Doc, Homless in LA

[_EAllusion]

Non-narcotic analgesics fall into two broad categories: NSAIDs like aspirin, and Tylenol. Yes, other things like muscle relaxers, alcohol, anti-depresents, etc. can have pain relief properties for some people in some circumstances. However, these other things aren't primarily analgesics.

There are three non-narcotic analgesic categories. I'm not sure if my link organizes it that way, but that's the standard system. The fourth category of analgesics, opiates, is usually broken down by strength into sub-categories. Inside the categories there tends to be a variety of options. Drug companies are constantly iterating on the classes.

My hypothesis is that the profit motive to keep selling opioids to adicts and future adicts outweighs the profit motive for a new drug that could be used for pain but wouldn't have the additional pecuniary benefit of creating a market for addicts and future addicts.

My argument is that opiates are an easy category of chemicals to develop for purposes of pain management because they work directly on the endogenous system that controls pain. The variety of opiate-based pain management for serious pain is a consequence of human biology. I also think that there is intense demand for a non habit forming alternative that is just as effective that would make a ton of money if it could be developed, but developing it isn't simply a matter of want-to. The demand side favors non-addictive substances.

[_Markk]

[
You just don't get how bad it is here and you think you can understand it with studies and by comparison to your little town of around 25OK. Just from 2016 to 2017 LA homelessness rose 23% to over 50k...and I bet that is low

Please be honest in what I wrote and what my question was to you.

The continuous Madison metro area including Monona, Fitchburg, Middleton, and Sun Prairie is somewhere in the neighborhood of 320k. In that same area, there's a few thousand homeless people at any given time with a significant uptick just recently. Our mayor is not great on the homeless issue, never has been, and it certainly could be better. This is a large enough homelesss population that you see the full range of problems that you keep describing like the very thought of it has never occurred to anyone before. You never quite articulate why a no one can possibly understand homelessness unless they live in an LA sized city with a larger homeless population. You just assert it, like a teenager explaiming "You just don't understand!" before running up to your room to cry in your pillow.

You have no idea what you are discussing...do you have tents and people pooping in the streets in front of store fronts in the business districts of these cities.

I bet most of the homeless you talk, are in homes and shelters of sorts or in cars... and not literally laying on the streets. How often do the Madison police close down th streets and sanitize the storefronts of the businesses.

I am not saying people can’t understand, I am saying you have no idea what you are talking about. You simply have no idea.

How will you make sure these folks take their meds and do what they are suppose to do, in a city of millions, with 1/5th the homeless as y=th eintire population of your city?

How many homeless people do you personally visit a day?

[_Res Ipsa]

So, not to confuse the discussion with data or anything, I looked at some stats and found something surprising. As of the 2017 count of the homeless, the Boston, NY, and DC metro areas had a greater rate of homelessness than LA county. New York City had a little less than 50% more homeless people than LA County. But when you looked at the percentage of homeless folks that had no shelter, the figure for LA County was 75%. All the east coast cities disappeared from the top rankings. Apparently, on the east coast, states have recognized a right to shelter. So, one source of the specific problem in LA appears to be the lack of shelters available to the homeless. https://www.seattletimes.com/seattle-ne ... e-country/

So, if you have a large homeless population, the majority of which has no access to shelter at all, maybe that helps create the conditions that Markk is filming.

[_Analytics]

There are three non-narcotic analgesic categories....

I consider COX-2 inhibitors to be a subcategory of NSAIDs. But that doen't really matter for the purposes of this discussion.

My argument is that opiates are an easy category of chemicals to develop for purposes of pain management because they work directly on the endogenous system that controls pain. The variety of opiate-based pain management for serious pain is a consequence of human biology. I also think that there is intense demand for a non habit forming alternative that is just as effective that would make a ton of money if it could be developed, but developing it isn't simply a matter of want-to. The demand side favors non-addictive substances.

If the demand really outweighs the financial advantages of selling addictive products, how come it hasn't been developed yet?

Maybe the optimal solution of dealing with the opioid addiction crisis is to be patient and wait for free market forces to come up with a way for big pharma to find something even more profitable than selling highly addictive drugs to addicts and future addicts. But I have my doubts.

[_Markk]

So, not to confuse the discussion with data or anything, I looked at some stats and found something surprising. As of the 2017 count of the homeless, the Boston, New York, and DC metro areas had a greater rate of homelessness than LA county. New York City had a little less than 50% more homeless people than LA County. But when you looked at the percentage of homeless folks that had no shelter, the figure for LA County was 75%. All the east coast cities disappeared from the top rankings. Apparently, on the east coast, states have recognized a right to shelter. So, one source of the specific problem in LA appears to be the lack of shelters available to the homeless. https://www.seattletimes.com/seattle-ne ... e-country/

So, if you have a large homeless population, the majority of which has no access to shelter at all, maybe that helps create the conditions that Markk is filming.

I think weather might be an issue, if 10k people froze to death that might be bad press...just a guess.

by the way...there are a lot of shelters, but shelters have rules.

Homelessness rose by 23 % last year...how can you keep up with that?

