San Francisco Renaming Schools

[financeguy]

Maybe a subsequent Slick Willie High can be named and opened by our new VP who can attest to the make work show up jobs provided by the former mayor in exchange for other "favors."

Regarding the "anecdotal" nature of my observations, guilty. When the anecdotes and personal experience are so unbelievably obvious, I don't need to read a study to tell me that SF is f'd in every possible way. You don't need data to determine this. Looking out the window and seeing a massive homeless encampment and needle deposit facility with many people relieving themselves wherever they want as businesses and residents flee pretty much speaks for itself.

[Caracal]

This is a city that reportedly has more drug addicts than high school students.  They've launched the nation's most intensive "harm reduction" drug program, with needle exchanges, emergency drugs to treat OD cases readily available, and virtually no enforcement of drug laws so that addicts won't be afraid to seek help.  And drug deaths have skyrocketed in the past year. 

As I understand it, this is to make drug addicts "safer".

All the evidence suggests that this is the right approach. Putting people in jail doesn't do anything to reduce drug abuse. There's also plenty of research that shows that nobody is incentivized to use drugs because of Narcan. It does, however, keep people from dying of drug overdoses. Ditto needle exchanges.

I sometimes wonder why people believe this sort of moral hazard garbage. Do you really think there are people who would stop injecting drugs if they couldn't find clean needles? Or decide they want to keep doing drugs because they can get injected with narcan if they OD? If you think of addicts as actual human beings, it is immediately obvious that nobody would make decisions that way.

[marshwiggle]

This is a city that reportedly has more drug addicts than high school students.  They've launched the nation's most intensive "harm reduction" drug program, with needle exchanges, emergency drugs to treat OD cases readily available, and virtually no enforcement of drug laws so that addicts won't be afraid to seek help.  And drug deaths have skyrocketed in the past year. 

As I understand it, this is to make drug addicts "safer".

All the evidence suggests that this is the right approach. Putting people in jail doesn't do anything to reduce drug abuse. There's also plenty of research that shows that nobody is incentivized to use drugs because of Narcan. It does, however, keep people from dying of drug overdoses. Ditto needle exchanges.

I sometimes wonder why people believe this sort of moral hazard garbage. Do you really think there are people who would stop injecting drugs if they couldn't find clean needles? Or decide they want to keep doing drugs because they can get injected with narcan if they OD? If you think of addicts as actual human beings, it is immediately obvious that nobody would make decisions that way.

There was actually a story from Vancouver a couple of years back, where paramedics were being called back to the same adress more than once in the same evening. Basically because people knew that they could be rescued, they continued taking drugs after being revived. So yes, moral hazard is real.

[Caracal]

This is a city that reportedly has more drug addicts than high school students.  They've launched the nation's most intensive "harm reduction" drug program, with needle exchanges, emergency drugs to treat OD cases readily available, and virtually no enforcement of drug laws so that addicts won't be afraid to seek help.  And drug deaths have skyrocketed in the past year. 

As I understand it, this is to make drug addicts "safer".

All the evidence suggests that this is the right approach. Putting people in jail doesn't do anything to reduce drug abuse. There's also plenty of research that shows that nobody is incentivized to use drugs because of Narcan. It does, however, keep people from dying of drug overdoses. Ditto needle exchanges.

I sometimes wonder why people believe this sort of moral hazard garbage. Do you really think there are people who would stop injecting drugs if they couldn't find clean needles? Or decide they want to keep doing drugs because they can get injected with narcan if they OD? If you think of addicts as actual human beings, it is immediately obvious that nobody would make decisions that way.

There was actually a story from Vancouver a couple of years back, where paramedics were being called back to the same adress more than once in the same evening. Basically because people knew that they could be rescued, they continued taking drugs after being revived. So yes, moral hazard is real.

Narcan is apparently really unpleasant. It basically causes rapid withdrawal symptoms. If someone takes drugs after being revived it is because they are terribly addicted, not because they don't have to worry about dying.

What would you propose? Have less Narcan so people die?

[marshwiggle]

All the evidence suggests that this is the right approach. Putting people in jail doesn't do anything to reduce drug abuse. There's also plenty of research that shows that nobody is incentivized to use drugs because of Narcan. It does, however, keep people from dying of drug overdoses. Ditto needle exchanges.

I sometimes wonder why people believe this sort of moral hazard garbage. Do you really think there are people who would stop injecting drugs if they couldn't find clean needles? Or decide they want to keep doing drugs because they can get injected with narcan if they OD? If you think of addicts as actual human beings, it is immediately obvious that nobody would make decisions that way.

