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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?


It is difficult but possible.

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.)




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