For years, Shawn Pleasants did nothing but rise up.
He was high school valedictorian, went to Yale, landed banking jobs on Wall Street, started his own business.
And then, for years, he did nothing but fall.
Lost his business, his home, the car he was living in, and landed on the streets of Los Angeles.
For about six years, home for him and his common-law husband was a lean-to near 7th and Hobart in Koreatown. And like a lot of L.A.’s sizable homeless population, Pleasants was addicted to methamphetamine, a cheap and abundantly available drug.
“It always felt to me like I’d fallen off a fire escape, and once you get on the ground, the ladder is 12 feet up in the air,” Pleasants told me. “I always thought, ‘If I could just get to that first step.’ But the first step is so far away.”
Pleasants found the bottom rung of that ladder in November of 2019, when he went into a residential rehab program. He now lives in an apartment with his husband and has been drug-free for more than 500 days.
We’ve heard endless policy discussions about shortages of housing and mental health services, but not nearly as much about the addiction epidemic. I don’t see how we’ll ever make a serious dent in the growing homeless population without a better way of freeing people on the streets — many of whom also struggle with mental illness — from the grips of drugs and alcohol.
What are we doing right, what are we doing wrong, and what should we do differently?
These are the questions I asked Pleasants and others.
“We haven’t treated substance abuse and access to mental health care the same way we would cardiac arrest,” said Sarah Dusseault, a board member with the Los Angeles Homeless Services Agency.
“If you scrape your knee,” Dusseault said, you’ve got your choice of multiple conveniently located urgent care centers, among other options.
But addiction treatment is harder to come by — and difficult to access and pay for. Dusseault said that when someone finally tells an outreach worker he or she is ready for rehab, the chance is often lost because there is no bed available at that moment.
“I think there needs to be a cultural change, where we don’t see someone who’s using drugs as the scum of the earth and not worthy of anything, and they got themselves into this and so they get what they deserve,” said Dr. Susan Partovi of Homeless Healthcare Los Angeles. She has practiced street medicine for many years and estimates that the vast majority of her patients — many of them reeling from one trauma or another — have an addiction issue.
Partovi said there’s hope that medication aimed at reducing meth use can help, and she’s also an advocate of safe, legal drug-use sites such as those operating in Denmark and Portugal.
Her colleague Mark Casanova, who traveled to Copenhagen to research their system, said drug use there is treated as a public health issue rather than a criminal problem, and there’s a recognition that not all users are ready for rehab.
Casanova said that anyone who’s using can go to a safe, supervised facility and legally use drugs, which helps prevent overdoses, moves drug use off the streets, and links clients with rehab and other services that might help them turn their lives around.
It’s a containment and harm-reduction strategy, Casanova said. And it’s the thinking behind California’s SB 57, introduced in December by several legislators, which would make overdose prevention programs available in Los Angeles County and in Oakland and San Francisco.
The bill argues that such programs operate in 10 countries and are “effective in reducing overdose deaths and HIV transmission, and in increasing access to counseling, treatment, and other risk reduction services.” Research has also demonstrated that they help “decrease use of emergency medical services, reduce public drug use, reduce syringe debris, and do not increase crime or drug use.”
Pleasants himself doesn’t claim to have all the answers. But the story of why he started using — and how he stopped — provides insights.
Pleasants, who is African American, grew up mainly in Texas, a nerdy loner, as he describes it, with multiple health problems and poor vision from birth. He had the good fortune of a stable, loving family, and he did so well in…