Thread by @ShellenbergerMD

A Los Angeles mayoral candidate was just nearly stabbed by homeless woman

“She said, ‘I’m gonna start killing people’"

I'm gonna go out on a limb & suggest mental illness or drugs were a factor

We need to shut down the open air drug scenes

THREAD

https://twitter.com/SoledadUrsua/status/1401957291566403586

What are called "homeless encampments" in Venice Beach and Skid Row in L.A., the Tenderloin and Blade neighborhoods of SF & Seattle, are what Europeans call "open drug scenes," and view as threats to public health & safety.

bmcpublichealth.biomedcentral.com/articles/10.11…

Progressive harm reduction and drug decriminalization advocates, myself included, have been misled, and in turn misled others, about what places like the Netherlands and Portugal *actually* did to deal with addiction

They didn't just hand out needles and methadone. At first they did, but it didn't work. Eventually, Amsterdam, Frankfurt, Lisbon, Vienna, and Zurich involved law enforcement. In several cities, including Amsterdam, they also improved housing and infrastructure

All of those cities and nations had functioning psychiatric and addiction treatment systems. California doesn't even though it spends more than every other state at a per capita level. The main reasons are that counties are poorly suited to deliver care and we don't mandate it.

Hard drugs like fentanyl and meth are not only killing people directly, they are increasing homelessness and undermining public order in liberal cities, as I noted again today

michaelshellenberger.substack.com/p/why-drug-abu…

Against the insistence among some that homelessness is strictly the result of poverty & housing prices, researchers for decades have documented the prevalence of mental illness and substance abuse among the homeless and their role in creating homelessness in the first place.

A new 5,406-person study of found the major personal characteristics of the unsheltered homeless were “unmarried status, criminal justice problems, weak social support, medical diagnoses, drug (but not alcohol) problems, low income, and inability to afford basic needs.”

While just 8% & 18% of SF homeless point to mental illness & substance abuse, respectively, as primary cause of homelessness, researchers know self-reports are unreliable due to the socially undesirable nature of addiction & lack of insight that often accompanies mental illness

Using other methods, San Francisco’s Health Department in 2019 estimated that 4,000 of the city’s 8,035 homeless, sheltered and unsheltered, are both mentally ill and suffering from substance abuse. Of those 4,000, about 1,600 frequently used emergency psychiatric services.

The same is true in other cities. In 2019, the Los Angeles Times analyzed government data and found that two-thirds of homeless in Los Angeles struggle with either addiction or mental illness.

latimes.com/california/sto…

When we toured Venice Beach and Skid Row last week, outreach workers estimated rates of addiction from 75 to 100%, and rates of mental illness from 30% to 50%

"I'm gonna say about 100%" said this @UrbanAlchemyUA worker

https://twitter.com/ShellenbergerMD/status/1399999191452045312?s=20

And there is abundant evidence of psychosis for all of us who live or work near open drug scenes

Psychiatrists say we can't know from psychosis whether it is from meth or an underlying illness (eg schizophrenia)

But what they all need is treatment!

https://twitter.com/BoardwalkVenice/status/1382347335397642240?s=20

In the late 1990s, I advocated drug decriminalization, harm reduction, & housing before I focused on energy & climate in the early 2000s. I stopped paying close attention to developments in the area, beyond voting for California state ballot initiatives to decriminalize drugs.

But then, around 2016 and 2017, as overdose deaths rose to 70,000 per year, I started to wonder whether we had gotten drugs wrong. And so in 2019 I researched and wrote an article for Forbes, “Why California Keeps Making Homelessness Worse,”

forbes.com/sites/michaels…

Today, drug overdose and poisoning deaths are the single largest cause of accidental death in the US. More people die of drug abuse than of homicide (13,927) or car accidents (36,096).

And the rate of increase in overdose/poisoning deaths has been astonishing, from 17,000 in 2000 to 88,000 overdose and poisoning deaths between September 1, 2019, and August 1, 2020, a number that is likely to reach 90,000 when data for the rest of 2020 becomes available.

Cities are essential to protecting the environment, and yet the addiction crisis is destroying California’s cities and affecting Environmental Progress directly.

