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Old 10-21-2024, 10:56 PM   #1981
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I think the issues are highly related. One is attacking leading indicators, one is dealing with lagging indicators.

I'm a huge proponent of housing first. There's enough data from decades ago that we shouldn't just be dicking around with this and actually implementing it at scale.

Someone needs to take serious aim at providing social services to kids in troubled households. Our "public" schools charging hundreds in fees, kids under fed because they rely on parents that aren't providing for them, and the lack of available extracurricular activities to kids without money or access to a car for transport are places it would be nice to see get some actual attention.
I agree with all of this. Providing housing also removes the open-air drug use issue for the most part.

The problem is we currently need a stop gap solution to address the toxic drug supply. Just saying "Well force them all into rehab" is just complete nonsense when you even half-examine it from a logistical standpoint.
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Old 10-22-2024, 05:13 AM   #1982
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Source?
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Old 10-22-2024, 08:07 AM   #1983
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Source?
You’re seriously asking for a source that people use intoxicants because they make them feel good?

Look, I understand why academics and policy wonks like to map structural factors and economics to social ills. It makes for convincing papers, and more importantly, remedies that are also structural and economic. But you can’t understand addiction without understanding that many people get pleasure from intoxicants. That they enjoy the feeling of being wasted, and socially bond over intoxication.

The guys I grew up with in middle and upper-middle-class suburban Calgary loved getting wasted daily. We all started in junior high - not because we came from distressed households, or were abused, but because we were bored and getting wasted was fun. By our late 20s most of us had toned it down enough to hold down jobs and keep a household together. Some didn’t. Some are dead now. Or fell off the face of the earth. Or still live in their parents’ basement.

Hard to say why some fell by the wayside and some didn’t. Each case was different. But it wasn’t socioeconomic (a couple of the guys who wound up dead by 40 came from affluent, stable households).
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Old 10-22-2024, 08:30 AM   #1984
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Just housing everyone is more complicated than it seems.

Firstly where do you house them? A free hotel? A treatment facility? Special building just for people experiencing homelessness? Who pays for this?

Then you've got the challenge of dealing with a large collection of people, some just down on their luck economically and/or some with severe mental health and addiction issues. This demographic attracts a lot of criminal activity. They assault each other. This group contains a lot of vulnerable people that others within the group will take advantage of. Who polices them? Who gives them medical treatment? Who cleans up after them?

Are people allowed to stay no matter how bad their behaviour is? Do you force people to stay who need treatment? Do you keep all of the people with addiction and/or mental health issues in their own separate housing? What about people who could be housed by themselves, but will take the government up on offers for free housing?

Vancouver also already has 1700 more housing units under construction, bringing the total to about 3800. That doesn't include emergency and temporary shelters. Vancouver has an estimated 2420 homeless people with only 605 being "unsheltered". That means many of the people you see on the streets have places to live, but probably just don't spend all of their time there. You also have to assume that some of the people on the streets are either unhousable or don't want to be housed.

https://vancouver.ca/people-programs...ess-count.aspx

BC also needs to address their housing issues, generally. The number of homeless people is increasing at a dramatic rate. A combo of a crappy economy, easy access to addictive drugs, and unaffordable housing are likely the culprits.

Anyways, I think housing those experiencing homelessness is a great idea. It's not as easy as it sounds to implement. It's certainly not going to solve all of the issues. They'll still be lots of people on the streets. Housing alone doesn't address mental health and addiction issues.
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Old 10-22-2024, 08:44 AM   #1985
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I think we've come to agreement that there are no easy solutions for a complex problem with many contributing factors, and anyone proposing one should be eyed suspiciously. Particularity when they promote a recovery model that hasn't been implemented fully, has no data to support it, and already claim success with dubious numbers.
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Old 10-22-2024, 09:38 AM   #1986
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And where are these magical treatment facilities in the province, staffed with people who know how to force people to do minimum wage labour?
We can syphon off some of the millions of dollars we spend on firefighters police, EMTs, and Public health workers who are delivering Naloxone 100 times a night.

It's not like we aren't already spending millions on healthcare for these people who overdose over and over again.
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Old 10-22-2024, 09:50 AM   #1987
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I think we've come to agreement that there are no easy solutions for a complex problem with many contributing factors, and anyone proposing one should be eyed suspiciously. Particularity when they promote a recovery model that hasn't been implemented fully, has no data to support it, and already claim success with dubious numbers.
You're correct, It is a complex issue that requires a coordinated effort at multiple levels. The priority should always be upstream determinants of health. Schooling, Housing, Safe supply, having meaningful work and a facilitating a stable family life are very important.

