Pubdate: Thu, 06 Apr 2006 Source: Vancouver Sun (CN BC) Copyright: 2006 The Vancouver Sun Contact: http://www.canada.com/vancouver/vancouversun/ Details: http://www.mapinc.org/media/477 Author: Paul Willcocks, Sterling News Service Bookmark: http://www.mapinc.org/rehab.htm (Treatment) SOME PROBLEMS WE SHOULD PAY FOR ONCE INSTEAD OF TWICE VICTORIA - I figure my acquaintance Dave has cost you about $52,000 in the past 12 months. He is an often likable person, with a drug problem, undiagnosed fetal alcohol spectrum disorder and the inevitably resulting series of bad decisions. I know of three hospital admissions. One was for a badly infected hand, the kind that called for those expensive antibiotics, another for a wrecked knee after a fall. Dave bolted both those times, once with an IV still attached and once with a pair of borrowed hospital crutches they're probably still looking for. Figure nine days in total, say $13,000 by the time you thrown in all the costs. I can't guess at the ambulance and emergency costs, or the help from clinics. An ER visit starts at about $120. Help from an ambulance crew probably around $200. Add another $1,000. And then there's the two fairly brief jail stays. Jail is cheaper than hospital, but more than a hotel (understandably.) Figure another $12,500. We aren't done yet. Dave sleeps on the street, or in shelters, or with his few remaining absurdly tolerant friends. Say half the year in shelters, at $70 a night -- $13,000. There's more. Social agencies that provide needed support, police that keep him moving -- say $5,000. And welfare, at $7,300 a year. Add it all up, and you're at $52,000 a year, in piecemeal support for a chaotic and often destructive life. (Dave is a real person, heavily disguised.) And that's not even counting the costs of having Dave wandering around downtown, the kind of person that storekeepers don't want to see outside their shops. Victoria's Police Chief Paul Battershill says that 90 per cent of property crime in the city is committed by addicts looking for drug money. That's 8,500 crimes last year -- home break-ins, car thefts, the crimes that undermine a community. Consider the cost, to victims and in police resources devoted to fighting a losing action against a problem that they can't solve. Addiction is a mental and social problem, not a criminal one. All police can do is minimize the damage when addicts do what it takes to pay for drugs. Battershill, an effective police chief, recognizes the reality. He has championed the four pillar approach to drugs. Enforcement is important in preventing open dealing and gang turf wars, but so are harm reduction, prevention and treatment. Leave out the intangible costs for now. Dave is going to cost the taxpayers $52,000, and have a miserable year. What he needs is a place to live, with someone there around the clock to talk to him about choices. It would probably work fine with five other people in the house. And that could be provided for about $30,000 a year, including welfare so Dave had some walking around money. It seems a good investment. Dave could die any day. Failing that, he's not going to move quickly to a smarter, better life in his current circumstances. He might in stable surroundings. Fiscally, it makes great sense to provide the help. Spend $30,000, not $52,000. So why not? I started thinking about Dave because of an article by the preternaturally clever Malcolm Gladwell in the New Yorker magazine. Gladwell was looking at the power law, a variation of Pareto's Law. To fix a problem, it suggests, you don't need to come up with a solution that deals with everyone who might be affected. Target the hard core, and things improve dramatically. (For them, and the collective.) But we struggle. Partly, I'm convinced, because we just don't think people like Dave deserve it. Objectively, he probably doesn't, especially because even if the help were there he'd mess up badly sometimes. And how do we tell a single mother on social assistance -- just under $200 a week for housing and everything else -- that we're willing to spend far more on Dave? Still, it seems a clear choice. Spend $52,000 a year to pick up after Dave in his chaotic march through life. Or spend perhaps half that much to support him in decent circumstance, and keep him mostly out of harm's way -- and of course, out of your way as well. You don't have to like it. But the numbers don't lie. It makes more sense to catch him, and keep him safe, than to pick up the pieces. - --- MAP posted-by: Larry Seguin