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> So how do you solve the heroin junky passing out/projectile vomiting/falling asleep/dying/leaving needles around/defecating everywhere but the toilet with the

> So how do you solve the heroin junky passing out/projectile vomiting/falling asleep/dying/leaving needles around/defecating everywhere but the toilet with the door locked problem? Universal healthcare, harm reduction and rehab services, comprehensive welfare, affordable housing and a sufficient number of properly trained and resourced social workers.

velobro 8y ago
That's already been tried. SF spends more on homeless per capita than anywhere else. Time for a police task force of a couple hundred forcing them to get rid of their addiction in jail.
- randomsearch 8y ago
  Presumably San Francisco’s problem is being an outlier in a nation that does little about its homeless epidemic. More affordable housing, a proper welfare system, and public healthcare seem to have solved this problem in almost all other western countries. The UK is trying a related experiment. We’re becoming more like the USA - closing hostels, slashing local authority budgets by ~ 60%, privatising healthcare, removing social welfare. The result - a huge rise in homelessness. Most major cities in the UK are now reminiscent of the US. Never thought I’d see it here. Talking to homeless people in London, the most common reason for being on the street seems to be welfare being withdrawn or problems getting housed.
  - tim333 8y ago
    Londoner here - yeah it doesn't seem that great an idea.
- inferiorhuman 8y ago
  > That's already been tried. Sure, and the shelters are full with long wait lists. It's almost as if there's widespread interest in getting off the street. > SF spends more on homeless per capita than anywhere else. Source?
thucydidesofusa 8y ago
No country has ever solved their junky problem even with those things. To some degree, we have to get used to junkies existing in jurisdictions that aren't inclined to lock them up. However, we can't spend our way out of the problem. San Francisco spends ~$40k/yr/homeless [0] , if that's not enough to solve the problem, then it's just too great. We cannot throw money away on problems created by cities that abet $4k/mo rents for one-bedrooms.
- xzel 8y ago
  Throwing money at the problem isn't the same thing as investing in effective policies. How many of the above policies mentioned are actually, keyword actually, implemented in SF? In my opinion, that is a huge problem with the US in general, such as prisons "rehabilitation": high cost per prisoner and very low amounts of actual rehabilitation.
  - dsfyu404ed 8y ago
    Substance addiction is a problem in the US in general in that we'd love to have less of it. Junkies shooting up in public, homeless people shitting on the sidewalk, etc, etc is a problem confined to a handful of cities on the west coast.
    - zanny 8y ago
      The substance abusers don't want less of it, thats why they do it to begin with. Address the causes that lead people into homelessness and addiction and you end up with less of it. That isn't conjecture, its fact, proven by dozens of disparate cultures and countries adopting or rescinding preventative measures with statistically traceable results proving positive correlation.
      - dsfyu404ed 8y ago
        Where did I say anything about what substance abusers want? For what it's worth many of them want to get clean but can't pull it off because that's how addiction works. My point was that substance abuse is (relatively) evenly distributed geographically and pretty much every city and state has more of it than they'd like. Homelessness to the point where it is a significant impact on the day to day lives of the non-homeless is a west coast problem (I've never had to step over human feces in DC, NY or Boston). I'm not saying anything about causes, effects or correlations.
outime 8y ago
This is correct. Helsinki is full of public, free toilets in very good condition and I never had such issues.
mynameishere 8y ago
There are two dead comments that are both just straightforward criticisms of this. I don't get it. The question is basically, "How do we keep bathrooms tidy?" and the answer is massive spending programs. Criticism of this sentiment is verboten. What the hell? As to the subject, gas stations and fast food restaurants, etc, have always been effectively public bathrooms all through the US. Maybe San Francisco is an exception that people here confuse with a rule.
- michaelt 8y ago
  Criticism of this sentiment is verboten. What the hell? People who live in SF imagine your city with tidy bathrooms, then follow this tree: (1): Does the city have homeless and drug addicts? If yes, go to (2). If no, go to (3). (2): And where are the bathrooms? If 'in private businesses' go to (4). If public toilets, go to (5). (4): The private businesses chase off the homeless, who shit in the street. SAN FRANCISCO IS HERE. (5): They're probably going to have people passing out in them, then. (3): OK, so where have the homeless drug addicts gone? If they've been cured, go to (6). If you've sent them to another city, go to (7) (6): Now you've probably got a massive spending program. THIS IS WHERE THE PEOPLE YOU'RE TALKING TO ARE (7): Eh, you aren't the first. THIS IS UNLIKELY TO EARN YOU UPVOTES ONLINE. It might earn you re-election if you get elected then do it by stealth though. If you've got a solution that avoids every pitfall I'm sure people would be eager to hear it - but if your explanation skips over some of the problems, that's less helpful.
  - johnisgood 8y ago
    > Does the city have homeless and drug addicts? If yes, go to (2). If no, go to (3). Why did you put the two together though? There are many drug addicts whose life circumstances are very different, and they are leading a successful life with their addiction, because addiction does not necessarily cause such psychosocial harm. "Homeless drug addicts" would be more accurate, which you are using later on though. :P But then again, many homeless people defecate publicly despite having the option not to, AND are not drug addicts. I guess when people refer to drug addicts, they are referring to people displaying a certain set of behaviors that we usually see from homeless or poor people, because they are less likely to be able to hide their addictions and whatnot, mostly because it affects them negatively more, and the consequences are more obvious. I also believe it is not actually due to drug addiction alone. Do not forget that there is a reason for why they started using drugs. It could have been merely because they ended up on the streets, and for totally unrelated reasons. https://global.oup.com/academic/product/addiction-and-choice-9780198727224 https://global.oup.com/academic/product/addiction-and-choice... The book explains it better than I ever could. It is very likely that I phrased myself incorrectly, the first two sections of this book should clear it all up. Cheers. This is what I am talking about (posted it here to avoid confusion): Relatedly, different life circumstances may protect people more or less well against impaired functioning (for a review, see Martin et al. 2014). For example, it is well known that addiction is associated with low socio-economic status alongside other mental health problems (Compton et al. 2007; Heyman 2009). But, in so far as addiction is diagnosed via negative consequences, wealth, alongside other forms of privilege, may offer a protective factor (cf. Matthews 2014; Schmidt et al. 2010). For example, a wealthy mother who drinks heavily but can afford a live-in nanny to ensure her children are adequately cared for is able to meet more of her role-related responsibilities than a poor woman who drinks equal amounts but whose children go hungry and miss school. The consequences are more serious by shared social standards in the latter case than the former, and so too, as a result, is the likelihood of a diagnosis. The implication that individual differences in conceptions of how to live and life circumstances can affect the likelihood of a diagnosis may give pause. Indeed, Martin et al. (2014) have proposed that the negative consequences of use should be considered ancillary rather than core features of addiction for this very reason, namely, that they introduce significant individual and context specificity. However once we acknowledge that drug use in itself is not indicative of any form of disorder, but rather offers instrumental means to fulfilling valuable ends, the idea that negative consequences are fundamental to the pathological nature of addiction becomes evident.
AlexTWithBeard 8y ago
I would think most of addicts are relatively poor people, therefore should be eligible for medicaid, which covers healthcare, detox and rehab services. Boils down to housing and social workers then?