No less, the status quo for enabling or turning a blind eye to the reckless public harm drug addiction causes is also not an option. I have worked with public health officials who work hard to implement and advocate harm reduction. Many of whom volunteer to enable harm reduction where possible. Just the same, I have consulted with ground level workers who are totally disillusioned by their day to day life where they continually respond to the same peoples overdosing again and again.
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Old 10-22-2024, 12:12 PM   #1988
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And where are these magical treatment facilities in the province, staffed with people who know how to force people to do minimum wage labour?
The conservative griftosphere is starting to transform their gay-conversion camps to these rehabuse centres

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We can syphon off some of the millions of dollars we spend on firefighters police, EMTs, and Public health workers who are delivering Naloxone 100 times a night.

It's not like we aren't already spending millions on healthcare for these people who overdose over and over again.
Emergency personnel get paid whether they respond to a car accident or an OD or wash their personal vehicles in the bay because its a quiet day.

It would be lovely to magically right-size those resources, but you are not finding money from those budgets anytime soon. In the looooong run perhaps it works out a bit that way (if new measures are succesful and sustainable...and not just a one-off political announcement)
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Old 10-22-2024, 12:17 PM   #1989
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We can syphon off some of the millions of dollars we spend on firefighters police, EMTs, and Public health workers who are delivering Naloxone 100 times a night.

It's not like we aren't already spending millions on healthcare for these people who overdose over and over again.
But then we would be defunding the police1!!

Last edited by Cappy; 10-22-2024 at 02:08 PM. Reason: sorry, this was sarcasm
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Old 10-22-2024, 01:01 PM   #1990
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The conservative griftosphere is starting to transform their gay-conversion camps to these rehabuse centres



Emergency personnel get paid whether they respond to a car accident or an OD or wash their personal vehicles in the bay because its a quiet day.

It would be lovely to magically right-size those resources, but you are not finding money from those budgets anytime soon. In the looooong run perhaps it works out a bit that way (if new measures are succesful and sustainable...and not just a one-off political announcement)
I think everyone needs to agree that a sustainable solution is going to cost a lot of money, and that starts by agreeing that we are already spending a lot of money.

unfortunately the UCP ( and covid) has meddled with opiate surveillance, (anecdotally we know the problem is worse now), the Q1 reports in 2020 for Alberta indicate that at minimum 4% of all urban hospital visits is related to opiate response. At some urban hospitals that number increases to 14%. In One hospital 19% of stays were related to drug poisoning! That is at a cost of $9,172 a stay. ( I know, this is the BC thread, I digress).

https://open.alberta.ca/dataset/f4b7...rt-2020-q1.pdf


https://www.albertahealthservices.ca...pital-stay.pdf

Again, most people who have worked in public health, or have a basic understanding of public health know that sustainable funding for the upstream determinants of health is the priority. I am un wavering in this position Housing Sustainability, Education, Harm reduction are crucial.

Still, it is reckless to have a catch a release system. There needs to be a serious and specific investment into mandatory addiction treatment. Addicts are powerless, they have lost their agency.

Mandatory treatment is not a novel concept, it has been a standard practice for public health concerns since 1913. Those with active Tuberculosis have to comply with daily observed therapy or they will be apprehended. Public Health workers do their best to intervene in every way possible to avoid that outcome, and we should do the same with drug addicts, but eventually the matter is out of their hands.
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Old 10-22-2024, 01:03 PM   #1991
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But then we would be defunding the police1!!
Defunding the police to invest in upstream interventions and down stream treatment is a great idea. The police should work only to facilitate those initiatives.
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Old 10-22-2024, 01:32 PM   #1992
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Originally Posted by TheIronMaiden View Post
I think everyone needs to agree that a sustainable solution is going to cost a lot of money, and that starts by agreeing that we are already spending a lot of money.

unfortunately the UCP ( and covid) has meddled with opiate surveillance, (anecdotally we know the problem is worse now), the Q1 reports in 2020 for Alberta indicate that at minimum 4% of all urban hospital visits is related to opiate response. At some urban hospitals that number increases to 14%. In One hospital 19% of stays were related to drug poisoning! That is at a cost of $9,172 a stay. ( I know, this is the BC thread, I digress).

https://open.alberta.ca/dataset/f4b7...rt-2020-q1.pdf


https://www.albertahealthservices.ca...pital-stay.pdf

Again, most people who have worked in public health, or have a basic understanding of public health know that sustainable funding for the upstream determinants of health is the priority. I am un wavering in this position Housing Sustainability, Education, Harm reduction are crucial.

Still, it is reckless to have a catch a release system. There needs to be a serious and specific investment into mandatory addiction treatment. Addicts are powerless, they have lost their agency.

Mandatory treatment is not a novel concept, it has been a standard practice for public health concerns since 1913. Those with active Tuberculosis have to comply with daily observed therapy or they will be apprehended. Public Health workers do their best to intervene in every way possible to avoid that outcome, and we should do the same with drug addicts, but eventually the matter is out of their hands.
Damn, they must have held some massive convoys for that back in the day.
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Old 10-22-2024, 04:25 PM   #1993
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You’re seriously asking for a source that people use intoxicants because they make them feel good?
You claimed "a lot of people are addicted because they just like getting high." What percentage of people dealing with extreme addiction issues are dealing with them solely on the basis that they like to get wasted, and not because there are other mitigating socioeconomic and mental factors?

Quote:
Look, I understand why academics and policy wonks like to map structural factors and economics to social ills. It makes for convincing papers, and more importantly, remedies that are also structural and economic. But you can’t understand addiction without understanding that many people get pleasure from intoxicants. That they enjoy the feeling of being wasted, and socially bond over intoxication.
No, they map it to those factors because that's what research and data supports. I get that anecdotal evidence is your favourite type of evidence, but people who do these things for a living need to use actual data.
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Old 10-22-2024, 04:27 PM   #1994
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You claimed "a lot of people are addicted because they just like getting high." What percentage of people dealing with extreme addiction issues are dealing with them solely on the basis that they like to get wasted, and not because there are other mitigating socioeconomic and mental factors?



No, they map it to those factors because that's what research and data supports. I get that anecdotal evidence is your favourite type of evidence, but people who do these things for a living need to use actual data.
Yeah, but did you know that people do drugs because drugs make them feel good?

Think about it.
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Old 10-22-2024, 04:32 PM   #1995
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The problem for Vancouver specifically is it doesn't matter how much housing we build as most of our homeless are not from Vancouver, Vancouvers climate already acts as a magnet for the housing insecure from all over Canada, if you are giving away free housing as well then you just keep attracting vastly more people with social issues.

As a Vancouver home owner I have no problem paying my taxes to help out people from Vancouver who are struggling but I am effed if I should be paying for Kamloops, Medicine Hat, Swift Current, Brandon and Thunder Bays social issues
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Old 10-22-2024, 05:11 PM   #1996
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Just housing everyone is more complicated than it seems.

Firstly where do you house them? A free hotel? A treatment facility? Special building just for people experiencing homelessness? Who pays for this?
You house them in housing. The same kinds of places the rest of us have the dignity of calling home.

In most case studies, even though units end up getting trashed here and there, this ends up being cheaper than not doing it. It's insanely expensive to shelter/hospitalize/jail people.
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Old 10-22-2024, 06:25 PM   #1997
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You claimed "a lot of people are addicted because they just like getting high." What percentage of people dealing with extreme addiction issues are dealing with them solely on the basis that they like to get wasted, and not because there are other mitigating socioeconomic and mental factors?



No, they map it to those factors because that's what research and data supports. I get that anecdotal evidence is your favourite type of evidence, but people who do these things for a living need to use actual data.
.

Do they? because the harm reduction programs aren’t working and it’s been over 20 years.
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Old 10-23-2024, 12:09 AM   #1998
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.

Do they? because the harm reduction programs aren’t working and it’s been over 20 years.

Since “Greg” isn’t dead and could still go into a treatment centre to help with his addiction, maybe harm reduction programs are working.
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Old 10-23-2024, 01:18 AM   #1999
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Do they? because the harm reduction programs aren’t working and it’s been over 20 years.
It's difficult to prove categorically that harm reduction works, as other social and medical interventions change the statistical model, but every indication is it has reduced HIV and Hep rates drastically in the DTES, we know clearly that Insite has dealt over 6500 overdoses, not all of them would have resulted in death but you have to assume if there was no widely available Narcan (another massive part of harm reduction) and those poor souls OD on the street half of them would be dead, 3000 less dead is a success where I come from
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Old 10-23-2024, 02:30 AM   #2000
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.

Do they? because the harm reduction programs aren’t working and it’s been over 20 years.
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It's difficult to prove categorically that harm reduction works, as other social and medical interventions change the statistical model, but every indication is it has reduced HIV and Hep rates drastically in the DTES, we know clearly that Insite has dealt over 6500 overdoses, not all of them would have resulted in death but you have to assume if there was no widely available Narcan (another massive part of harm reduction) and those poor souls OD on the street half of them would be dead, 3000 less dead is a success where I come from
Yeah, but corperatejay doesn't look into things, he shoots from the conservative hip! Them liberals are done wrong and shoot from the woke hip!.
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