this post was submitted on 24 Dec 2025
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I have lots of compassion for people without a roof over their heads, and I agree there's no one-size-fits-all solution, and we shouldn't just use this program to move people into a prison or cattle pen away from public view.
And while I support and advocate for tackling the precursors to both addiction and homelessness (affordable homes, secure food supply, safe drug supply, proper care, up-skilling), there's a certain level where those things won't work well anymore and you have to move to treat before things get even worse for them. How can one navigate living on their own if they are on the street bent over from the fent? A program shouldn't treat every homeless person in the same way as an addict, but an individual in the bent over situation needs treatment that they cannot easily obtain on their own, and would make sense to put them in involuntary treatment until they can make their own decisions uninfluenced by drugs.
I believe the evidence is pretty clear that the best method of getting people to achieve long-term self-driven improvements around these issues is offering them health and social care (e.g., wounds, food, shelter, employment info) where they are (eg, using in a safe consumption site, on the street, admitted to emergency or hospital) and building relationships with them, as opposed to temporarily taking away all their decision-making capacity and incarcerating them. Medicalizing the problem is to treat it very superficially and has a revolving door effect on patients, which is costly and associated with worse outcomes. I appreciate the discussion. It's making me realize that I may want to do more work in this area.