[_Res Ipsa]

So, not to confuse the discussion with data or anything, I looked at some stats and found something surprising. As of the 2017 count of the homeless, the Boston, New York, and DC metro areas had a greater rate of homelessness than LA county. New York City had a little less than 50% more homeless people than LA County. But when you looked at the percentage of homeless folks that had no shelter, the figure for LA County was 75%. All the east coast cities disappeared from the top rankings. Apparently, on the east coast, states have recognized a right to shelter. So, one source of the specific problem in LA appears to be the lack of shelters available to the homeless. https://www.seattletimes.com/seattle-ne ... e-country/

So, if you have a large homeless population, the majority of which has no access to shelter at all, maybe that helps create the conditions that Markk is filming.

I think weather might be an issue, if 10k people froze to death that might be bad press...just a guess.

by the way...there are a lot of shelters, but shelters have rules.

Homelessness rose by 23 % last year...how can you keep up with that?

Well, yes. There are enough shelters for 25% of the homelesss. When 75% have no access to shelter, they're going to be sleeping outside. If they have no access to showers, they're going to be dirty. If they have no access to toilets, they're going to use the sidewalk.

Do you have any evidence that there are shelters in the LA area standing empty because people won't follow the rules?

by the way, the 23% is for the year before. The results of this year's count haven't been released yet.

[_Gadianton]

I think weather might be an issue, if 10k people froze to death that might be bad press...just a guess.

As if the problems you're recording don't make for bad press?

I think the reason is stated in the articles you linked to. Strong economy and lack of affordable housing -- part of that being old buildings getting fixed up the poor can't afford to rent. Know anyone fixing up old buildings for a living? : ) If people can't afford the nice, fixed up building, they've got the street.

The articles also stated more money is being thrown at the problem. As Res said, proportional to city size, LA's problem isn't as big as some cities; money isn't the issue, but slow response or poor planning, depending on how you look at it.

In 2006 (IRC) there was a bad heat wave in SoCal. I was coastal enough that I never needed AC, but that year, it was horrible, and I set out to buy more fans. I went all over and couldn't find a single fan. If I would have recorded the empty shelves and the sweat pouring from my forehead I'd have captured a temporary condition of the kind you are capturing. In your case, it may take years rather than weeks to recover from the shortage, but it's looking like the problem is perfectly tractable.

[_Markk]

I think weather might be an issue, if 10k people froze to death that might be bad press...just a guess.

As if the problems you're recording don't make for bad press?

I think the reason is stated in the articles you linked to. Strong economy and lack of affordable housing -- part of that being old buildings getting fixed up the poor can't afford to rent. Know anyone fixing up old buildings for a living? : ) If people can't afford the nice, fixed up building, they've got the street.

The articles also stated more money is being thrown at the problem. As Res said, proportional to city size, LA's problem isn't as big as some cities; money isn't the issue, but slow response or poor planning, depending on how you look at it.

In 2006 (IRC) there was a bad heat wave in SoCal. I was coastal enough that I never needed AC, but that year, it was horrible, and I set out to buy more fans. I went all over and couldn't find a single fan. If I would have recorded the empty shelves and the sweat pouring from my forehead I'd have captured a temporary condition of the kind you are capturing. In your case, it may take years rather than weeks to recover from the shortage, but it's looking like the problem is perfectly tractable.

And when it gets to a certain degree, they open places like the national guard armories here.

by the way, when it gets hot many homeless with vehicles, or a bus ticket just go to the beach...ever been to Venice beach or pacific beach?

[_EAllusion]

If the demand really outweighs the financial advantages of selling addictive products, how come it hasn't been developed yet?

Same reason no one has developed a medication that reverses the age process despite the fact that people would pay almost anything for it. Not all drugs are equally easy to develop. Human physiology and luck are limiting factors. Opiates exist because it just so happens that a long time ago people discovered a plant that produces chemicals that bind to opiod receptors in humans. It's quite another thing entirely to develop a new class of of non-narcotic drugs that work just as well. I'm fairly certain a boatload of money has already been thrown at this problem.

[_EAllusion]

You have no idea what you are discussing...do you have tents and people pooping in the streets in front of store fronts in the business districts of these cities.

I bet most of the homeless you talk, are in homes and shelters of sorts or in cars... and not literally laying on the streets. How often do the Madison police close down th streets and sanitize the storefronts of the businesses.

I am not saying people can’t understand, I am saying you have no idea what you are talking about. You simply have no idea.

You probably could've googled for 30 seconds rather than just make losing bets. You seem to think the homeless in California are particularly incorrigible. You have no basis to think that beyond your personal incredulity that people can have similar problems anywhere else.

How will you make sure these folks take their meds and do what they are suppose to do, in a city of millions, with 1/5th the homeless as y=th eintire population of your city?

Presumably a larger city means more people can be devoted to social services. It's a per capita problem that should scale up.

How many homeless people do you personally visit a day?

About zero. The people I help usually are in or are transitioning to a stable residence when I'm brought on board to help people function well in the community. I think you are still misunderstanding what I am saying.