In reply to CARLOS SPINOZA.

Add insult to injury – all conveniently sorted into plastic bags that your taqueria on the block would get fined for by the City if they where caught going back to using them again.
When they switched away from needle exchanges, the AIDS foundation *swore* we wouldn’t end up where we are today. It is high time we find better advice than what we’ve been offered in the past.

In reply to CARLOS SPINOZA.

The point of needle reduction is to reduce the chance of further disease and infection when they take the drugs, because it costs more to treat HIV/AIDS etc than giving out needles they’ll use with drugs anyways.

You’d know that if you READ the article.

Harm reduction is a BIG umbrella doing many different things to tackle the big problems.

In reply to John Parker.

And you know, just ignore all the dead people who didn’t get proper treatment for what they have.

It’s called survivorship bias.

You hear from the 12 steppers who survive, not the ones who relapse.

It’s like food allergies, idiots forcefed their children something they were allergic to in the “good old days”, until we found out that the consequences are quite real.

Similar to how Manic depression was really a mental illness called Bipolar disorder.

They didn’t survive the 12 step, and you have to be dumb if you think LESS treatment options would be better than MORE.

In reply to bchill.

…This comment is shortsighted and nonsensical.

Why are ML and health professionals paying for a government problem? Breed should be leading and funding solutions that are effective.

Then there’s the comment about ideologues, about people who literally research and field test solutions, alongside cost factors from status quo. And here’s someone mocking health professionals without basis that they are increasing the problem.

“Enlightened” approach for well over 20 years? We aren’t “enlightened”, harm reduction came from the aftermath of the HIV/AIDS crisis, because of blood borne diseases spreading that cost municipalities a lot more than prevention by magnitudes. It’s a core principle for public health response since at least the 80s nationwide because it saves government money.

This is why your rhetoric is dumb, because it’s reactionary and so ill informed, that you ignore a entire article of health professionals simply explaining their work.

In reply to Doctor Who.

I am SO tired of societal problems being bandied around like tennis balls favoring one team or another. This either/or mentality is and will continue to kill people. Literally. Often very slowly and with billions of dollars pouring through the chasm between proposed resolutions. It isn’t the actual tangible efforts that are the problem. It’s the gaps between the efforts and the politically motivated policies that none of you are either driven or willing to try to bridge. It’s ridiculous, sickening, and utterly infuriating. Cooperation would solve a lot more problems than this incessant pandering to the ignorance of the masses.

This is a great article on a very complicated subject.

San Francisco’s overdose policy is indeed “disjointed, involving dozens of nonprofits without an overarching goal.” Why?

For some it pays.

I have been homeless (and tentless!) in the city twice for extended periods.

I didn’t drink or take drugs. For general assistance money (a pittance) I once “volunteered” for a harm-reduction non-profit. I mostly believe in harm reduction practices.

I definitely believe so-called “tough love” policies are a pretense that involve very little love, but provide generously to the wounded egos of the well-heeled who want to atone for the damage their greed and desire for influence inflict on all of us.

On the streets we ridiculed the labyrinthine public assistance at which San Francisco supposedly excels: the filthy and smelly lines and waiting rooms, the scowling and contemptuous bureaucrats, the jabberwocky rules enforced to break one.

Beyond the bloated and Kafkaesque government, we called most of the non-profits “poverty pimps.”

They might trot us out for their lavish fund-raising parties as examples of how effective they were.

It is all very sad because most of their tough, poorly-paid non-profit front-line workers were themselves but a step away from destitution: their bosses and boards tight-lipped and hard-nosed, always aspiring, but forever locked out of the real accomplishments their professions had prepared them for.

And don’t get me started about the way these poverty pimps partner with idealistic suburban weekenders who come to San Francisco to get a lesson in “giving”, or the tech wiz-kids who tithe time and gimmicky anti-poverty solutions to look good to their bosses, or rather to make their bosses look good.

Be it all as it may, there are really no villains, only an antiquated system that puts profits for a minority ahead of providing for the needs of the majority in our world.

Off the streets today, my life today is no heaven. But I observe how this system is increasingly failing us, and how society’s problems are interconnected.

