Housing Drunks and Letting Them Drink Saves Millions

April 02, 2009

Study: Housing Homeless Drunks And Letting Them Drink Saves Millions
Three years ago, an experiment known as 1811 Eastlake opened in Seattle. It's a large apartment complex just off downtown and it houses about 100 chronic inebriates, as the term goes, all of them formerly homeless. The experiment part is that for eons America has attempted to grapple with the problem of urban street drunks by either sticking them in jail (very expensive and a practice that largely stopped in the 1970s), forcing them into housing where they couldn't drink (and inevitably relapsed and got the boot) or leaving them on the streets where they cycled from street to jail to ER to sobering center to homeless shelter to the liquor store to the streets. Commonly, such people (and it's usually guys) run up a $50,000 a year or so tab on the public purse and harm reduction advocate got to think that maybe it made more sense to stick such folks in long-term publicly supported housing and let them drink their brains (and livers) out and it'd wind up being cheaper.

This harm reduction bit got a lot of play in an interesting piece in the New Yorker in 2006, concerning a homeless man in Reno, Nev. known as "Million Dollar Murray."

The Seattle facility garnered tons of press--local and national--when it opened in late 2005 because it was the first big facility of its kind in the US, and many commentators were scornful of the place and the idea that the public would, in effect, be paying these guys to get drunk. I wrote my own piece on 1811 in Seattle Weekly and I'd written earlier of a lawsuit brought in attempt to keep the place from opening at all. My own sense of things--based on a decade or so of reporting on social issues--was that no approach whatsoever seemed to work with chronic street drunks, they were running up tons of expenses on the public dime, so why not try something new?

The 1811 facility wasn't a mats on the floor homeless shelter, but an actual apartment building with units along the lines of a college dorm room.

A new study came out in JAMA this week detailing whether the concept of "Housing First," as it's known, had any impact (here's an AP piece on the study). The 98 street drunks whom the study tracked had cost the public $4,066 a month prior to entering 1811 and afterwards they cost $1,492 a month after six months in the facility and $958 a month after 12 months. That's a pretty big savings and, oddly enough, some of the residents began to drink less. Some even got sober. (Some also died.)

My own interviews with residents there in 2006 turned up several who drank upwards of two fifths of hooch a day and had been for 20 years. Yes, it is amazing what the human body can endure.

While this sort of program would have to replicated elsewhere to see if these savings hold, it sure is a vastly more humane way to deal with a chronic urban problem than in the past. It also has all sorts of implications for addressing homelessness among the mentally ill, chronic crackheads and junkies of every stripe. My own guess is that, for example, housing the mentally ill who are homeless instead of herding them into very stressful homeless shelters or leaving them to the streets would improve their mental health issues dramatically, with or without medications. There is something magical about having a roof over one's head, even a modest one.

On a side note, I sure hope Robert Jamison (formerly a columnist at the now defunct Seattle Post-Intelligencer) and Ken Schram (a commentator at KOMO-TV in Seattle) plus a few other reporters in Seattle paid attention to this study. Because they were wrong, very wrong, about this place. (For some reason, I cannot find Jamison's attack on the place on the new seattlepi.com's website. Weird.)

1811 Eastlake is operated by the Downtown Emergency Service Center, a large social service agency in Seattle.

Full disclosure: I worked 15 shifts as a shelter counselor at DESC's main homeless shelter downtown as a relief, on-call, temporary employee from mid-December 2007 to mid-January 2008. I made $10 an hour. I doubt that it influenced anything I wrote in this post, but I thought I'd let you know.
Posted by Philip Dawdy at April 2, 2009 12:03 AM


It's an interesting idea.I wonder if any other places have tried this and what their success rate is.Although I guess success is measured by how much money you save the taxpayers and not how many people quit drinking.

This is a wonderful idea in my opinion.

I'm related to a lot of people with substance abuse and mental health issues and come into a lot of people with similar issues through the soup kitchen I volunteer at, and have seen many of them cycle between being living in a shelter and having an actual home. For the most part, they seem to do a lot better when they have an actual place to call home. Psychologically shelter life is stressful, and oftentimes brings about feeling of shame and despair, which can lead to worsened mental health, increased substance use, et cetera.

It doesn't even really matter how much this is "saving the taxpayer" or whatever, what matters is that it can help people a lot-- giving them some feeling of dignity and pride, a sense of stability, and helping them to no longer feel like the invisible subhumans that so many Americans view homeless people to be.

This is very interesting. It would be interesting to see how this same model would work with drug users.