velobro 8y ago

That's already been tried. SF spends more on homeless per capita than anywhere else. Time for a police task force of a couple hundred forcing them to get rid of their addiction in jail.

randomsearch 8y ago
Presumably San Francisco’s problem is being an outlier in a nation that does little about its homeless epidemic. More affordable housing, a proper welfare system, and public healthcare seem to have solved this problem in almost all other western countries. The UK is trying a related experiment. We’re becoming more like the USA - closing hostels, slashing local authority budgets by ~ 60%, privatising healthcare, removing social welfare. The result - a huge rise in homelessness. Most major cities in the UK are now reminiscent of the US. Never thought I’d see it here. Talking to homeless people in London, the most common reason for being on the street seems to be welfare being withdrawn or problems getting housed.
- tim333 8y ago
  Londoner here - yeah it doesn't seem that great an idea.
inferiorhuman 8y ago
> That's already been tried. Sure, and the shelters are full with long wait lists. It's almost as if there's widespread interest in getting off the street. > SF spends more on homeless per capita than anywhere else. Source?

thucydidesofusa 8y ago

No country has ever solved their junky problem even with those things. To some degree, we have to get used to junkies existing in jurisdictions that aren't inclined to lock them up. However, we can't spend our way out of the problem. San Francisco spends ~$40k/yr/homeless [0] , if that's not enough to solve the problem, then it's just too great. We cannot throw money away on problems created by cities that abet $4k/mo rents for one-bedrooms.

xzel 8y ago
Throwing money at the problem isn't the same thing as investing in effective policies. How many of the above policies mentioned are actually, keyword actually, implemented in SF? In my opinion, that is a huge problem with the US in general, such as prisons "rehabilitation": high cost per prisoner and very low amounts of actual rehabilitation.
- dsfyu404ed 8y ago
  Substance addiction is a problem in the US in general in that we'd love to have less of it. Junkies shooting up in public, homeless people shitting on the sidewalk, etc, etc is a problem confined to a handful of cities on the west coast.
  - zanny 8y ago
    The substance abusers don't want less of it, thats why they do it to begin with. Address the causes that lead people into homelessness and addiction and you end up with less of it. That isn't conjecture, its fact, proven by dozens of disparate cultures and countries adopting or rescinding preventative measures with statistically traceable results proving positive correlation.
    - dsfyu404ed 8y ago
      Where did I say anything about what substance abusers want? For what it's worth many of them want to get clean but can't pull it off because that's how addiction works. My point was that substance abuse is (relatively) evenly distributed geographically and pretty much every city and state has more of it than they'd like. Homelessness to the point where it is a significant impact on the day to day lives of the non-homeless is a west coast problem (I've never had to step over human feces in DC, NY or Boston). I'm not saying anything about causes, effects or correlations.