There was actually a story from Vancouver a couple of years back, where paramedics were being called back to the same adress more than once in the same evening. Basically because people knew that they could be rescued, they continued taking drugs after being revived. So yes, moral hazard is real.

Narcan is apparently really unpleasant. It basically causes rapid withdrawal symptoms. If someone takes drugs after being revived it is because they are terribly addicted, not because they don't have to worry about dying.

What would you propose? Have less Narcan so people die?

I would much prefer statistics about how many people have completed drug treatment programs and are clean after a year (or whatever). Simply keeping people alive is a pretty low bar to aim for if they are still homeless, unemployable, etc. The most important goal has surely got to be improving their quality of life.

So yes, they need to be kept alive to be able to get treatment, etc. but the fewer who actually get off drugs the harder it is to make the case that this approach is the best available.

[mahagonny]

I sometimes wonder why people believe this sort of moral hazard garbage. Do you really think there are people who would stop injecting drugs if they couldn't find clean needles? Or decide they want to keep doing drugs because they can get injected with narcan if they OD? If you think of addicts as actual human beings, it is immediately obvious that nobody would make decisions that way.

I think some would, but I don't know how many. Many quit deliberately (not by dying or being jailed); some do even with no assistance. There are many good reasons to finally turn that corner and you named one. I recall years ago reading a thing that was designed to help people quit smoking. The method was, make a list of all the hazards and inconveniences of smoking. Expense, the labor involved in buying, carrying, disposing of your butts, the loss of taste sensation, coughing, bad breath, more frequents colds, burns on your clothing, smelly car and home etc. Then after quitting make a list of the benefits already noticed.
I had a former junkie friend. He would never have quit if he hadn't been busted. After prison he too obese and old to function on the street. He pretended to have schizophrenia so he could get drugs. He basically never learned anything from all his self-inflicted suffering. His forearms were purple. He would say 'my veins have had their use' and chuckle. Dull needles and haste. He was 300 pounds of stationary self-pity. He didn't care, but some people would. Some people quit meth when they notice teeth are about to fall out. You never know which one is that last straw.

[ciao_yall]

I would much prefer statistics about how many people have completed drug treatment programs and are clean after a year (or whatever). Simply keeping people alive is a pretty low bar to aim for if they are still homeless, unemployable, etc. The most important goal has surely got to be improving their quality of life.

So yes, they need to be kept alive to be able to get treatment, etc. but the fewer who actually get off drugs the harder it is to make the case that this approach is the best available.

If they are dead, they can't get or keep clean. So, there's that.

I live in SF and we have a weekly needle exchange around the corner. It's not about "hey, let's make it easy for you to do drugs." It's about reaching people where they are at, letting them know there are services available for them when they are ready.

It takes a few tries before someone who has been using can build trust and decide to go with the nice people with the sandwiches and brochures instead of wandering off with their needles.

I will also say that the following day is the calmest around my neighborhood. It seems to attract the most civilized junkies.

[mahagonny]

I would much prefer statistics about how many people have completed drug treatment programs and are clean after a year (or whatever). Simply keeping people alive is a pretty low bar to aim for if they are still homeless, unemployable, etc. The most important goal has surely got to be improving their quality of life.

So yes, they need to be kept alive to be able to get treatment, etc. but the fewer who actually get off drugs the harder it is to make the case that this approach is the best available.

If they are dead, they can't get or keep clean. So, there's that.

I live in SF and we have a weekly needle exchange around the corner. It's not about "hey, let's make it easy for you to do drugs." It's about reaching people where they are at, letting them know there are services available for them when they are ready.

It takes a few tries before someone who has been using can build trust and decide to go with the nice people with the sandwiches and brochures instead of wandering off with their needles.

I will also say that the following day is the calmest around my neighborhood. It seems to attract the most civilized junkies.

Wishing them the best!

[apl68]

This is a city that reportedly has more drug addicts than high school students.  They've launched the nation's most intensive "harm reduction" drug program, with needle exchanges, emergency drugs to treat OD cases readily available, and virtually no enforcement of drug laws so that addicts won't be afraid to seek help.  And drug deaths have skyrocketed in the past year. 

As I understand it, this is to make drug addicts "safer".