We give “billions to war, but all we get is a lousy t-shirt!”

For those who are sick and on the street I have this practical advice: get into the program, any program.

The people you expect to help you will lie to you and make things impossible for you. It is as if they want you to drop out and just go away.

Don’t allow it. When the program fails, and it will, go back and tell them you did everything they asked of you and ask them “what do I do next?”

The ball will be in their court and they will resent you, but after so long of this they will give up and actually help you. Just to get rid of you!

They can then pat themselves on the back, while you may possibly have your own door to close and lock, or find a small space where you can be more free to live your life on your own terms.

If nothing more, you will have an education unlike any other.

You may start to ask real questions about why we tolerate so much sickness and death in our streets. How did it get this way? Who does it serve?

Why do so many clamor for “accountability” from those who can least afford it, but none from those who can?

“needle exchange”
Mentioned 3 times.
This is the kind of miss-reporting that casts a shadow on this whole opinion piece.
We don’t have a “needle exchange” program.
We have a needle and drug use equipment distribution system.
In 2019 the Department of Public Health distributed 4.45 million needles.
Who knows what it is today.
You can walk in and get all sorts of stuff to keep your addiction to insanely dangerous and debilitating drugs “safe”.
Cookers, cotton (small and large), alcohol wipes, sani hands, sterile water, saline, tourniquets (both latex and non-latex), and, to keep your vitality up, vitamin C.
And aluminum foil, pipe covers and brillo, wound care and medical supplies like gauze, medical tape, hot hands (instant hot compress), Band-Aids, saline, and triple antibiotic ointment for those gangrenous wounds.
Don’t forget, you can now get needles in 6, count them six! – convenient sizes.
I recommend 30 gauge 1/2 inch for the fastest trip to the morgue.

Perhaps I’m ignorant but it sure sounds like San Francisco is in the enabling business almost to the point of encouragement that being a junkie is just a lifestyle choice and we’ll help you consume all you want to the point of death.

In reply to Doctor Who.

Translation: people you don’t like to look at should just die? They are “not us.”

I think the fundamental question here is do we, as a society, have an obligation moral or otherwise to help drug addicts.

The data suggests that rehabilitation with the current harm reduction approach is highly, highly unlikely, so what we are solving for is keeping them alive. I would argue that it is not success to merely keep someone on the streets alive, and allow them ready access to drugs.

In most expensive rehab clinics, it is a form of tough love – you are forced to live in a drug free environment; why do we not to do that with the folks here? In other words, you get clean shelter, but you cannot bring any of your belongings, pets, or drugs with you – at this moment, you cannot care for yourself and so the main priority is to get you into a clean environment where you are forced to sober up. Also, the negative externality of screwing up public spaces for law abiding citizens is quite frankly ridiculous – a poor, drug free person pays tax to fund a drug addict’s treatment already, is it fair to say they shouldn’t bear the burden of also walking over their comatose, feces covered body on the street? I think so.

In reply to bchill.

No, bchill, “we” haven’t been trying “enlightened approaches” for any amount of time in SF. That would require everyone having stable housing and health care, and access to drug treatment.

The problem with quoting “Experts” is you can find an expert that agrees with whatever point you want to make. People who have experienced long term recovery from addiction and alcoholism through 12 step programs are experts, and they do not believe harm reduction is the best approach. Confronting addiction head on and then finding a path to total abstinence has worked for hundreds of thousands if not millions of people for many decades.

ML and health professionals are good at science, but they are not good at paying for it, figuratively and literally

It’s very easy for ideologues and scientists to advocate for their ideas and goals, but they do so in a vacuum, waving their collective hand at consequences of those ideas and goals, much in the vein of, “those side-effect problems aren’t our problems to solve.”

But more to the point, we’ve been trying ‘enlightened’ approaches for well over 20 years in SF, and, while some addicts and other street people have benefited from those approaches, most people have paid the price for it in money spent and general city disorder that they’ve had to put up with.

It’s time for another city to be a petri dish for social experiments. San Francisco needs to be done with all of it now.

That means that some traditional elements of tough love have to return to the equation. Measure F is a good start.