The more I reflect on the issue of panhandling, the more reasons I come up with as to why I choose to give people money:
- At my funeral, I don’t want them to say, “None of his charitable donations were ever misused.” I want them to say, “He gave every chance he had.”
- In the case that a panhandler uses my money to purchase drugs or alcohol, the act of giving still reduces harm in the community as they would otherwise have had to resort to illegal activities to address their addiction.
- I have less human connection with people in absolute poverty than I did when I worked as a street nurse. Giving to panhandlers provides, at times, a means to connect with people conversationally.
- As someone who preaches the importance of greater income equity, particularly in relation to health (we know at a population health level that income equity is more important than absolute income level for health), I need to actively pursue ways to share my above-average income with those who have a below-average income.
- I want my children to see me give to panhandlers so that they develop an ethic of compassion.
- I want others to see me giving to panhandlers, so they will at least be triggered to think about giving. When I am with friends, they often give when they see me do so.
- 100% of panhandling donations go directly to those in poverty, which is better than the most efficiently run charity.
What do you think, are there ones that I have missed? Or are there an overwhelming number of reasons not to give?
You can read more about us in this year’s UWO Health Sciences Alumni Matters magazine on pages 10 and 11: http://www.uwo.ca/fhs/_files/downloads/pdf/HSM/HSM2011.pdf.
Have you heard about what is going on in Orlando right now? In response to a city by-law prohibiting food sharing in public parks, local poverty activists are hosting such events and being arrested. This is an important event being watched across North America, as more and more municipalities attempt to address poverty through making it illegal (see the sit/lie bylaw in San Francisco as another example). This approach is referred to as NIMBYism, short for Not in My Backyard, and is reflective of the idea that people want to move poverty away from the places where they live, work, and play.
The discussion around criminalizing poverty is also quite active here in London, as discussions of methadone clinics and panhandling have both hit the local news in the last few weeks. One of the most frustrating parts of this public dialogue for me is when it is not based on accurate information. Most importantly, in terms of panhandling, it should be noted that we already have the ‘Safe Streets Act’ that prohibits aggressive panhandling and panhandling on the street (ie. squeegeeing and street median walking). Many of the things I hear people suggest outlawing are already illegal.
The problem is that criminalizing behaviours related to poverty is not an effective solution. This simply adds to the burden of poverty as people now have tickets to pay down, and moves people elsewhere. This can be seen in large urban areas such as Vancouver where gentrification of urban cores does not privilege those who live by paying rent or live in social housing, and simply means they must move somewhere else. The other thing that should be noted is that many of the activities seen as ‘a blight’ on our cities, such as panhandling or tenting in urban spaces, are often less harmful than the alternative (ie. theft or squatting in private buildings).
Our municipalities should indeed respond to public concerns regarding poverty. However, a long-term response is to provide safe and affordable housing for all, address poverty and health inequities, and ensure that our cities are spaces where those of any socio-economic status can feel welcomed.
A recent report on homelessness in Denmark demonstrates that those experiencing homelessness face many of the same challenges in other countries as they do in Canada. I have mentioned before the people experiencing homelessness have some of the highest morbidity rates and lowest age of mortality in the developed world. In the Danish study (length of time not given), 17% of the homeless men died, making life expectancy 22 years shorter than the national average. Similar to my stats of 2/3 mental illness and 1/3 addictions in Canada, in the Danish study 62% of men had a mental illness and a higher rate of 49% of men were experiencing an addiction.
Creating system-level change requires political will. Political will follows public will. Hopefully numbers such as these will help provide motivation for the general public in London and Canada to say that homelessness is no longer acceptable in our society, and we will work to provide safe and supportive housing for all.
The most commonly used street drugs in London, Ontario are not actually street drugs, they are prescription opiates. This includes such things as Oxycontin, Oxycodone, Percocet, Dilaudid, Fentanyl, etc. These substances originate from prescriptions at hospitals, walk-ins, or family doctors, or are diverted from pharmacies, or stolen from hospital supplies. Some individuals divert their entire prescription, some use part and divert the rest. Opiate addiction is powerful as there is a strong physical effect and change in neuro-chemicals that make the need to use more substance inevitable, and the ability to stop more difficult.
In Ontario, Bill 101 is a well intentioned attempt to reduce the harm in communities of prescription opiate use. The bill is focused on more ‘responsible’ prescribing of narcotics for physicians, requiring disclosure of information around monitored substances. Having received Royal Assent in November of 2010, the bill has begun to have the intended effect of reducing the prescribing of opiates. Subsequently, availability on the street has gone down, and price per unit has gone up.
At the same time as Bill 101 has been rolling out, in the U.S. they have started reconstituting opiates with antagonists so that if they are crushed or dissolved, the effect is negated. This has led to a large decrease in the supply coming from the 11 hospitals in Metro Detroit, that land first in Windsor.
What is the outcome? Unfortunately, the outcome is not a reduction in narcotic addiction. Making substances more difficult to access does not constitute a treatment for addiction. Rather, what we are seeing is a resurgence of heroin use in Ontario, with Windsor leading the way. We will likely actually see an increase in harm in our communities, as the heroin trade comes with all sorts of unpleasant components that do not exist when an individual experiencing addiction is simply obtaining substances through a prescription, theirs or someone else’s.