Pin It
Caseythoughts Today I'd like to return to a topic which has received as much media coverage as any in the past year (and that's saying something isn't it??), perhaps more. What the media continues to describe as the 'opioid epidemic' has one strange characteristic: as far as I can discern, it is a topic which generates headlines but which,since it is a topic which not a great many people actually understand, it results in a frustrated shrug of the shoulders and a look of exasperation as to its causes and solutions. A sad, gruesome photographic essay in this past week's New Yorker is testimony to the lack of words to describe the issues involved or the solutions proffered. Yet, for all the ink and airtime, it seems to produce few solutions, and limits debate due to a profusion of misunderstanding and frustration at its multiple causes.

So, let's, for talking sake, look at the crisis through a local lens and try to get an unusual stereoscopic view of two seemingly disparate issues, here in our own backyard.

First, opioids and addiction, which according to reputable sources, kills over fifty thousand Americans a year. For perspective, that's almost as many dead as died in VietNam, or ten thousand more than the AIDS epidemic at its peak. That's almost half again as all those who died in motor vehicle accidents last year, and is now the leading cause of death for Americans under the age of fifty (whoah...).

Now, the so-called 'Ithaca Plan', as envisaged by the Ithaca mayoral task force last year had an unusual and highly controversial proposal: Legal injection sites monitored by a health professional, where opioids could be injected 'safely'. This so-called plan did not address several issues which are part and parcel to the issue of opioid/heroin addiction: for a few examples, crime to obtain the drugs to ingest/inject (possibly ninety percent of the crime in Ithaca is attributable to drug usage), in addition to issues such as insurance companies refusing adequate coverage and admittance to inpatient drug rehabilitation centers (not to mention the lack of facilities to adequately handle those wishing to enter inpatient treatment), the refusal of local hospitals to provide detox services, the paucity of trained counselors (for a number of reasons), the criminal culpability of Big Pharma (see New Yorker October 30 issue) and legions of doctors who have turned a blind eye to the horrible effects of over-prescribing killer drugs.

These issues not addressed in the Ithaca Plan were subsumed by the one issue which was bound to draw attention (we love controversy don't we??): legal injection sites. I'll leave the issues NOT addressed for later columns, as it is always the tendency to over-simplify. So, let's combine the injection site with another issue which Tompkins County has wrung its collective hands over, as well as appointed task forces and written reports, but seems unable to act on, while it is actually concomitant with the drug issue: Housing.

It is a well known and oft-repeated fact that 'livin' ain't easy' in this county. Housing is extremely expensive due to several factors (including high property taxes) and contributes greatly to the social factors which are underlying unemployment/underemployment, property crime, drug usage and overall poverty. Which of these are cause or caused by each other is a chicken and egg question which has been debated ad nauseum and tends to obfuscate the problems and its possible solutions. But, let's say for argument's sake that a root problem for much of our disadvantaged society in Tompkins County is reasonable and accessible housing. Even the Ithaca Times cites an Urban Renewal Agency study which found that our black brothers and sisters make up a disproportionate proportion of people using Housing Choice Vouchers, nearly twenty percent of the voucher applicants are black, while sixty two percent of area landlords do not accept these vouchers (thus contributing to the three year waiting list for Section Eight housing availability).

Did you know that about thirty percent of people who work in Tompkins County do not live in the county due to inability to find affordable housing?? And that's the working population. So, enough said for the housing situation in Tompkins County, except for 'one more thing' as Columbo liked to say: we use the phrase 'affordable housing' as a way of avoiding a more politically volatile phrase, 'low income housing', which has been dropped from the lexicon because of the negative response it gets from many of those who feel that 'affordable housing' is not such a political minefield.

Now, let's turn to our elected city and county officials who are 'looking at' legal injection sites. Let's, just for talking sake, assume that these men and women would/could actually vote yes or no on the issue. Don't say they can't or won't vote this way: both Common Council and County Legislature vote often, too often, on issues over which they totally lack any control, just to put them on record and pat themselves on their collective backs, to smile and say they are 'for' or 'against' something over which they have not the slightest control. Assuming they might bring to a vote, either city or county, a 'sense' of the members, to establish a 'safe injection site', and they vote yes, not needing to vote on any details. Such niggling issues as location, money, legalities.....they can vote 'yes' and rest easy: there won't be any decision as to neighborhood, right?

The same procedure could be in place for a vote to establish 'a sense of the legislature/council' to work toward 'low income, adequate housing' to alleviate what really is a true crisis in Tompkins County. (There's that word 'crisis' again, and I use it cautiously, but appropriately). Again, this vote would be harmless, since no one would scream about the intention as long as it has no teeth, no real intention, no placement in a neighborhood, and it wouldn't disrupt anyone's perceptions, right? Everybody could feel good and go about their business, happy that they had expressed solidarity with a concept, instead of a real answer.

Now, let's put these two votes together, but with a responsible caveat. Are you aware, perhaps seen, or read about, Second Wind Cottages in Newfield? A possible model, so to speak. Small, well OK, tiny, cottages for recovering alcoholics and addicts. These cottages were a brilliant brain child and have given a number of alcoholics and addicts something that is critical, vital to recovery effort: a roof, a stable place to live. Yes, at Second Wind it is required that they stay 'clean', but let's put that to the side of our plate for now.

Even a reactionary deep red state like Utah has recognized that without a roof over an addict/alcoholic's head recovery is almost a foregone impossibility. So Utah provides in certain cities a 'roof first' policy, then addresses the other issues with no policy for 'clean'. So, Tompkins County has fourteen legislative districts, and also has many, many parcels of under/undeveloped, even condemned land that are held for non-payment of taxes or other reasons (Look how long they have held the Old Library site, useless and undeveloped for years, finally giving in to the inevitable, but still arguing to hold onto it). These sites are crying to be used, and could be so used to address a few of our oft-cited problems.

