Harm reduction for homeless alcoholics might be a safe place to have a drink

Nov 7, 2017

San Francisco’s “housing first” philosophy makes some accommodations for homeless alcoholics. But there’s a more cutting-edge experiment taking place elsewhere, and advocates say the city needs to get on board.

In this year’s homeless count and survey, more than 40 percent of homeless people in San Francisco reported drug and alcohol abuse.

The idea of safe injection sites — where IV drug users can shoot up in safe supervised environments — has been gaining a lot of attention recently.

 

But there’s another experimental concept that's been struggling to break through for more than five years — housing explicitly for alcoholics — where they would be allowed to keep drinking.

It’s a controversial idea, but the data show it seems to be working elsewhere, and some think it could make a dent in San Francisco’s massive homeless population.  

Dann’s House

Traverse City, Michigan, is a long way from San Francisco. But this small town of 15,000 happens to be home to an alcohol-friendly facility for the homeless: Dann’s House. Brian Dudley, who’s watching TV in the living room, says finding this place saved his life.

“Traverse City in the wintertime gets very, very cold. Some homeless people die and I was almost one of them,” Dudley explains. “Probably would’ve fell in one of the lakes or rivers over here and just went ’bloop’, and that’s about it.”

Dudley is 61 years old. And he’s an alcoholic — by his own admission. But over the past year, he’s significantly reduced his drinking, significantly.

"Taxpayers save money, people's health improves, their substance use decreases. The problems they're experiencing decrease. They're able to retain housing and become more stable parts of our community."

“I was drinking — two 12-packs a day and and half a gallon of vodka,” he remembers. “But now, I drink not too much. A 12-pack will freaking last me, I don’t know, until tomorrow.”

A 12-pack every day or two might sound like a lot, but if you do the math, that’s a huge difference. So how’d he cut down so much?

By living in a house full of other alcoholics.

It’s not just a bed, it’s a home

Dann’s House is an unassuming one story home along a busy road, it houses eight chronically homeless alcoholic men, with two beds to each room

The state of Michigan provided a startup grant. But now, Dann’s House’s bare-bones operating budget — just $100,000 a year — all comes from supportive individuals and foundations.

There’s a pot of chili bubbling on the stove for lunch. But that’s not where the action is. Out back, past a garden with Detroit Tigers logos stenciled along the fence, is the heart of the community — the garage, or as it’s affectionately known: “The Man Cave”

It looks a lot like a suburban teenage hangout. Old couches and easy chairs, posters on the wall. There’s a bunch of guys in here drinking beer, smoking cigarettes and medicinal marijuana.

Glynn Butler sips on a tall can of Natty Daddy malt liquor. He says back on the streets, he would have to chug his booze, before the cops took it away, or he was forced to share with his friends. Not at Dann’s House — the pressure to drink fast, which leads to falls and other health risks — is off.

 

Dann’s House residents Doug Wilson and David Whitney.
Credit Andrew Steltzer / KALW News

“It’s a place that I could sit and have a beer and know that if I went and bought five or six and put ‘em in my refrigerator, that I didn’t have to drink all five or six of ‘em,” says Butler. “I could have one or two and they were good and they were safe because everybody here respects each other’s stuff.”

Housing first for alcoholics — Seattle is leading the way

The Dann’s House garage illustrates the “Housing First” philosophy; that’s a growing trend amongst experts in the quest to end homelessness. In a nutshell it means: people don’t have to abstain from substances to attain and maintain housing.

University of Washington associate professor Susan Collins studied a similar facility in Seattle — called 1811 Eastlake — which houses 75 chronically homeless alcoholics and allows drinking. Since its founding in 2005, it’s become a national model.

“(1811 Eastlake) was the first housing first effort that was focused on people with alcohol use disorders,” says Collins. “Within the first year of operation, the housing first model saved taxpayers about $4 million.

That savings came from fewer emergency 911 calls and trips to hospitals, shelters and jails. Collins also found the people who live at the Seattle facility end up, on average, drinking less over time than when they moved in.

“What the research kind of unequivocally shows is that when we invest money in the health and well being of our fellow citizens, everybody wins,” explains Collins. “Taxpayers save money, people’s health improves, their substance use decreases. The problems they’re experiencing decrease. They’re able to retain housing and become more stable parts of our community.”

It’s often a tough sell to neighborhood residents, so there’s only a smattering of facilities like this all over the world. They’re often referred to as “wet housing” — a controversial name that many advocates don’t like. Some provide alcohol to the residents in doses; one in Canada even teaches participants how to distill hard liquor — so that they don’t do it wrong and end up accidentally killing themselves.

