Thursday, June 23, 2022

First Comes Job-loss/Precarity, Then Comes Addiction, Then Mental Illness

Wired |   To promote policy that actually works, reporters and editors need to act more like science journalists and less like stenographers who—whether implicitly or explicitly, accidentally or deliberately—bolster political campaigns that use ignorance to drive fear.

It would be hard to find a better example of this problem than Nellie Bowles’ recent essay in The Atlantic, which argues that San Francisco is a “failed city,” in large part because liberal policies have worsened addiction and mental illness. These policies persist, she suggests, because local politicians refuse to confront the empty-headed but well-intentioned delusions of the hippies and their descendants who just want to let it be. She also claims that the recall of progressive district attorney Chesa Boudin in a June 7 election demonstrates that the city is finally awakening from this daze.

Bowles’ work is far from alone in its failure to look at evidence of effectiveness of various policies when discussing the politics around them. In one 24-hour period in June, a columnist for The Washington Post argued that “Boudin’s recall proves that Democrats have lost the public’s trust on crime”—without any mention of data on which policies work best. A similar news analysis from The New York Times also mentioned no actual data. And a New York magazine essay on “Chesa Boudin and the Debacle of Urban Left-Wing Politics” similarly ignored the question of whose preferred approaches are supported by evidence—and whose aren’t.

Bowles writes that her hometown “became so dogmatically progressive that maintaining the purity of the politics required accepting—or at least ignoring—devastating results.” She describes the city’s de facto supervised injection site in the Tenderloin as a place that looks like “young people being eased into death on the sidewalk, surrounded by half-eaten boxed lunches.”

Her argument falls apart in the face of scientific data. Hundreds of studies support the “harm reduction” approach used in clean needle programs and supervised injection sites—and none of them show that it makes drug use or civic life worse.

Indeed, harm reduction was deliberately adopted based on research evidence, not platitudes from the 1960s. Further undermining her analysis, studies overwhelmingly illustrate the counterproductive nature of using cops and coercion first. For one, red states with old-school tough prosecutors actually have worse crime rates than liberal ones like California.

However, since Bowles apparently assumes that harm reduction tactics were adopted because they seemed groovy, she ignores this research base. (Which, ironically, is the type of mindless approach she critiques San Francisco policymakers for supposedly having used.) What she and many other journalists frame as the failure of harm reduction is actually the failure of criminalization.

A brief tour of the data: According to the Centers for Disease Control and Prevention and dozens of other obscure organizations like the World Health Organization, the National Academy of Medicine, and the American Medical Association, clean needle programs dramatically reduce HIV transmission without increasing drug use rates. One study published in the Journal of Substance Abuse Treatment showed that, compared to people on the street who do not, those who participate in syringe service programs are five times more likely to seek more traditional forms of recovery and three times more likely to quit injecting.

What about supervised drug consumption? Here are three reviews of the literature, which show that it reduces HIV risk, injecting, harm associated with injection, and overdose death rates—while not increasing and sometimes reducing local crime and needle litter. (A 2018 review widely touted by critics for suggesting that supervised consumption did not have a significantly positive outcome had to be retracted by the International Journal of Drug Policy due to poor methodology.)

How about the “problem” that Bowles identifies with reduced penalties for drug possession and the increased use of incarceration and coerced treatment she apparently prefers?

 

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