outime 8y ago

This is correct. Helsinki is full of public, free toilets in very good condition and I never had such issues.

mynameishere 8y ago

There are two dead comments that are both just straightforward criticisms of this. I don't get it. The question is basically, "How do we keep bathrooms tidy?" and the answer is massive spending programs. Criticism of this sentiment is verboten. What the hell? As to the subject, gas stations and fast food restaurants, etc, have always been effectively public bathrooms all through the US. Maybe San Francisco is an exception that people here confuse with a rule.

michaelt 8y ago
Criticism of this sentiment is verboten. What the hell? People who live in SF imagine your city with tidy bathrooms, then follow this tree: (1): Does the city have homeless and drug addicts? If yes, go to (2). If no, go to (3). (2): And where are the bathrooms? If 'in private businesses' go to (4). If public toilets, go to (5). (4): The private businesses chase off the homeless, who shit in the street. SAN FRANCISCO IS HERE. (5): They're probably going to have people passing out in them, then. (3): OK, so where have the homeless drug addicts gone? If they've been cured, go to (6). If you've sent them to another city, go to (7) (6): Now you've probably got a massive spending program. THIS IS WHERE THE PEOPLE YOU'RE TALKING TO ARE (7): Eh, you aren't the first. THIS IS UNLIKELY TO EARN YOU UPVOTES ONLINE. It might earn you re-election if you get elected then do it by stealth though. If you've got a solution that avoids every pitfall I'm sure people would be eager to hear it - but if your explanation skips over some of the problems, that's less helpful.
- johnisgood 8y ago
  > Does the city have homeless and drug addicts? If yes, go to (2). If no, go to (3). Why did you put the two together though? There are many drug addicts whose life circumstances are very different, and they are leading a successful life with their addiction, because addiction does not necessarily cause such psychosocial harm. "Homeless drug addicts" would be more accurate, which you are using later on though. :P But then again, many homeless people defecate publicly despite having the option not to, AND are not drug addicts. I guess when people refer to drug addicts, they are referring to people displaying a certain set of behaviors that we usually see from homeless or poor people, because they are less likely to be able to hide their addictions and whatnot, mostly because it affects them negatively more, and the consequences are more obvious. I also believe it is not actually due to drug addiction alone. Do not forget that there is a reason for why they started using drugs. It could have been merely because they ended up on the streets, and for totally unrelated reasons. https://global.oup.com/academic/product/addiction-and-choice-9780198727224 https://global.oup.com/academic/product/addiction-and-choice... The book explains it better than I ever could. It is very likely that I phrased myself incorrectly, the first two sections of this book should clear it all up. Cheers. This is what I am talking about (posted it here to avoid confusion): Relatedly, different life circumstances may protect people more or less well against impaired functioning (for a review, see Martin et al. 2014). For example, it is well known that addiction is associated with low socio-economic status alongside other mental health problems (Compton et al. 2007; Heyman 2009). But, in so far as addiction is diagnosed via negative consequences, wealth, alongside other forms of privilege, may offer a protective factor (cf. Matthews 2014; Schmidt et al. 2010). For example, a wealthy mother who drinks heavily but can afford a live-in nanny to ensure her children are adequately cared for is able to meet more of her role-related responsibilities than a poor woman who drinks equal amounts but whose children go hungry and miss school. The consequences are more serious by shared social standards in the latter case than the former, and so too, as a result, is the likelihood of a diagnosis. The implication that individual differences in conceptions of how to live and life circumstances can affect the likelihood of a diagnosis may give pause. Indeed, Martin et al. (2014) have proposed that the negative consequences of use should be considered ancillary rather than core features of addiction for this very reason, namely, that they introduce significant individual and context specificity. However once we acknowledge that drug use in itself is not indicative of any form of disorder, but rather offers instrumental means to fulfilling valuable ends, the idea that negative consequences are fundamental to the pathological nature of addiction becomes evident.

AlexTWithBeard 8y ago

I would think most of addicts are relatively poor people, therefore should be eligible for medicaid, which covers healthcare, detox and rehab services. Boils down to housing and social workers then?