With a resolution by the county legislature, each of the fourteen districts would be obliged to provide twenty cottages (a la Second Wind) either on one parcel (strictly within zoning, or with Ithaca type variances which are so popular when the political expediency calls for variance), or perhaps two parcels of ten cottages, or whatever combination makes sense and adds up to twenty 'roofs' in the legislative district. You could take for example (although the home example in this case is much larger than I envision) the clustering of smaller homes in Fall Creek that Cosentini built with lot variances to accommodate the cluster). Twenty tiny cottages per fourteen legislative districts equals, simply, two hundred eighty roofs, shared and spread equally from Danby to Ulysses, Lansing to Town of Ithaca, plus the city. The land is donated by the county/city, the cottages might be financed, or perhaps donated by local banks/developers/builders (what a state and federal tax break!!!). These cottages would have a few caveats, such as located on a bus route, strict income restrictions (with no income NOT a deterrent) and standard and adequate amenities. They would also be inspectable by an authority set up by the county for health and safety requirements on a regular schedule. It could be staffed by one inspector, one administrative assistant, and one contractor on a per diem basis. Not exactly cheap, but if you take into account that the county has well over seven hundred employees, this effort could be added to an existing department. But, the issues of money and financing are issues to be worked on: remember, we are asking for a 'direction' vote, first, and once approved, it could then be argued how to look at what is, basically, an effort which is much less expensive than the present alternatives which are just not working. We like alternatives, don't we??

IMPORTANT: All low income and especially the homeless are eligible and welcome, and, even more importantly, there is no requirement to stay clean, thus giving the opportunity for a space that allows for usage of drugs without an explicit endorsement by a governmental authority which carries an enormous legal and ethical risk. In other words, you as a human being have a 'right' (there's a word Ithacans love to bandy about) to a safe, clean, warm and dry abode to call your own. You will be expected to allow an inspection on a regular basis to maintain safety and health standards, and a simple lease could be set up for six month intervals. Other than that, your warm and dry abode also gives you privacy, a place to 'use' if that's what you plan on using it for. No more using public restrooms ( have you noticed the profusion of 'no public restrooms' signs, and wondered why?), no more going into the Tompkins County Public Library, Wegman's, or other public sites with open bathrooms and wondering what is going on behind the doors. With this 'yes' vote to proceed, we have now opened up two hundred eighty low/no income abodes for our most unfortunate (Did you know that the Rescue Mission is being forced to charge for a bed now by state regulations. Oh, you hadn't heard that?). But, we have now opened up the possibility that some of these cottages will be the 'site' of private decisions as to use of drugs, as the 'Ithaca Plan' envisaged. Will it be less expensive? I daresay it might be, but at least this idea would not require supervision except for housing safety/health. Think of what medical supervision 24/7 seven days a week at a so-called injection site would cost. Not to mention the insurance aspect.

Oh, there is one other thing to think about, which is really the crux of my argument. If one site were a 'legal' injection site, can you imagine the uproar in that neighborhood? (Some wags have suggested it be placed next door to the mayor's home, or one of the committee member's home...why not?)

So, what this plan does is put the issues (theoretically) right in the lap of the ten Common Council members and fourteen county legislators. Equally responsible and equally responsive to the demands of housing, and addiction, these elected members would realize and recognize that each of them would be voting for twenty of these warm and dry, and relatively safe, cottages in their home districts, and therefore would turn the theoretical into the practical. Their 'yes' vote would say, in essence, 'I vote yes to help with the housing issue and with one answer to the addiction issue. I am going to risk the wrath of many of my constituents, as well as the plaudits of others, both groups which claim to want to 'solve' these issues, by voting to take some of the responsibility for living up to the ideals that we like to talk so much about. In otherwords, I am walking the walk, putting my conscience where my words reside. Voting should be a conscientious act on the part of both the representative and the represented. I'm willing to risk my position and see if my district's constituents really mean what they say about addiction and housing. NIMBY-ism has a holly stake through its heart with my yes vote, and I hope you will agree. I am personally taking responsibility to help in a very small but significant way the homeless, the downtodden, the desperate in our neighborhoods, and I am willing to explain this vote to you, the taxpayer and constituent.'

I've heard it said in my church that it's the 'last, the least and the lost' who deserve our attention. Could our legislators put their hands to the plow, so to speak, with such an idea (an outline, to be sure, but details can be hashed out) with such an up or down vote? Could they be heard to say that this time his or her vote could very well be what's missing from the real debate? In otherwords, the courage of conviction? Would a vote be a risk? SHOULDN'T a vote of this magnitude, and with so much riding on it, be a risk of conviction, a task of conscience?

Or will they (we, in otherwords) shrug in exasperation and continue to debate with words and hours of nothingness, with no risk, the way current politics dictate? Push it to eternal committee reports, growing dusty on some shelf, endless discussion, murmurs of 'that's useless/pointless/fruitless/solution-less'. Or, perhaps one or more of our elected officials in the city/county would risk all to attempt to, if not solve, at least tackle, these two intractable community problems and say, out loud: 'Let's try something new and risky. Let's get out of our safe and small shells of belief and actually try to deal with our biggest challenges, instead of platitudes and sound bytes.'

If we don't, aren't we just really saying 'It's too complicated', 'It's really not my problem', and prove that talk really is cheap. Solutions are risky, but not necessarily 'expensive', depending on how you define expensive. Risk is expensive, so is trying something radical and really new. So, Tompkins County (not just the representatives, but ALL of us): Have you got the guts? Or shall we continue to wring our hands about something which we might actually have an answer to, if we dare to believe there might be solution?

Pin It