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April 10, 2025 43 mins

We don’t have a drug crisis—we have a policy crisis. 

In episode one, Allyson Pinkhover, MPH, CPhT, CHO and Dr. Joe Wright explore some of the ways that urban planning, zoning, policing, and the location of addiction services combine to create or enforce a geography of containment. In Boston, Wright argues, land prices and the politics of what another scholar describes as “complaint-oriented policing” led to a smaller and smaller area in which visible drug use and homelessness were tolerated, and services for people with substance use disorders were located. This kind of geography, variations of which can be seen in many cities and towns, can create both problems and opportunities for patients as well as complex challenges for substance use care and public health.

Key Takeaways

  1. Urban planning and zoning laws play a massive but overlooked role in shaping substance use patterns in cities.
  2. The concept of ‘Hamsterdams’ reveals how some cities create designated spaces for drug use without public acknowledgment.
  3. Effective policy solutions require looking beyond criminalization and understanding the root causes of addiction and containment.

Timestamps:

[00:00] Introduction – Setting the stage for the discussion on zoning, real estate, and drug containment zones

[02:15] What are ‘Hamsterdams’? – Explaining the concept of drug containment zones

[06:40] How zoning laws influence substance use – The hidden role of urban planning in drug policy

[11:55] The connection between real estate and drug containment – How property values and urban design affect policy

[17:20] Public policy decisions that shape urban drug landscapes – Examining the role of legislation

[22:45] Why some neighborhoods become containment zones – The factors that push certain areas into this role

[28:30] The ethical debate around containment policies – Who benefits and who suffers?

[34:10] What actually works in harm reduction? – Examining successful policies from various cities

[39:05] Lessons from cities that changed their approach – Case studies and alternative strategies

[42:10] Final thoughts and solutions – Where do we go from here in policy and public health?

Links


Further Reading

  • Complaint-Oriented Policing: Regulating Homelessness in Public Space, Chris Herring
  • Homelessness is a Housing Problem, Gregg Colburn & Clayton Page Aldern
  • The Death and Life of the Great American Cities, Jane Jacob
  • Arbitrary Lines, Noland Grey
  • Fighting for Space, Travis Lupick
  • All Health Politics are Local, Merlin Chowkwanyun
  • The Color of Law, Richard Lawson

Find us online at amersa.org, and see our tweets at x.com/AMERSA_tweets.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

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