Why Should We Give Homes to Winos Who Won’t Stop Drinking

Because it saves taxpayer monies.

Traditionally treatment of alcoholics required that they hit bottom before they can change.   But what happens if they end up in the gutter and they still don’t change?

New Thinking. The results from a two year study results are in. “Bunks for Drunks” saves tax dollars. 

Providing housing for chronic alcoholics, who are still drinking, can save taxpayers more than $40,000 annually, per alcoholic, according to the study released this week  in The Journal of the American Medical Association.

Nearly $4 million was saved by taxpayers by housing chronic, homeless drunks in a Seattle housing program, versus letting them sleep on the streets — which triggers costly health care and criminal justice services.

When it was first unveiled three years ago, Seattle’s pilot program was not well received.

“It was perceived by the public that we were simply opening a party house where individual …. were going to be allowed to drink, run amok and generally set their hair on fire. ” said executive director Bill Hobson.

“We’re paying for them to live there… sitting around all day in publicly subsidized apartments and drinking,” said Tucker Carlson of WNBC, who was apoplectic when he first heard about it. . “That’s a dream for winos. That’s a dream for a lot of Americans. I think that Kevin Federline essentially does that.”

“It’s a living monument to a failed social policy” said John Carlson, a conservative local talk show host. It’s “aiding and abetting someone’s self-destruction.”

The University of Washington study followed 95 participants in the Housing First program and a 39 person wait-list control group. The researchers compared public costs of the two strategies: giving the homeless housing — despite continued alcohol use — and leaving them out on the streets.

Initially, the county identified 200 of the most severe alcoholics who had been randomly ricocheting through jails, hospital emergency rooms, and social service outreach programs. A lucky ninety five were offered permanent homes — studios — in the new four-story apartment building, which cost $11.2 million, and was  paid for with city, state and federal dollars

The researchers found the average cost of alcohol-related services — hospital emergency care, the nonprofit “sobering center” (where police bring alcoholics to dry out), and the King County jail was $57,984 per person, per year while the 95 were living on the streets.

The savings and results were nothing but dramatic. Twelve months after moving into the apartment building, the average cost for these services for the same population dropped to $11,496 per person per year — an annual savings of  $46,488.

The study also found that daily drinking fell by roughly 2% per month while subjects were in the program, which offered the alcoholics permanent homes with some supportive services.

The research by Mary E. Larimer, Ph.D et al,  is in a murky area where we have historically gotten everything wrong. For too long, society has both coddled and demonized this woeful segment.

–On the one hand we have been mean-spirited towards them and cruelly let them drink and drug themselves to death on our urban streets.

–On the other hand we have permissively allowed them to destroy the quality of life in our public spaces, with panhandling, loitering, petty crimes, urinating and defecating in public.

The alcoholic homeless often live outside the existing laws because the police don’t want to deal with foul smelling vagrants who will seldom show up in court or pay fines.

Homelessness and drug addiction are certainly not a new phenomenon. Public health historians estimate that between 4 and 8 percent of the population of all societies is dysfunctional because of addiction or mental problems or both; a percentage that has remained constant throughout recorded history. Traditional treatment of alcoholics has mandated that  they be sober — that they have to “reach bottom” to get better. But the Seattle project puts some of this thinking in a new light.

In America, the most abused drug by far is alcohol.

What is new is the additional 400,000 mental patients out on the streets with little support since we closed most mental hospitals over the last three decades.

Freedom proved to be a grim gift for many of the helpless souls. Today many of these brazen, troubled people are imposing their bizarre private hells on the rest of us.

The reality is that most single, homeless street people are alcoholics, drug addicts and/or psychologically impaired. They self-medicate with alcohol and drugs.

Most of these unfortunate souls desperately want help, but their illnesses prevent them from taking it. If going to a clean warm bed in a shelter or enrolling in a social program means giving up alcohol or drugs, they simply can’t do it.

These woeful homeless people are almost impossible to treat.They refuse to stop drinking and abusing drugs. But what should we do about them? Leave them out on the streets to die? Leave them out on the streets to foul our neighborhoods?

Nationwide 125,000 drug addicts and alcoholic  die prematurely every year. (Worldwide the figure is two million) These people have a disease that is as real and deadly as cancer; and at some level, most people recognize this.

But there is something about the concept — of supporting drunks  who continue to drink — that offends the Puritan moral sense of many Americans. Most  simply can’t believe that chronic winos and drug addicts don’t have a choice.

When it comes to alcoholics and drug abusers, there is a mean streak in the Christian values of the American character. The idea of taking care of the obviously sick and the dying doesn’t seem to cut it. Where are the compassionate right-to-lifers when you need them?

What started three years ago in Seattle may have repercussions nationwide. Delegations from New York, Atlanta, Fort Worth, Phoenix and Los Angeles have traveled to Seattle to learn more about the cost saving project. A similar program to house Native Americans with chronic drinking problems is underway in Minneapolis.

Housing First is a low-cost, modern day asylum — a refuge  that seems to humanly solve a multitude of problems both for society and the individuals themselves.

<em>The study was funded by grants from the Robert Wood Johnson Foundation, the National Institute on Alcohol Abuse and Alcoholism, and the NIH.

Write: jfleetwood@aol.com.

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About Blake Fleetwood

Blake Fleetwood Blake Fleetwood was formerly on the staff of The New York Times and has written for The New York Times Magazine, New York Magazine, The New York Daily News, the Wall Street Journal, USA Today, the Village Voice, Atlantic and the Washington Monthly on a number of issues. He was born in Santiago, Chile and moved to New York City at the age of three. He graduated from Bard College and did graduate work in political science and comparative politics at Columbia University. He has also taught politics at New York University. He can be reached at jfleetwood@aol.com.
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