All the evidence suggests that this is the right approach. Putting people in jail doesn't do anything to reduce drug abuse. There's also plenty of research that shows that nobody is incentivized to use drugs because of Narcan. It does, however, keep people from dying of drug overdoses. Ditto needle exchanges.

I sometimes wonder why people believe this sort of moral hazard garbage. Do you really think there are people who would stop injecting drugs if they couldn't find clean needles? Or decide they want to keep doing drugs because they can get injected with narcan if they OD? If you think of addicts as actual human beings, it is immediately obvious that nobody would make decisions that way.

If drug deaths are skyrocketing despite all the "harm reduction" measures, then the strategy is clearly NOT working.  I'm not at all opposed to law enforcement and emergency responders using Narcan to revive overdose victims.  It's the common-sense thing to do.  There may even be a case for needle exchanges in some places.  But when a jurisdiction effectively eliminates enforcement of drug laws, and then experiences a massive increase in the number of addicts and the number of overdoses, it's hard to see how the policy has made things better. 

And it's certainly alarming to think that other jurisdictions may be considering following in their footsteps.  Oregon just effectively legalized everything.  This is precisely why I was always against the "medical" marijuana con.  It was clear all along that it was only the thin end of a wedge for policies that are now causing an already appalling problem to balloon.

[marshwiggle]

I sometimes wonder why people believe this sort of moral hazard garbage. Do you really think there are people who would stop injecting drugs if they couldn't find clean needles? Or decide they want to keep doing drugs because they can get injected with narcan if they OD? If you think of addicts as actual human beings, it is immediately obvious that nobody would make decisions that way.

If drug deaths are skyrocketing despite all the "harm reduction" measures, then the strategy is clearly NOT working.  I'm not at all opposed to law enforcement and emergency responders using Narcan to revive overdose victims.  It's the common-sense thing to do.  There may even be a case for needle exchanges in some places.  But when a jurisdiction effectively eliminates enforcement of drug laws, and then experiences a massive increase in the number of addicts and the number of overdoses, it's hard to see how the policy has made things better. 

And it's certainly alarming to think that other jurisdictions may be considering following in their footsteps.  Oregon just effectively legalized everything.  This is precisely why I was always against the "medical" marijuana con.  It was clear all along that it was only the thin end of a wedge for policies that are now causing an already appalling problem to balloon.

The "harm reduction" principle sounds very odd when placed in other contexts.

In the US, there are many accidental firearms deaths every year. These include things like toddler finding gun in mom's purse and shooting self, mom, sibling,etc. One case involved the birthday child at a party shooting self with gun whuch had fallen out of a relative's pocket.
An obvious "harm reduction" measure would be to give out free trigger locks to anyone and everyone. Clearly, trigger locks would prevent the kinds of deaths I mentioned. Even if only a fraction of gun owners used them, it would still reduce those accidental shootings.

I imagine most people appalled at the number of gun deaths would be somewhat unsatisfied with this "harm reduction" measure, because it doesn't get at the fundamental problem of the casual attitude towards guns that is behind those deaths. A person who casually brings a gun in their pocket to a child's birthday party, and doesn't even notice when it falls out, is a menace.

Some people become addicted to drugs because of accidents or illness where they were prescribed painkillers. However, a large number of addicts just started using recreationally. As long as the recreational use of drugs is implicitly condoned, especially by those trying to "help", the fundamental problem is being completely ignored.

[ciao_yall]

I sometimes wonder why people believe this sort of moral hazard garbage. Do you really think there are people who would stop injecting drugs if they couldn't find clean needles? Or decide they want to keep doing drugs because they can get injected with narcan if they OD? If you think of addicts as actual human beings, it is immediately obvious that nobody would make decisions that way.

If drug deaths are skyrocketing despite all the "harm reduction" measures, then the strategy is clearly NOT working.  I'm not at all opposed to law enforcement and emergency responders using Narcan to revive overdose victims.  It's the common-sense thing to do.  There may even be a case for needle exchanges in some places.  But when a jurisdiction effectively eliminates enforcement of drug laws, and then experiences a massive increase in the number of addicts and the number of overdoses, it's hard to see how the policy has made things better. 

And it's certainly alarming to think that other jurisdictions may be considering following in their footsteps.  Oregon just effectively legalized everything.  This is precisely why I was always against the "medical" marijuana con.  It was clear all along that it was only the thin end of a wedge for policies that are now causing an already appalling problem to balloon.

The "harm reduction" principle sounds very odd when placed in other contexts.

