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A stable environment is certainly going to dramatically increase the chance of overcoming an addiction. It obviously does not guarantee success but it's a cruci

A stable environment is certainly going to dramatically increase the chance of overcoming an addiction. It obviously does not guarantee success but it's a crucial first step in the process. As pointed out in the article the housing first approach is actually saving money in the long run by reducing subsequent costs incurred by social services, so the "everyone else is paying for their addiction" argument does not really work – there are going to be costs either way, and an addict who has a home is easier and cheaper to care for than one who is roaming the streets.

sugarplant 2y ago
do people really believe this claim up front? providing active junkies: 1) completely free units to destroy 2) 24/7 emergency care teams 3) completely free healthcare and mental healthcare 4) no sobriety expectations of any sort 5) no possibility to be kicked out of the program for any reason is going to be cheaper than putting them in jail or an institution? wow sounds almost too good to be true it would be interesting (or funny) to get a summary on exactly how they are deriving the cost metric for this. i would just about guarantee they've taken creative liberties to make the numbers fit. according to HUD[0] infestations, flooding, and fires are "typical behavior problems" in housing first programs. only in "extreme circumstances" does this warrant switching them to another unit. there is no way these are cheap damages to fix. housing first programs are often mixed into ordinary developments too. i bet families living near or adjacent to these units really enjoy living next to completely unstable addicts. housing first programs explicitly prioritize the least stable, most mentally ill addicts too. but it's the humane thing to do at everyone else's expense. a lot of cities in the US have a housing first program, among many other programs in a similar vein (ie safe injection sites). take san francisco for example. they spend billions of dollars every year on programs for the homeless. from what i hear the situation is still terrible. there are even businesses moving out of SF directly citing quality of life. the cost of living in my city is so expensive that there are adults that work full time who have to have roommates to live at subsistence level. there are also housing first programs here that give junkies units for free to continue getting high in indefinitely. this is a ridiculous situation. either way i would rather it cost more to have people institutionalized or put in jail for breaking the law. this would also do good for actually having resources to help the ones who are actually down on their luck. [0]https://www.huduser.gov/portal/publications/hsgfirst.pdf https://www.huduser.gov/portal/publications/hsgfirst.pdf
- Arn_Thor 2y ago
  I think perhaps your biases are showing in the language you deploy (junkeis, free to destroy). You're asking for evidence that's readily available, if you want it, from studies to meta studies. The evidence ranges from conclusive to inconclusive, which isn't surprising given the many different types of implementation and existence of support ystems (or lack thereof). In terms of cost, we need to look at the total social cost. If (big if) we were to assume that property destruction in housing units costs money, it is no strech to think that any marginal decrease in for example medical expenses (much more expensive in total social resource terms) more than make up for it. And a marginal improvement in a long-term expensive social problem would easily justify a high initial upfront cost. I'm not saying you're wrong for asking the question, just that I have no problem accepting the findings that housing first is a cheaper solution in the long run if it gets more people clean and off the streets--as the evidence indicates.
  - sugarplant 2y ago
    >marginal decrease in for example medical expenses why would there be a decrease rather than an increase? they're linked up with a full time care team as well as paths for more healthcare services. they also are allowed to continue to destroy their body with drugs. a local newspaper just ran an article here about how many health problems they have when they get into the local program. yes i am very bias about the topic, and it wouldnt matter to me if it were much cheaper. but it truly doesnt sound plausible. i do not think setting up society so that people can comfortably get high all day, for free, at everyone else's expense, is a good or fair setup. there are many people struggling to stay afloat. maybe we could focus on solving that first. or focusing on the sober homeless.
    - throwawayq3423 2y ago
      > yes i am very bias about the topic, and it wouldnt matter to me if it were much cheaper. So is what the US is doing right now working? Just the in healthcare, the US pays more per person when addressing this problem than anywhere else in the world, and gets nearly the worst result. Isn't that alone worth trying something else?

sugarplant 2y ago

do people really believe this claim up front? providing active junkies: 1) completely free units to destroy 2) 24/7 emergency care teams 3) completely free healthcare and mental healthcare 4) no sobriety expectations of any sort 5) no possibility to be kicked out of the program for any reason is going to be cheaper than putting them in jail or an institution? wow sounds almost too good to be true it would be interesting (or funny) to get a summary on exactly how they are deriving the cost metric for this. i would just about guarantee they've taken creative liberties to make the numbers fit. according to HUD[0] infestations, flooding, and fires are "typical behavior problems" in housing first programs. only in "extreme circumstances" does this warrant switching them to another unit. there is no way these are cheap damages to fix. housing first programs are often mixed into ordinary developments too. i bet families living near or adjacent to these units really enjoy living next to completely unstable addicts. housing first programs explicitly prioritize the least stable, most mentally ill addicts too. but it's the humane thing to do at everyone else's expense. a lot of cities in the US have a housing first program, among many other programs in a similar vein (ie safe injection sites). take san francisco for example. they spend billions of dollars every year on programs for the homeless. from what i hear the situation is still terrible. there are even businesses moving out of SF directly citing quality of life. the cost of living in my city is so expensive that there are adults that work full time who have to have roommates to live at subsistence level. there are also housing first programs here that give junkies units for free to continue getting high in indefinitely. this is a ridiculous situation. either way i would rather it cost more to have people institutionalized or put in jail for breaking the law. this would also do good for actually having resources to help the ones who are actually down on their luck. [0]https://www.huduser.gov/portal/publications/hsgfirst.pdf https://www.huduser.gov/portal/publications/hsgfirst.pdf

Arn_Thor 2y ago
I think perhaps your biases are showing in the language you deploy (junkeis, free to destroy). You're asking for evidence that's readily available, if you want it, from studies to meta studies. The evidence ranges from conclusive to inconclusive, which isn't surprising given the many different types of implementation and existence of support ystems (or lack thereof). In terms of cost, we need to look at the total social cost. If (big if) we were to assume that property destruction in housing units costs money, it is no strech to think that any marginal decrease in for example medical expenses (much more expensive in total social resource terms) more than make up for it. And a marginal improvement in a long-term expensive social problem would easily justify a high initial upfront cost. I'm not saying you're wrong for asking the question, just that I have no problem accepting the findings that housing first is a cheaper solution in the long run if it gets more people clean and off the streets--as the evidence indicates.
- sugarplant 2y ago
  >marginal decrease in for example medical expenses why would there be a decrease rather than an increase? they're linked up with a full time care team as well as paths for more healthcare services. they also are allowed to continue to destroy their body with drugs. a local newspaper just ran an article here about how many health problems they have when they get into the local program. yes i am very bias about the topic, and it wouldnt matter to me if it were much cheaper. but it truly doesnt sound plausible. i do not think setting up society so that people can comfortably get high all day, for free, at everyone else's expense, is a good or fair setup. there are many people struggling to stay afloat. maybe we could focus on solving that first. or focusing on the sober homeless.
  - throwawayq3423 2y ago
    > yes i am very bias about the topic, and it wouldnt matter to me if it were much cheaper. So is what the US is doing right now working? Just the in healthcare, the US pays more per person when addressing this problem than anywhere else in the world, and gets nearly the worst result. Isn't that alone worth trying something else?