So why hasn’t San Francisco — where over 3,000 homeless people self-report drug and alcohol issues — gotten on board?

For starters, there’s still a pretty serious stigma about enabling drug and alcohol use — even among the homeless themselves.

An informal survey of people in downtown San Francisco that are struggling with housing issues revealed skepticism about a facility allowing homeless people to drink.

“I don’t think it’s a good idea,” said Marjorie Robinson. “Because it's eventually gonna cause chaos.”

“I’m an alcoholic ... I don’t think it's good,” reflected Melvin King. “I know what alcohol does to certain people.”

“I feel like some people don’t know how to handle their alcohol,” added a women named TJ. “So it's hard to give them the ability to have somewhere to drink.”

Former District 8 Supervisor Bevan Dufty says he used to be a skeptic too.

“Even I when I first read about it, I thought ‘well how in the world could you give alcoholics access to alcohol?’” remembers Dufty.

But Dufty, who directed San Francisco’s Housing Opportunity Partnerships & Engagement initiative for almost four years, was intrigued. He brought mayor Ed Lee to visit the renowned program in Seattle, where Dufty says, he didn’t see people hanging out on the street at all.

“You don’t see the problems that even you see on some of our regular shelters where there are folks that are on the street and then there are people who are dealing to those people. It’s just not like that,” he says.

The more he learned, the more it made sense to try something different.

“A facility that really would have 75 to100 individuals would definitely have an impact,” says Dufty. “You would see a change on our streets having that many people safe and housed.”

San Francisco’s current options for homeless alcoholics

According to the city’s Department of Homelessness and Supportive Housing, the city does have 74 designated beds for alcoholics, along with specialized treatment; but they are scattered across six different sites around the city, and federal funding rules make it hard to qualify.

Advocates like Dufty say there’s a need for the community and specific support that a central location can provide.

He first tried unsuccessfully to create a 50 unit, alcohol-friendly facility in a San Francisco church back in 2012.

The concept almost made it into city legislation in late 2016. But it just hasn’t gained enough momentum, and Sam Dodge, the former deputy director of the city's homelessness-services department, says that it's “certainly not the most pressing issue that I hear from constituents and from the board of supervisors.”

 

Dodge says the city is giving higher priority to establishing safe injection sites — supervised places for IV drug users to shoot up.

 

Plus, San Francisco’s subsidized housing sites already have relatively tolerant attitudes about addictive substances — residents don’t automatically lose their beds at most city supported housing programs, just because of alcohol use.

 

“Chronic inebriates have been successful in this housing," Dodge explains, "so we hadn’t seen the absolute need" for any additional programs for homeless folks with alcohol problems.

 

 

But the Drug Policy’ Alliance’s Laura Thomas, who lobbies on both city and state legislation, says “San Franciscans as a whole still want to try new things,” and the city should move ahead with centralized, alcohol-friendly facilities.

 

Thomas’ group commissioned a survey in 2016 that found 64 percent of likely San Francisco voters support housing allowing indoor alcohol consumption.

 

She says San Franciscans want positive, compassionate solutions, but instead, political leaders generally offer options that criminalize the homeless, like the sit-lie ban.

“I think that there’s a lot of support for the idea here,” said Thomas. “I think the bigger problem is actually finding ... a building where this program can be situated, given the intense demand for supportive housing and for affordable housing.”

Given the housing crunch, convincing neighbors to open a housing complex dedicated to alcoholics on their block could be a monumental task.

 

So for now, the idea isn’t getting much attention.

Back in Traverse City, Michigan, Patrick McConnell says that’s a shame.

“Every town of any size should have this option,” says McConnell, who was living on the streets for seven years before he moved into Dann’s House. Now, he’s taking some steps to turn his life around.

“I just recently got out of a treatment center in Northern Michigan ... And that was just something that I knew I had to do for myself.  Now, would I have done that while I was living on the street?  Probably not,” he reckons.

Traverse City’s mayor and police chief are now on the board of directors. The success of Dann’s House, and similar projects elsewhere, will likely keep the idea on San Francisco’s radar.

 

KALW collaborated on this story with the San Francisco Public Press, whose fall edition is all about creative, outside-the-box solutions to homelessness. Check out Andrew Stelzer’s companion piece in the paper, and his follow-ups online this fall. We’ll also be working with the Public Press in January on a day-long gathering called Solving Homelessness: A Community workshop. You can learn more at sfpublicpress.org/homelessness/workshop2018.