In the US, there are many accidental firearms deaths every year. These include things like toddler finding gun in mom's purse and shooting self, mom, sibling,etc. One case involved the birthday child at a party shooting self with gun whuch had fallen out of a relative's pocket.
An obvious "harm reduction" measure would be to give out free trigger locks to anyone and everyone. Clearly, trigger locks would prevent the kinds of deaths I mentioned. Even if only a fraction of gun owners used them, it would still reduce those accidental shootings.

I imagine most people appalled at the number of gun deaths would be somewhat unsatisfied with this "harm reduction" measure, because it doesn't get at the fundamental problem of the casual attitude towards guns that is behind those deaths. A person who casually brings a gun in their pocket to a child's birthday party, and doesn't even notice when it falls out, is a menace.

Some people become addicted to drugs because of accidents or illness where they were prescribed painkillers. However, a large number of addicts just started using recreationally. As long as the recreational use of drugs is implicitly condoned, especially by those trying to "help", the fundamental problem is being completely ignored.

It's more complicated than that.

Yes, some people become drug addicts because one day at a party they decided to try something new and whoosh, down that rabbit hole.

We know now that pharmacies were pushing the use of opioid painkillers, essentially turning people into drug addicts because of their physical pain instead of helping them with other, less profitable, pain management solutions.

More commonly, those with drug problems are self-medicating their mental health problems. Nicotine and alcohol are part of many cultures' ways of handling minor stress... and they can be abused. And some people try harder substances because they are embarrassed to seek help, don't know how to seek help, think that the drug is solving their problem and that they can control it.

And when the drugs get to be too much, instead of offering treatment we throw them in jail with a whole lot of other people suffering from mental health crises. And we wonder why this problem continues...

[marshwiggle]

And when the drugs get to be too much, instead of offering treatment we throw them in jail with a whole lot of other people suffering from mental health crises. And we wonder why this problem continues...

If a school has a high dropout rate and/or a high failure rate, if the school "offers" tutoring, remedial help, etc. what matter is how many students actually avail themselves of it and profit by it. If no-one does, then it's not an effective solution, no matter how well intended.

[Parasaurolophus]

If drug deaths are skyrocketing despite all the "harm reduction" measures, then the strategy is clearly NOT working.

Do we have any reason to believe this is true?

InSite Canada began operating in 2003, and we have reams of evidence from those 17 years indicating that it had a positive effect on drug deaths and treatment (as in: fewer and fewer deaths, more and more treatment). My understanding is that this evidence has been borne out at supervised injection sites elsewhere in the world.

Now, drug deaths in Vancouver have skyrocketed in 2020. But that's not because InSite sucks or isn't working; it's because the pandemic exacerbated conditions, and has made treatment--and supervised injection--much more difficult.

So: do we have reason to believe that the 'skyrocketing' of drug deaths in whichever context you're talking about--is it SF, or broader?--is due to the ineffectiveness of harm reduction measures, or might it be an artifact of the pandemic?

[Caracal]

In the US, there are many accidental firearms deaths every year. These include things like toddler finding gun in mom's purse and shooting self, mom, sibling,etc. One case involved the birthday child at a party shooting self with gun whuch had fallen out of a relative's pocket.
An obvious "harm reduction" measure would be to give out free trigger locks to anyone and everyone. Clearly, trigger locks would prevent the kinds of deaths I mentioned. Even if only a fraction of gun owners used them, it would still reduce those accidental shootings.

I imagine most people appalled at the number of gun deaths would be somewhat unsatisfied with this "harm reduction" measure, because it doesn't get at the fundamental problem of the casual attitude towards guns that is behind those deaths. A person who casually brings a gun in their pocket to a child's birthday party, and doesn't even notice when it falls out, is a menace.

If giving out free trigger locks would be an effective way to reduce accidental shootings, I'd be all for it. If the person bringing a gun to a kid's birthday party is less likely to accidentally shoot someone there, that seems like a good thing, no?

Just because something doesn't completely fix a problem doesn't mean it isn't worth doing if it reduces some of the harms.

[Caracal]

And when the drugs get to be too much, instead of offering treatment we throw them in jail with a whole lot of other people suffering from mental health crises. And we wonder why this problem continues...

If a school has a high dropout rate and/or a high failure rate, if the school "offers" tutoring, remedial help, etc. what matter is how many students actually avail themselves of it and profit by it. If no-one does, then it's not an effective solution, no matter how well intended.

The problem with this analogy is that in most places treatment resources for drug abuse are woefully inadequate.