is upwards of $100k/year? You could leave but that’s a big leap for someone battling addiction with no resources and a very small world.
Don’t know.. it just seems like other places in the world have decriminalized to better effect and something else is wrong in West Coast cities. The cost of housing seems like one possibility.
Edit: could also be cultural. I know Vancouver has a deeply rooted opiate culture. Just go listen to some 90s industrial from that place. Every song is about smack or trying to kick smack or being back on smack. Good music though. There’s a whole thing about heroin and good music. Too bad it’s so addictive and toxic.