Two of my colleagues moved out of San Francisco earlier this year to escape problems created by its large open drug scene. I regularly encounter, and often try to help, floridly psychotic homeless people near my office.

Just one week ago, while driving on the highway, I almost hit a man with my car. He was running across the crowded highway, perhaps in a meth-induced psychosis.

Meanwhile, fentanyl is making experimentation with drugs a death sentence. “This is my son Alexander,” said Amy Neville at our Venice Beach protest last week. “He passed away last June from a single pill. I found him on the floor of his bedroom.”

Alexander was just 14. He had only started experimenting with opioids that week. Jaime Puerta’s daughter thought she was sniffing a line of cocaine. It was contaminated with fentanyl and she died.

When people hear those stories, many blame the parents perhaps because their stories are so disturbing. In truth, experimentation with drugs is widespread and while we should strongly urge children not to do it, they should not be allowed to die for their transgressions.

A better approach would be to treat the mental health issues that often underlie the desire to use hard drugs, including pharmaceuticals, spend $1 billion on PSAs warning of their danger, and break up the open drug scenes that make hard drugs cheap and available, as Europe did.

The problem, as I described in past columns, is not just that the policy makers aren’t taking the action they need to take. It’s that they're making the problem worse.

michaelshellenberger.substack.com/p/why-californ…

In San Francisco, where the overdose death rate is quadruple that of the rest of the U.S., policymakers are only now questioning whether simply reviving overdose victims is a sufficient response to two overdose deaths a day.

sfchronicle.com/local-politics…

“I think it’s the left combined with libertarianism around substances that makes it really hard to manage these problems,” said Biden Advisor & Stanford Uni's @KeithNHumphreys “Out west, it’s more, ‘Do whatever you want,’ and, ‘No one has a right to interfere with your view.’"

"Sometimes that is terrific. We’re the home of gay rights. But it doesn’t work well for addiction. The pursuit of allegedly individual freedom ends up ultimately killing the person, and does enormous damage to everybody else.” @KeithNHumphreys

Motivated to address this problem, Environmental Progress’s board of directors has decided to expand our work, and I'm happy to announce that HarperCollins will publish a new book by me on the untreated addiction, mental illness, and homeless crisis facing America.

The good news is that solving the addiction and overdose crisis offers a chance for Americans to come together at a time of historic division. The only way we know how to solve open-air drug scenes is with a combination of carrots and sticks, toughness & love, services & police.

Amsterdam, Frankfurt, Lisbon, Vienna, Zurich and New York City show that we do not need to choose between mass incarceration and mass homelessness.

We can have livable & walkable cities, humane & efficient treatment of mentally ill & addicts, & freedom

pubmed.ncbi.nlm.nih.gov/33710091/

There's a 3rd way: mandatory drug & psychiatric treatment as alternative to incarceration for those who commit crimes. Nobody's proposing to prosecute people for drugs in the privacy of their homes. Nor do Californians want to return to the “One Flew Over the Cuckoo’s Next”-era.

@JoeBiden isn’t doing what needs to be done but neither did Trump. While it was progressives who liberalized laws allowing for open drug scenes, conservatives have mostly advocated incarceration, rather than universal psychiatry & mandatory drug treatment, as the right response

We must marry the best of liberal & conservative instincts. We need to be compassionate but we need order. People whose addiction results in them breaking the law, whether through camping in parks & defecating in streets, and selling, buying, and using hard drugs in public.

We don't have all the answers, but we are finding allies of change, including parents, neighborhood activists, psychiatrists

Our proposal for peace in the streets and our minds is here

environmentalprogress.org/california-pea…

Man in crowd: "She's high on meth!"

She denies the charge and says her name is Angel

ktla.com/news/nationwor…

It’s almost as though residents of Venice Beach had warned of this kind of thing

https://twitter.com/venicecitizen/status/1389741317094137860

The woman appears to have been violent before with no visible consequences for her behavior

No wonder constituents of @mikebonin are so angry

https://twitter.com/purplelionleo/status/1401918974875426820

And… the knife-wielding woman is back on the street

smh

https://twitter.com/soledadursua/status/1402109452560461850