But to the OP's point, if heroin was sold at clinics or pharmacies there'd be an opportunity for nurses and pharmacists to intervene and offer alternatives before a person's a full blown addict. Even if it's just, "Hey, you're hitting it a bit hard lately, maybe try this meetup group instead."

She's wasting her life away, but also endangering others' (as well as her dog's). Her dog was taken away most recently because she was out on a weeklong bender and left the dog locked inside the house. After a few days of wailing and notices, animal control finally went in and rescued the dog. This being San Francisco, of course she got the dog back after claiming she went on vacation and just forgot about the dog.

That said, there was feces and urine piled up in the apartment for that week, and a few weeks after. She also had a stopped up toilet that backed up raw sewage into her apartment for "several weeks" according to the health dept. She was literally walking around on waste soaked carpets for weeks...and didn't care. Because heroin don't care.

She would also freak out and randomly dial 911 while high and insist that there were people in her apartment that were trying to kill her.

I, mean, I could go on for days writing up the crazy stuff she does while high. Her family wants nothing to do with her. She owns her place, has a pile of money, doesn't pay any real estate taxes, is a "frequent flier" for the police and fire department, but all of this is just A-OK, right San Francisco?

Honestly, I could care less about her life at this point. I'm just worried about the dog. It never gets walked and lives in literal squalor.

Definitely keep complaining to animal control about the dog, and report illegal activity, but other than that it sounds like you should mind your own business.

Local councils also have some other powers for their Community Protection Officers.

That's part of why I think the funnel approach is going to yield better results: when someone's hooked, they are in deep trouble, and with far-reaching impacts.

My musing is that federal agencies are the right choice for this: they can ignore local pressure groups and focus on the global optimum.

So you what do you propose as a solution for this (likely unrepresentative) anecdote? Lock her up?

Until people realise that this is a rational and sensical decision there won't be any solutions for these problems and these cases.

The US drug "treatment" / "rehab" industry is notoriously awful and is dominated by pseudo-religious ideologues obsessed with abstinence (to the point that "cult" is often an accurate, non-hyperbolic term) and whose practices are not based on any medical evidence of what reduces deaths. It's a fucked up industry that loves to use degradation, isolation, and humiliation on its "patients", loves to make people withdraw suddenly from their drug use and force them to endure the withdrawal symptoms, and isn't even particularly good at helping people not die from heroin/opioid use.

Given the current state of the rehab industry, and given how ineffective the "treatments" it offers are, it can alas be a rational decision to avoid it.

here's some reading that is relevant: https://www.theatlantic.com/magazine/archive/2015/04/the-irr... http://theinfluence.org/the-rehab-industry-badly-needs-to-cl... http://www.salon.com/2012/08/28/do_12_step_programs_lead_to_... http://projects.huffingtonpost.com/dying-to-be-free-heroin-t...

Unless the US adopts some sort of ASBO laws, there's not much you can do about forced treatment for someone who doesn't choose treatment.

Also, you could substitute heroin here with any other equally damaging substance like alcohol and the situation wouldn't change.

I encourage everyone to read https://en.m.wikipedia.org/wiki/Anti-social_behaviour_order which has a list of things the government was allowed to punish you for, including "rudeness" and "xenophobia". The most recent ASBO legislation is https://en.m.wikipedia.org/wiki/Anti-Social_Behaviour,_Crime... which I am not familiar with.

Keep that ASBO trash on the other side of the pond.

I prefer my government to absorb the cost of human despair rather than bill for it. Don't write policy based on outliers.

You are very good at using language. The reality is that government doesn't 'absorb' anything. Other people, some of whom can't afford to, pay for it.

No taxes, no currency, no economy to speak of (see: anywhere without a functioning government).

I don't get how some on the internet live and breathe in a government-sponsored property and currency regime and rail against the government part of it, but want to keep the property and currency.

Government turns around and spends those dollars in the economy. They are reallocated, not removed.

Desk jobs and fast food? As long as we have public healthcare I reserve the right to smack that bag of chips out of your chubby fingers. /end of rant

Then just systematically lock all addicts up and ship them off to freshly constructed prisons in Alaska.