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These "obliteration drunks" used to have a place in our society. However meager and pathetic their living was compared to yours and mine, they had homes (cheap SROs ), jobs (casual labor), and a social life (getting wasted in rough downtown taverns). None of those options are available to them now, so they live outside, drink outside, and beg instead of work day labor.

What's more, very little of the homeless services are for them. Homeless dollars in Seattle mostly go where they are perhaps most useful -- to families -- but that leaves a lot of people behind. They can't go to the shelters because they're drunk.

So, really, society has decided to squeeze these people out, and not to pay for very much emergency services for them. So they live rough and die. Surprised?

Posted by Fnarf | December 5, 2006 10:46 AM

I'd say I have to agree with your take on this.Pretty insightful piece, glad I read it.

Posted by Yupper | December 5, 2006 10:48 AM

Bringing back SROs may not be possible. But opening "wet" shelters is.

Posted by Dan Savage | December 5, 2006 10:49 AM

-I totally agree. Obliteration drunks are simply slow suicides. Not as slow a suicide as heavy smokers, though.

-94 deaths, many related to alcohol, many premature. Obviously, though, people with homes die early related to alcohol, so a person shouldn't feel guilty for *all* those deaths. Maybe just 71 or so.

Posted by him | December 5, 2006 10:52 AM

Many, if not most, homeless people self-medicate mental illness with alcohol and drug use. It's more complicated than saying that they don't want to quit drinking/using. It's a cyclical condition; under-lying mental illness treated with illicit drugs and/or alcohol contributes to an individual's inability to hold a job (thus leading to homelessness). Substance abuse exacerbates the symptoms of mental illness. The condition of being homeless leads to depression further aggravating increasing symptoms of mental illness and drug/alcohol abuse.

Getting off alcohol and drugs is pretty fucking hard for a person with personal, social, and financial resources. Telling a homeless person to quit drinking/using, which is the only thing they have left in their life, is almost pointless when they don't have access to psychopharmaceutical therapy, or, oh, yeah, a place to live. Many homeless people might want to quit using, but can't envision their lives sober, much less how to actualize such a major lifestyle change.

Posted by dewsterling | December 5, 2006 10:57 AM

I didn't say we should wag fingers at them and tell them to quit using. And I'm for services, and we should do what we can to save the salvageable. All I'm saying is that we have to recognize that there are limits. Some folks can't be helped. All the money in the world won't help them.

Go to, oh, Sweden or Denmark, home of cradle-to-grave welfare and the best socialized medicine socialism can provide. They still have their fair share of obliteration drunks on the streets offing themselves slowing with the help of the bottle.

Posted by Dan Savage | December 5, 2006 11:03 AM

A reality check like this is worthwhile, but your (and Nelson's) assumptions are concerning...

Nelson says: "Many of the causes may be socioeconomic... but the fundamental problem is a personal one; it only becomes a social problem when the numbers start to swell, as they will in times of recession."

Where did he come up with this? Is it a sociological law? The reasoning seems to be based on an assumption that the current social structure is normal, i.e. the only suicidal drinking that occurs now is due to that inevitable percentage that cannot be helped because they are suicidally drunk.

Only when the numbers swell does it become a social problem? What if we consider the current numbers "swollen"? It is probably true that certain homeless alcoholics are beyond help, but the fact that they have reached that point cannot be attributed only to personal choice.

One more thing: This is a theoretical argument you are making about "the drunks." In fact, each come from different background and have different capacities to overcome alcoholism. The problem is that we don't know which ones will and which won't. in standard suicide prevention, they assumes that some people will commit suicide and accept that is their final decision; but no one is written off, no matter how hopeless their case appears, and many people are alive now because of that.

Posted by Jude Fawley | December 5, 2006 11:05 AM

Yes, wet shelters are a step in the right direction. But hugely controversial. We have one; where's the second one going to go? Because Prohibition may have been repealed, but America is still a profoundly prudish and anti-alcohol country, even -- especially -- in it's most liberal spots. And absolutely no one likes seeing these lowest of the low in their neighborhood.

Posted by Fnarf | December 5, 2006 11:05 AM

You're crazy Dan...the Coroner does a yearly death report. Every year he makes a point of raising the issue of people dying while homeless. This year a KC Health dept. office (Health Care for the Homeless Network) just pulled the info from the Coroner's report to highlight the problem that the death rate has been increasing. It's mostly just a cut and paste job from the coroner's yearly report.

Yeesh, the average death age was 47. Even if these are all people who are trying to "kill themselves"...isn't that a problem worthy of attention, a little compassion, and at least not called out as an issue worthy of ridicule?

Posted by LH | December 5, 2006 11:06 AM

I wish there was this level of concern dedicated to providing the working poor with health care services. Where is the outrage and concern about all the people by who have no access to health care and are bankrupted by having to visit a doctor when their symptoms get too severe? At least half of the twenty-somethings I know who work, who have apartments, who are trying to live the "American Dream" don't have health coverage. One physical misstep and they would be screwed for life. I'm all for helping the homeless, but I think there's a much greater issue afoot. Thanks for your thoughts, Dan. Very insightful.

Posted by Cedarling | December 5, 2006 11:14 AM

I agree with Dan completely. ALL countries have homeless people begging on the street. Germany, France, Scotland, et al have homeless people running around in every city. They have socialized medicine, tons of aide for poor people, housing, etc. Hell, in Germany your landlord can't kick you out for not paying rent! I mean, come on. Yet, in every city in Germany there are people of all ages begging while drunk/high in the streets.

And here in the states, even if its mental illness keeping them drunk/high, we can't keep them institutionalized (nor would they like to be I am sure). We can do our best, and try and improve the system, but there will always be people on the streets, killing themselves slowly. The problem wont ever go away entirely.

Posted by Monique | December 5, 2006 11:18 AM

There are TWO wet shelters in Seattle.

One was infamous because it was new construction and therefore required public process. Oh, that and a Benaroya lawsuit.

The other was the rehabilitation of an old building and was therefore below the radar (no "change of use"). Anyone want to guess where it is? Clue: It even has some fancy retail on the first floor.

Posted by Finish Tag | December 5, 2006 11:20 AM

Cedarling: It's funny you should mention that, because the problems are related. Allow me to explain: Currently, street drunks tend to receive medical assistance through ERs, which are prohibited from turning away people for lack of funds. They are often transported their by private ambulance services, which bill for transport starting from around $700 per trip. Since this population has no means of paying, the costs incurred by these ambulance rides and ER visits are passed on to the paying customers, which largely means those who pay insurance premiums. One reason ambulance rides are so expensive is because they have to recoup the losses from customers who can't pay. One reason lines in ERs are so long is because they have become de facto homeless clinics.

Our society has been making choices since at least the Reagan era about how to deal with homeless people (a population that has been swelling since the same period), and our response has largely been that welfare and other "handouts" are too expensive and those people should be left to fend for themselves. Far from saving us money, however, refusing to provide basic services for these people ends up costing far more in the form of things like law enforcement and the aforementioned ER care, which is the most expensive of all possible methods for providing health care. So the same people that are so unwilling to pay for these services in the form of taxes instead pay a premium for them in the form of higher health care costs.

A friend of mine who worked as an ambulance driver (and thus functioned as a street-drunk taxi, every night ferrying the same people from Pioneer Square up to Harborview) put it to me like this: We could build a wet-house and smash it with a wrecking ball and build it again every three years and that would still be cheaper than what we are currently doing to address this problem.

It is not a matter of throwing money at a problem. It is a matter of spending money on the front end when it's less expensive and not on the back end where the costs are more hidden but are far greater.

Posted by flamingbanjo | December 5, 2006 11:31 AM

Where's the ridicule in my post? Where are the jokes?

I'm all for compassion. I'm for services. I'm for attention—it must be paid, etc.

I'm not for useless hand-wringing and endless guilt trips about how we have failed as a city, county, and nation to solve what is, at the end of the day, regardless of the amount of resources we pour into it, an unsolvable problem.

That's not ridicule.

There's only so much that we can do—and we should do it. But if you've ever watched someone drink themselves to death (I'm Irish, remember), you know that there are limits to compassion, intervention, etc.

Posted by Dan Savage | December 5, 2006 11:33 AM

People engage in suicidal behaviors everyday whether it is their ultimate intent to kill themselves or not. (My father has been committing suicide with every meal for the past sixty years).

Drinking oneself to death or any self-induced terminal event, is a manifestation of under-lying mental illness (situational or organic). Wanting to end ones own life sometimes is a "normal" mental process, taking steps, consciously or unconsciously, to make that happen is not. Mental illness is so stigmatized and the symptoms are so insidious that it is largely untreated across all populations. Consequently, more non-homeless people die of alcoholism-related illnesses and over-doses than non-homeless.

I'm sorry I'm so argumentative about this, but a close friend of mine started drinking heavily dealing with the death of his father and it's out of control now.

Posted by dewsterling | December 5, 2006 11:37 AM

maybe we have different definitions of ridicule, but I read these quotes:

“It seems the county has discovered”
… “No shit” …. “How much did we spend on this study?” … “credulous liberal guilt slopping around” …

as ridicule towards 1) the County for issuing the findings and 2) the reporter for writing about the topic.

Posted by LH | December 5, 2006 11:53 AM

94 deaths processed through the ME's office, not total homeless deaths.

The 1811 wet housing project (championed and managed by Harborview) paid for itself within 1/2 year in saved ER and related expenses (which are ultimately unpaid and written off). It is a massive financial success and the most humane and moral option available to us.

Posted by Red | December 5, 2006 12:12 PM

What the report and King’s story fail to acknowledge is the fact that many of the homeless who died last year had been trying to kill themselves, probably for years, but only finally managed to succeed in 2005.

Amen, Dan. No one ever wants to talk about all the drinking, drug abuse and willful self destruction that goes into the lives of the homeless. But it's a big part of the problem.

Posted by Gomez | December 5, 2006 12:21 PM

Um, Gomez, people talk about the wilful self-destruction of the homeless every day. The people who work with them talk about it with them constantly. And it's important to remember that the stumbling drunk homeless guy represents a small proportion of the total homeless population, most of whom are not drunk and not visible to you. Families, for instance.

Posted by Fnarf | December 5, 2006 12:36 PM

Dan, nice even-handed post. Realistic even. Not everyone hates being drunk, without creditors, without a landlord, without a boss at all. It's their life... hard for folks to except (and there is no reason for folks to try to understand/empathize with it(as nice as that is)) but in the real world, there are people who just want to drink, 24x7 and damn the consequences... and another persons "helping hand(out)"? Not expected or wanted, they will get along fine without, thank you very much, now leave me alone.

Liberal guilty begins and ends with a liberal person understanding, but not realizing, that not all their positive thoughts, donations, and actions will be wanted or will make a difference. The world will not conform to how they want it to be. Liberals alone will not and can not change the world, despite the wide-eyed promises of that philosophy.

Perhaps the political climate of recent will shift society’s pendulum towards housing and services and away from the current housing or services (due in most part to limited funds and a great need).

The pipe-dream of homelessness is prevention. Prevention does speak towards a social safety net; concern about the individual’s welfare in all aspects of a life span... disease prevention and treatment, quality early and higher education, affordable housing at all income levels, earning a living wage (not industry set wage), self-discipline, respect towards others, respect of laws, manageable consumer debt, a satisfying social life. Those things contribute to the general welfare of the individual (and to that extent: society). But welfare, either with a lower case "w" or capital "W", is not popular in America. America really is about “ME” first. and the others? Only according to what “I” feels is correct. If “YOU” and “ME” connect at the same point, great for “YOU”. Otherwise, “YOU” are out of luck, loser, because the “ME” trumps the “YOU”

Posted by PHENICS | December 5, 2006 12:59 PM

FNARF is correct @1 - now we force all the public to deal with people being drunk and inconvenience everyone, just to pretend that they'll do something about it.

Posted by Will in Seattle | December 5, 2006 2:00 PM

I work in low-income housing; many of the people we subsidize are chemically dependent and mentally ill. Some people are indeed slow suicides, but you can never tell which ones will clean up and stay clean and which ones will continue to get drunk and raise hell in the streets. Whether or not they are slowly suicidal should not lessen our obligation as a society to take of them. The families are usally through with them, so the government and non-profit agencies are all they have. Believe me, dealing with addicts is annoying and exasperating. But I also think letting them die in the streets or in the ER is unacceptable when you could get them into housing, ie, "wet houses".

Posted by andrew | December 5, 2006 2:06 PM

Has anybody asked the homeless what they want?

Would they rather more money be spent on clinics or on combo packages of Schlitz and NyQuil?

We all assume that living longer is better, because -- presumably -- if we have the time to post comments on a blog in the afternoon on a workday, life must be pretty comfortable. But for a Vietnam vet with PTSD and a seemingly insurmountable addiction to alcohol, what is life? Some have the will to live, some do not. Is the guy who steps up and asks, "Can I have a couple bucks to get fucked up tonight?" any more deserving than the woman with the cardboard sign which reads, "Homeless single mother, .... God Bless!"? Is wanting to continue to live a prerequisite to receive your generosity?

I drink. I get drunk. I buy people drinks all the time, and people buy me drinks all the time. Many of them are probably alcoholics. The only difference between a drunk on the street and the one on the barstool next to me is one of aesthetics, and, I suppose, a lack of sharing.

For those who wring their hands about the homeless problem, I double-dog dare you to give the next homeless drunk you meet a dollar and stand there and actually talk to him or her for a minute or two. Nevermind the smell or the appearance and imagine it's just some friendly yuppie in line at Starbucks. And listen.

And if you can't do that, then shut the fuck up, because you're just a pretentious, patronizing liberal wuss.

Posted by imofftoseethewizard | December 5, 2006 2:45 PM

Hey #23, what's your point? I can't tell if your argument is socialist or libertarian. Both of which have merits.

I feed homeless folks and give them money all the time - and listen to them - and vividly remember Reagan's catastrophic policies on de-institutionalization (Billie Boggs, anyone?) so Dan's argument really rings hollow to me. We absolutely should be ashamed that veterans, families, children and teenagers are homeless. Just because you're a hostile, psychotic drunk doesn't mean you've ceded your humanity - it just means I won't be inviting you to dinner. But I'd happily PAY MORE TAXES to have better services for you, especially because you probably served in Vietnam and your life's been shit ever since.

And though there are a lot of services out there, there aren't enough and there aren't always the right kinds. In addition to everything else, if you're homeless, it means constant rejection - shelter's full, come back to clinic next month, when that rattling cough's turned to pneumonia, but we might have some time to see you, etc.

All this and I grew up with an obliteration drunk! But you know what? He got sober after about 35 years of drinking. How 'bout that?

Posted by jtroop | December 5, 2006 3:50 PM

Billie Boggs refused psychiatric treatment. Should she have been committed involuntarily? She posed no threat to anything other than the sensibilities of rich New Yorkers.

Posted by keshmeshi | December 5, 2006 4:58 PM

From another lefty commie pinko liberal....AMEN DAN! Couldn't agree with you more.

Posted by Matthew | December 5, 2006 5:24 PM

You can't help people who don't want to change and I have the right to have my parks and sidewalks free of lowlifes. Lock them up or commit them. All of them. Know what's worse than callous conservatism? It's liberal condescension.

Posted by ektachrome | December 5, 2006 8:12 PM

Keshmeshi, Billie Boggs desperately needed help. She refused psychiatric treatment because she was schizophrenic, psychotic and any of a dozen other diagnoses that prevented her from functioning rationally. Maybe I don't believe in letting sick people sleep in sub-freezing weather, no matter how much they complain. There's a fine line between allowing people their civil liberties and allowing them to die.

It's criminal that Reagan's attitude actually won, that people now actually believe that mentally ill homeless people 'choose' to be on the streets.

God, I need a drink.

Posted by jtroop | December 5, 2006 9:46 PM

Way to go, Dan! We'll make a libertarian out of you yet.

Posted by David Wright | December 5, 2006 9:51 PM

Calling deceased chronic drunks suicides basically says that they deserved to die.

Charming post, Dan.

Posted by Not economically viable | December 6, 2006 1:14 AM

It was the New York Civil Liberties Union that fought to keep Billie Boggs on the streets, not Reagan.

Posted by keshmeshi | December 6, 2006 10:30 AM

Hey, ektachrome @ 27 re: your "right to have my parks and sidewalks free of lowlifes."

Which "right" is that? Sounds like one you might have in Nazi Germany, but it's not any "right" you have in this country. Disgusting truly.

Posted by LH | December 6, 2006 11:18 AM

I support ektachrome's right to walk in front of a Metro bus.

Posted by Mr .X | December 6, 2006 11:29 AM

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