In San Francisco, where I am most familiar, SROs which are used to house homeless junkies are the primary location of overdose deaths, even though they house fewer junkies than the streets surrounding them.
While it's true that shelter placement has some advantages for high needs folks (e.g. older, women, or disabled), those themselves don't correlate with opioid overdose deaths. There was a randomized trial of permanent supportive housing, which is a stronger intervention than simple housing, in Santa Clara (DOI 10.1111/1475-6773.13553) where those who received PSH died at slightly higher rates than those did not and never found housing of their own.
Thanks for finding that, looks like it might indeed increase risks.
> We enrolled 423 participants (199 intervention; 224 control). Eighty-six percent of those randomized to PSH received housing compared with 36 percent in usual care.
> We found a similar high mortality rate in both treatment and control groups. Individuals experiencing homelessness have a greater age-adjusted mortality rate than housed counterparts.25 Among those who died, 89 percent of those in the intervention group had been housed compared with 28 percent in the control group.
I really want to pattern match, but it’s just not enough data. Worse they may have undercounted deaths in the control group. “Abode provided data on death for all participants who died while living in Abode housing. We queried County death certificate data on all participants who did not appear in any source of study data for 6 or more months.”
It's easy to find fallacies if you think about it. For example I could say the opposite
> giving an addict 4 walls and privacy is the key that unlocks recovery
I've constructed my argument identically and provided the same amount of evidence for my position.
When you compare both positions side by side, I think you can easily see that neither is valuable. They are both opinions being presented as facts (begging the question / assumption of truth / unwarranted assumption).
> giving an addict 4 walls and privacy is the key that unlocks recovery
except that when we talk about privacy for addicts, we are actually talking about extreme loneliness.
which is the fastest route towards OD.
evidence show that
adults with mental health issues are more than twice as likely to experience loneliness as those with strong mental health [1]
Loneliness can increase the risk of early mortality by 26% [2]
editor's note: loneliness alone, imagine loneliness + mental health issues + severe drug addiction.
addicts don't need privacy, on the contrary, they need sociality. 4 walls shared with other people could provide that, 4 walls alone won't and will probably make things worse.
[2] Holt-Lunstad et al., ‘Loneliness and social isolation as risk factors for mortality: a meta-analytic review’, Perspectives on psychological science 10.2 (2015), pp. 227-237.
The 4 walls they get are literally a single room... If you put another person in there outcomes will be even worse.
What everyone's missing is the Quality of the housing.
If the place is so roach infested and you fight bed bugs others bring in and you constantly lose everything you own to the conditions of the building, then in what mind would that have better outcomes than on the street?
The depression that they term loneliness isn't just loneliness, it's a complete sense of defeat and pointlessness resultant directly from environment.
> The 4 walls they get are literally a single room.
Theoretically yes.
In practice, no.
I've dealt with heroin addiction in my family, believe me when I say that privacy is not the solution, the solution is giving people a purpose outside of their constant quest to find ways to shoot up.
As I said, 4 walls can be beneficial, unless it's 4 walls to hide and keep everybody else out, except their dealers.
I'm all for reducing the damage, it works, but it doesn't mean simply giving them a hone, it means giving them a home to go back to, after they did something useful outside of that home.
The 4 walls should represent going back to a normal life.
> If the place is so roach infested and you fight bed bugs others bring in and you constantly lose everything you own to the conditions of the building, then in what mind would that have better outcomes than on the street?
if addicts cared about that, there would be no problem.
Society can't have it both ways - they can't be both receiving constant direct intervention and be invisible at the same time.
So long as the majority just want them out of sight or dead, we need to focus on ensuring that they are seen as members of the community rather than a blight, right?
> that they are seen as members of the community rather than a blight, right?
I don't know how it works in the US, but they are primarily people in need of care, like a person with a disease, they need to be cured before they can go back to the society and be part of it or they will return to segregate themselves and die alone sooner or later.
Putting them behind 4 walls is exactly making them invisible, so that the general population won't be upset.