Discussing the Unhoused Part 2
Pandemic Diary Entry #61
October 12, 2020
Last week I discussed the unhoused portion of the homeless situation, and mentioned that it is a three part problem, so today I would like to take on the drug portion of the equation.
The drug situation is world wide. In the US, of all 50 states, California ranks a low 40th when it comes to drug abuse and San Francisco is in the top ten cities in the US with the lowest overall drug use, which is why hit pieces filmed by the likes of Christopher Rufo are insulting to those of us that live here.
2018 data shows that every day, 128 people in the United States die after overdosing on opioids. The misuse of and addiction to opioids — including prescription pain relievers, heroin, and synthetic opioids such as fentanyl — is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement. — The NIH, National Institute on Drug Abuse.
San Francisco City Attorney Dennis Herrera has taken an interesting tack in this issue and has sued 28 alleged drug dealers, who each had at least 2 prior arrests for dealing. If the lawsuits are approved in California Superior Court, it is hoped that it will prevent the alleged dealers from entering a 50-block area in the Tenderloin and part of South of Market. Violating this would bring about a mere fine of $6,000 but also seizure of all drugs and money. It is a start.
- Of the 28 alleged drug dealers named, 27 live outside of San Francisco
According to the National Coalition for the Homeless, addiction can be both a cause and a result of homelessness. This fact makes negative stereotypes about addiction and homelessness misguided.
In a 2009 survey of 489 homeless people that were living rough in London, England, 63 percent of respondents identified substance use (including alcohol) as one of the reasons they became homeless. Also, the study showed that overall, drug and alcohol use increased the longer the respondents had been homeless.
A 2006 survey taken in New Haven, Connecticut found drug use was most prevalent among people who had been homeless for six months to three years and less among newly homeless people and people who had been homeless four years or more. They found that only 25 percent of respondents said their homelessness was due to drugs, most often cocaine.
A 2008 study in Melbourne Australia found that 43% of the sample had substance abuse problems. Of these people, one-third had substance abuse problems before they became homeless and two-thirds developed these problems after they became homeless. Young people were more at risk of developing substance abuse problems after becoming homeless than older people and that most people with substance abuse issues remain homeless for 12 months or longer.
Sterling Johnson, a Philadelphia-based advocate for the human rights of people who use drugs has said “When you’re unhoused it causes a lot of distress, which causes drug use,” “You’re responding to a really traumatic situation in a reasonable fashion.”
So how do we deal with this situation? A review of 20 facilities offering substance abuse treatment to the homeless found these characteristics necessary for dealing with the issue:
- Housing access –A stable living environment is a critical factor in recovery of the homeless.
- Well-trained staff –Compassionate, flexible and experienced care is vital to an effective program.
- Client-centered services –A tailored treatment plan can provide a better pathway to recovery than a one-size-fits-all program.
- Integrated services –Since the homeless often have co-occurring mental issues, having multidisciplinary professionals in-house can provide centralized, coordinated treatment for greater effectiveness.
- Comprehensive services –Addressing the many complex needs of a homeless person — including survival and social needs — treats homelessness holistically (treats the whole person, rather than just symptoms). — From “Providing Treatment for Homeless People with Substance Use Disorders.” National Health Care for the Homeless Council. August 2003.
Like everything else in our lives COVID is having an impact on the drug situation across the world.
According to the United Nations: While the impact of COVID-19 on illegal drug supplies is not yet fully known, border and other restrictions linked to the pandemic have already caused drug shortages on the street, that have diminished purity, while leading to price hikes.
Meanwhile rising unemployment and plummeting opportunities are expected to disproportionately affect the poorest, making them more vulnerable to drug use, trafficking and cultivation, to earn money so they can survive the global recession.
“The COVID-19 crisis and economic downturn threaten to compound drug dangers further still, when our health and social systems have been brought to the brink and our societies are struggling to cope” Ghada Waly, former Egyptian Government minister, and now head of the UNODC.
In San Francisco, data published by the San Francisco Department of Public Health showed that 165 people fatally overdosed from fentanyl or other drugs with fentanyl in them in 2018. In 2019 that number more than doubled at 339.
The city medical examiner still has to conduct autopsies and toxicological tests on hundreds of cases, but experts believe 2020 will be even worse. Experts say that many people are taking drugs alone in an attempt to social distance, and therefore there is no one around to help when they overdose.
In June the San Francisco Board of Supervisors unanimously passed legislation that would allow safe-injection sites through an overdose prevention program. The law would create permits to allow nonprofit health providers to operate the sites. The city is waiting for approval under state Assembly Bill 362, and if it is approved those sites may be open by next year.
While Safe Injection Sites are controversial, international evidence suggests that letting addicts take drugs under supervision saves lives. According to NPR “At least 100 supervised injection sites operate around the world, mainly in Europe, Canada and Australia. Typically, drug users come in with their own drugs and are given clean needles and a clean, safe space to consume them. Staff are on hand with breathing masks and naloxone, the overdose antidote, and to provide safer injection advice and information about drug treatment and other health services.”
The world’s illicit drug situation is a horrible tragedy, but America is behind in attempting to address the situation.
According to Glenn Greenwald, a former lawyer, New York Times bestselling author, and journalist, the decades-long “War on Drugs” as one of many “criminalization approaches” that are “abject failures,” because they exacerbate problems instead of properly addressing them.
Fortunately, things are getting better, as many in government have realized the “War on Drugs” was a systematic failure of policy.
This is not an simple problem to tackle, it will take compassion on the part of American citizens to be willing to fund programs and facilites to help end this epidemic. This is done with federal dollars and that means taxes.
So yes, drugs are a part of the homeless situation in San Francisco, but they are not the only issue, and linking them together in a blanket way does not do justice to either issue, and certainly not to those people that find themselves living on the streets.
My Horoscope for today: You’ve never been clearer on what you want in a relationship. If there’s anything you’ve learned it’s that the glass slipper either fits or it doesn’t.
San Francisco weather: 72 degrees and sunny
NYSE DOW compared to one year ago: +2063
COVID cases in the US: 7,997,549
Deaths from COVID in the US: 219,775
Foreign word of the day: to faint
OED word of the day: LOL — To laugh out loud; to be amused
Days since Shelter In Place was initiated: 211
Reading: The Plague by Albert Camus
My Black and White Picture of the Day
Something Silly From the Internet: