Victoria, British Columbia is trying to figure out how to deal with an encampment of homeless people who have serious substance use problems. Most homelessness is caused by rents being too high and wages being too low, but in this case the encampment is next to a shelter with empty beds, warmth, food and bathrooms (but presumably no allowance of substance use). The people quoted in the story seem baffled by why the homeless people are not using the shelter, but as the essence of addiction is prioritization of substance use over matters of basic biological necessity, they really shouldnâ€™t be surprised at all (especially not Dr. Perry Kendall, who is a smarter guy in person than he comes off in this story — bad quoting by the reporter maybe).
The bottle gang under the bridge or on skid row, the heroin shooters who camp out by the train tracks, the methamphetamine and crack addicts clustered in burned out housing are each a portrait of human misery and a call to action for the rest of us. Quite frequently cities respond by starting a predictable cycle. Tolerance is the order of the day at first, live and let live. As adverse health and social consequences increase, service professionals are sent in to ameliorate the damage. Finally, the problem gets even worse and the police are sent in to shut the whole thing down, cracking heads as necessary.
The needle park in Platzspitz in Zurich, Switzerland is the emblematic case. The park was declared a drug tolerance zone for the hundred or so addicts who were initially there. More addicts gathered over time, and public urination and defecation, prostitution, and petty theft became common. The city responded by providing services in abundance: needle exchange, methadone dispensing, safe sex education and a variety of other social services. But the problem didnâ€™t get better. It got worse. At its peak, several thousand drug users/sellers a day were either in the park or passing through, and Platzspitz became completely unsafe both for the users and for everyone else. This photo captures the scene
Finally, the fed up local residents agitated for a crackdown and the police closed up the park. The addicts were dispersed and continued to both experience and to cause suffering around Zurich for many years.
There is no questioning the goodwill or humanity of a doctor who stitches up the face of a homeless alcoholic who has had a bottle smashed over her head, or a social worker who gives out a condom and safe sex advice to someone who is prostituting him or herself for drugs. Neither is there a basis to question the decency of a police officer who acts to stem public health and safety risk when encampments of addicted homeless people swell to an enormous size. The trap cities seem to fall into though is using only one of these responses and one set of agencies at a time. The problem is handed off in frustration to a new set of professionals who know how to do one specific thing, so they do it. It’s almost like a mother who after trying unconditional love all day with a difficult child says to the father as he returns home: â€œIâ€™m sick of this and I want nothing more to do with this little brat. Slap some sense into him!â€.
I wonder if any RBCers are aware of a case where public safety and public health professionals tried to handle one of these encampments together. I personally would like to see arrests made in the cases of prostitution/drug dealing/assault/petty theft with the arrestees put into mandatory abstinence programs akin to 24/7 Sobriety or Project HOPE, with services offered contemporaneously for medical, psychiatric, housing, employment and dental problems. Just a carrot will not do it, and neither will just a stick. And neither will a pile of carrots suddenly withdrawn and replaced with a pile of sticks.