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Comment by cwkoss | Hacker News Reader

Make a brutalist prison-like structure downtown where:

- Anyone can get a free bed/meal

- Anyone can get illegal drugs provided to them by a nurse for free. Nurse may give 5 min sobriety pep talk before administering.

- You have to piss clean before you can leave.

Seems like for $80k/person a year, we could clean up the streets, make the addicts much happier and safer, and perhaps even have some money left over. I'm sure it'd take a huge load off emergency services too - removing the economic needs of satisfying addiction seems like it could drastically reduce crime, why steal for a fix if you can get it for free?

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> make the addicts much happier and safer

This is the current trend in many progressive cities, and so far it's a massive failure. Perhaps it's not surprising that when you work to make addicts happier, you attract more addicts. You also wind up with an entire industry that spends hundreds of millions of tax dollars catering to the addicts, and which perversely needs addicts to remain addicted in order for the industry to survive. The situation only gets worse.

These policies put the addict's needs above those of the non-addicts, since most non-addicts do not want a neighborhood filled with junkies who moved in to get free services, free needles, and legal injection sites.

Common knowledge used to be that an addict needs to hit "rock bottom" before they will turn their life around. If this is true, by making addicts happier and more comfortable, you're not helping anybody.

This has not been attempted anywhere. What are you referring to?

>who typically do not want their neighborhood filled with addicts who have moved in to get free services, free needles, and safe spaces.

The lack of a policy for dealing with homeless addicts is a effectively just a policy of keeping them in the poorest neighborhoods. Ignoring them doesn't make them go away, we can do better.

> The lack of a policy for dealing with homeless addicts is a effectively just a policy of keeping them in the poorest neighborhoods.

No, becoming a drug addict will keep you in poorest neighborhoods. This is simple cause and effect. And why should drug addicts not live in poor neighborhoods? Why would you move the drug addicts out of poor neighborhoods, but not the non-addicts? You are suggesting policy that incentivizes addiction.

> This has not been attempted anywhere. What are you referring to?

If you don't live in San Francisco, I'd recommend checking out this recent video:

https://www.cnn.com/videos/us/2018/12/14/san-francisco-opioi...

There are certain blocks of the city in the Tenderloin and SoMa where people are free to shoot up heroin in broad daylight. The city hands out 400,000 free needles to junkies every month. We spend $300 million a year on homeless programs with little oversight or accountability, and recently voted to double that to $600M+. And now they're proposing official safe injection sites in the middle of the city. Is this putting a dent in the addiction problem? No, the city is becoming a dystopian hellscape.

That's why you also need free heroin inside, and the price to leave is a clean piss test.

Concentrate the people creating the 'dystopian hellscape' so services can be provided to them more efficiently and cheaply. If they can't get clean, they can stay inside and get a daily lecture on why they should be sober before their fix.

I'm not saying that its "fair" that everyone else pays for this. I'm saying we're already paying more than this and it isn't working, so puritan notions that "Govt should never provide people with certain drugs" should be challenged if there is a strong economic benefit.

Seattle does not enforce laws against public drug use and recently vacated all gross misdemeanor charges, citing the "case load". This just incentivizes bad behavior and further increases the case load. Every time I take my weekly walk I find 2-5 of those "free" used syringes with uncapped needles on sidewalks. While some decriminalization is good, if it is accompanied by indulging people's addictions and lackadaisical enforcement of littering, loitering, and harassment laws it only makes the problem worse.

By making the decriminalization location-based, it would concentrate the problem and make providing services to those individuals much cheaper because of economies of scale.

I'd imagine if there was free heroin and needles inside, not many people would continue buying H and discarding syringes on the street.

Hopefully these facilities can consistently confront disagreeable and potentially unstable users and ensure they are discarding all needles that were used before leaving. Seattle's track record of enforcement in other areas makes me pessimistic, unfortunately.

One idea I've heard of is requiring more needles to be handed in before fresh needles are handed out as a means of incentivizing neighborhood cleanup.

> Common knowledge used to be that an addict needs to hit "rock bottom" before they will turn their life around.

There are some newer treatments of drug addiction (e.g. wrt. opioids) that seem to hit a useful middle ground. They do more than simply letting the addict hit "rock bottom", e.g. they do mitigate the effects of physical dependence and withdrawal - but they seemingly do not replicate the "rewarding" and "addictive" effects of the drug. They're still rather controversial, precisely because nobody wants to inadvertently "enable" an opioid junkie in their destructive habit, but their use may be worthwhile here.

> This is the current trend in many progressive cities, and so far it's a massive failure

> Perhaps it's not surprising that when you work to make addicts happier, you attract more addicts.

> Common knowledge used to be that an addict needs to hit "rock bottom" before they will turn their life around.

Please cite your claims.

Is the idea that people with psychological disorders and under/unemployment should also have to develop an addiction to drugs?

A segment of the homeless population is excluded from housing services because they are not willing to give up their addictions. If they use drugs, they are kicked back onto the street.

I by no means think this should be the only homeless solution, but for the subset of the homeless unwilling to stop using drugs, our currently policies literally leave them out in the cold.

> You have to piss clean before you can leave.

