3 ms·

So it's not solved? Perpetually spending more and more money is not a solution. I'm also not surprised to see the architect blame funding as opposed to admitti

So it's not solved? Perpetually spending more and more money is not a solution. I'm also not surprised to see the architect blame funding as opposed to admitting their policy failed. Again, we are trying to do the same in Canada, and while overdoses are decreasing, these policies are not solving the crisis. In some places they are making it worse.

kristopolous 3y ago
> Perpetually spending more and more money is not a solution. That's how running a society works. The criminalize and lockup method isn't free of cost Are you expecting biological addiction to be like breeded out of the gene pool? How would a $0 cost solution eventually happen?
- happytiger 3y ago
  I feel like many of these solutions are fueled first by ideology, and only then by the evidence. On the right, people criticize and blame the users, rant about personal responsibility, and try to lock drug users and the mentally ill up and throw away the keys. This is failed policy. On the left, people invest in legalization and treatment as a personal ideology and don’t seem to be willing to admit when their policies fail. It almost seems like a failed policy conflates to some kind of personal failure that cannot be examined or criticized. And instead of policy failure, it’s always a funding issue, no matter how many times consistent results emerge. This is looking more and more like failed policy too. I’ve seen it in Van, Portland, Sacramento, Seattle, San Francisco and LA, and it’s pretty consistently not only not getting better but getting much worse. Ultimately, neither approach seems to be working very well. And in the meantime people are living lives of hopelessness and despair in tremendously awful conditions. Are there no other options available than these two counter positions? I think we should be having more of an open dialogue about how to solve the problem and be more ready to examine the evidence, even when it doesn’t support our positions, for the greater good of those suffering, and I often see conversations on the topic break down into the tit for tat I’m seeing here. These kinds of conversations are the default, and solve nothing.
  - nullindividual 3y ago
    Neither Portland nor Seattle have received funding to tamper drug addiction to the necessary degree to provide indication that such a policy would work or not, which leads me to believe your other examples also did not get such funding, thus negating your entire argument, sans the failure of the lock em up policy, of course.
    - happytiger 3y ago
      But in doing so you’re doing precisely what I’ve referenced as leading with ideology. You are making assumptions about funding being the issue based on what you think should work and then attacking my argument by justifying your belief with assumptions to support the conclusion you want instead of letting the data and the facts lead.
  - huytersd 3y ago
    For what it’s worth, draconian penalties against drug use, possession and trafficking actually do work. Countries like Singapore and many middle eastern countries have death penalties for drug smuggling and life sentences for simple possession and these places genuinely have very low drug usage in society. As a civilized society it’s really not worth killing people over this though.
huytersd 3y ago
You’re going to perpetually spend on crime caused by junkies, it’s serious financial burden on the healthcare system and a social burden on families. You’re much better off spending a fraction of that money on rehab.
- ddd00001 3y ago
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- trogdor 3y ago
  Treatment works best when people are motivated to get clean. It doesn’t work when they are not. Moreover, the likelihood of good long-term outcomes decreases dramatically when addiction is comorbid with other serious mental illness. Sadly, I don’t believe that most mentally ill, homeless addicts are going to get better. It’s a terrible situation, and I don’t know of a solution. I don’t think anyone does. I would also note that most rehab facilities for substance use disorders espouse an abstinence-based approach to treatment. That approach simply doesn’t work. The standard of care for opioid use disorder is medication assisted treatment, which is both evidence-based and far more effective than abstinence-based programs. The difference in outcomes is stark, particularly since dropout often results in death. Bottom line, though, from my perspective: you can’t effectively treat people unless and until they are motivated to enter into and engage with a treatment program. “Junkies” of the type you describe rarely fit that bill. Drug courts are a good step in the right direction, but they need to take a more evidence-based approach to their operations. I wish there was an easy solution to this problem, but there isn’t.

kristopolous 3y ago

> Perpetually spending more and more money is not a solution. That's how running a society works. The criminalize and lockup method isn't free of cost Are you expecting biological addiction to be like breeded out of the gene pool? How would a $0 cost solution eventually happen?

happytiger 3y ago
I feel like many of these solutions are fueled first by ideology, and only then by the evidence. On the right, people criticize and blame the users, rant about personal responsibility, and try to lock drug users and the mentally ill up and throw away the keys. This is failed policy. On the left, people invest in legalization and treatment as a personal ideology and don’t seem to be willing to admit when their policies fail. It almost seems like a failed policy conflates to some kind of personal failure that cannot be examined or criticized. And instead of policy failure, it’s always a funding issue, no matter how many times consistent results emerge. This is looking more and more like failed policy too. I’ve seen it in Van, Portland, Sacramento, Seattle, San Francisco and LA, and it’s pretty consistently not only not getting better but getting much worse. Ultimately, neither approach seems to be working very well. And in the meantime people are living lives of hopelessness and despair in tremendously awful conditions. Are there no other options available than these two counter positions? I think we should be having more of an open dialogue about how to solve the problem and be more ready to examine the evidence, even when it doesn’t support our positions, for the greater good of those suffering, and I often see conversations on the topic break down into the tit for tat I’m seeing here. These kinds of conversations are the default, and solve nothing.
- nullindividual 3y ago
  Neither Portland nor Seattle have received funding to tamper drug addiction to the necessary degree to provide indication that such a policy would work or not, which leads me to believe your other examples also did not get such funding, thus negating your entire argument, sans the failure of the lock em up policy, of course.
  - happytiger 3y ago
    But in doing so you’re doing precisely what I’ve referenced as leading with ideology. You are making assumptions about funding being the issue based on what you think should work and then attacking my argument by justifying your belief with assumptions to support the conclusion you want instead of letting the data and the facts lead.
- huytersd 3y ago
  For what it’s worth, draconian penalties against drug use, possession and trafficking actually do work. Countries like Singapore and many middle eastern countries have death penalties for drug smuggling and life sentences for simple possession and these places genuinely have very low drug usage in society. As a civilized society it’s really not worth killing people over this though.

huytersd 3y ago

You’re going to perpetually spend on crime caused by junkies, it’s serious financial burden on the healthcare system and a social burden on families. You’re much better off spending a fraction of that money on rehab.

ddd00001 3y ago
[dead]
trogdor 3y ago
Treatment works best when people are motivated to get clean. It doesn’t work when they are not. Moreover, the likelihood of good long-term outcomes decreases dramatically when addiction is comorbid with other serious mental illness. Sadly, I don’t believe that most mentally ill, homeless addicts are going to get better. It’s a terrible situation, and I don’t know of a solution. I don’t think anyone does. I would also note that most rehab facilities for substance use disorders espouse an abstinence-based approach to treatment. That approach simply doesn’t work. The standard of care for opioid use disorder is medication assisted treatment, which is both evidence-based and far more effective than abstinence-based programs. The difference in outcomes is stark, particularly since dropout often results in death. Bottom line, though, from my perspective: you can’t effectively treat people unless and until they are motivated to enter into and engage with a treatment program. “Junkies” of the type you describe rarely fit that bill. Drug courts are a good step in the right direction, but they need to take a more evidence-based approach to their operations. I wish there was an easy solution to this problem, but there isn’t.