This is clearly unconstitutional, unless you have to be tried and convicted of a crime in order to enter, which I suspect would make it less attractive. Not to mention I think your view of what homeless people want/need is, uh, not exactly informed by a lot of experience in the streets.

why would an addict want to better themselves in this situation?

Why do humans have motivations?

Alot of people have motivations or goals but never fulfill them, giving them incentive to not fulfill them at the same time makes no sense. in fact its doing the opposite by incentivizing complacency.

Because most addicts want to better themselves and once basic needs are met they have the ability too.

The only change I'd make to this is to let addicts out, and not completely disconnect them from society.

I'm a huge fan of these types of ideas.

While I like this one specifically, and think it has promise, what we really need to do is try 20 different ideas. Each should be a small randomized trial, with pre-registered outcome metrics.

Get all the conservatives, liberals, progressives, socialists in a room. Get them to agree on optimal outcomes (I actually don't think this is insane, as we often want the same thing). Then run a series of experiments, where each partisan leaning can propose an experiment.

Obviously, in real life with actual humans, this would never work. But I can dream...

While I agree with you totally about the experiments -- am I the only person that thinks it's crazy that we're going to give $80K a year to the most useless people in our society when the median household income is like 33% less than that!?

It'd be great to, you know, not have the homeless problem. But when it's going to cost substantially more per person than the average person earns in a year, that just doesn't seem fair...

Not only that, but you are basically incentivizing people to quit their jobs and and live their lives on taxpayer dollars getting high 24/7 and some of those drugs have extreme effects on their futures like heroin and meth. This is WALL-E to the extreme.

I feel the same way about public housing. Why even have a job? I make $200k per year, and I don't want to spend $600K on a house -- yet that's what the average public housing unit costs in LA. If you win the poverty lottery, you get to live there for free. Well, what about EVERYONE else I know my age that doesn't work in tech and -- at current prices -- won't ever be able to buy a house? They've gotta work all day and live 6 adults to a house. But if you're poor, and you get the golden ticket, it's all gravy. Doesn't seem fair.

Again, it'd be great if everyone, you know, everyone could have a roof over their head. But how come if you work an average job you have to share an apartment with 2 other adults. And if you're poor and lucky, we just give you a brand new unit for free? And what about all the poor people that aren't lucky? They just get nothing, while someone else lives like a poor king.

There's got to be a better use for $600K...

Completely agree that the numbers are frustrating, but if you genuinely think people in public housing are living like kings and "it's all gravy", I recommend spending some time around a public housing development. These places are not all-inclusive resorts with luxurious lodging. The poor conditions in a lot of developments make the cost per unit even more frustrating, but there's not some colony of poor people who won the lottery and dance around all day laughing at what a fool you are for working for a living.

Spending per currently-homeless individual isn't necessarily a reliable metric, as people who are helped into homes are no longer counted in the denominator.

I'm not being glib but I think agreeing on outcomes is a much harder issue than you think that it might be. In my experience in this space, disagreement on desired outcomes is the root of political problems around drug addiction, mental health, and homelessness.

I would hazard a guess that you support harm reduction strategies, those policies do not garner widespread support amongst the voting public. Further, even when it is, it is very easy for opponents to say, "Why are we giving drug addicts this money when school teachers haven't had a raise in five years and can't afford to live here?"

>I think agreeing on outcomes is a much harder issue than you think that it might be.

This. People will pitch their idea going into the experiment then torture the resulting data until it suggests that their proposal was the most effective.

That's a great point. Maybe for example:

* level of negative externalities due to homeless people in city X goes down by Y%

* number of short-term homeless people in city X goes down by Y%

* number of chronically homeless people in city X goes down by Y%

* number of homeless people in city X goes down by Y% of which no more than Z% may be due to decreased arrival rate or increased departure rate of homeless people

* number of homeless people in city X goes down by Y% without raising net tax burden in city X by more than Z%

* tax burden of homeless services primarily met by those who benefit financially from increased rents

* housing stock in city X increases by Y%

* median apartment rent in city X decreases by Y%

* average apartment rent in city X decreases by Y%

* apartment rent in city X keeps place with inflation

* Gini coefficient (income inequality) in city X decreases to at least Y

* unemployment rate in city X decreases to at least Y

* government refrains from conditioning benefits or services on acceptance of drug treatment

* government refrains from conditioning benefits or services on cessation of drug use

* government refrains from conditioning benefits or services on acceptance of mental health care

* government requires acceptance of drug treatment or mental health care as a condition of receiving services

* no increase in arrests for crimes often committed by homeless people

* substantial increase in arrests for crimes that significantly affect other people's property or quality of life

(this isn't even including broader-based changes to unemployment insurance, welfare, or health care systems)

I don't disagree but you've already lost the voter. I think the best possible chance of success here wraps harm reduction and treatment strategies into an emotional story of paternalism/punishment.

That framework is really powerful in America and I've yet to see a narrative around harm reduction that resonates with most people, it just simply isn't attractive to spend tax money on needles and rent for drug addicts.

Oh, I meant this list to serve as examples of your point that people would find it hard to agree on these metrics, because some of them directly contradict each other!

Stop brutalizing brutalism.

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