In 2020, the EU reported 5800 drug overdose deaths in a population of 440 million. The same year, the United States, with a population of 330 million, reported 68 000 drug overdose deaths.
I think the cultural aspect is also very important. I Europe, having used drugs a couple of times is viewed as completely fine, as long as you are not currently addicted to them. Add to that the lack of a social net in US and you have the perfect storm.
I’m still rattled by videos of the homeless camps in US. Those people have no way out. Drugs at least provide an escape.
Have serious social anxiety? Well, you can’t hide in your room and be addicted. You gotta get out there and mingle and build connections to keep your supply up.
As silly as that sounds, it gives people with nothing to do and nothing to think about a sense of purpose. However chaotic their life may be, they’ve got something to do every day of the week.
I am terribly antisocial. I don’t really have any close friends at all. I don’t invite anyone to come into my home and hang out. I like my family around and that’s it.
When I was using I was always somewhere and always surrounded by people. I didn’t have anything in common with any of them, but we always ran around trying to come up with drugs and looked out for each other so it felt like I was close to people.
That part of it is what keeps most people tied to the life.
It was easy for me to walk away from the people, places, and things.
It’s not easy for people who enjoy having friends and are capable of building honest connections.
When I saw sports on US television for the first time I was horrified by an advertisement of an opiod from astrazeneca. I still remember that ad today, suggesting to have an opiod prescribed by the gp.
there is plenty of ads for over the countrr medicine like aspirin or the wici medinait, which is hilarious to be sold otc. It contains alcohol, ephedrine (methamphetamine precursor), dextromorphan (opiod) and paracetamol (tylenol). That is quite a drug cocktail right there.
But yeah, advertisment for prescription drugs is insane. Nobody should ask there doctor if some drug they saw on the tv could be right for them.
I mean I just watched "Painkiller" on Netflix (but I heard "Dopesick" is better) and it explains a few things.
Like the insanity of advertising for a drug (like going to doctors and promoting your drug). Or the way Oxycodone was pushed through the FDA with bribes. It's no surprise that you get addicts when you push a "12-hour" painkiller that only lasts for around 6-8 hours, sending patients into withdrawal. But if they allowed doctors to prescribe a lesser dose every 6 hours for example there would be cheaper alternatives (the 12-hour thing was the entire marketing selling point). Just awful :-/
It’s no surprise that you get addicts when you push a “12-hour” painkiller that only lasts for around 6-8 hours
No, it works for 12 hours for most people. Meaning that a small bit sizable percentage would have been better off on the old kind. Which isn't anything new in medical fields, it's true for damn near every "extended release pill".
But Sackler buried that, they would make way more off XR, so they wanted docs prescribing it as normal to everyone. Then the patients and the doctor could work it out on their own.
But a patient telling their doc their 12 hour opioid where's off in 6 so they need more...
Sounds like an addict. So doctors wouldn't and the patient had to turn to the streets. Or the doctor didn't care and would give them multiple extra refills.
If you wanted to come up with a program scientifically designed to create opioid addicts...
You couldn't do much better than this without giving people 5 gallon buckets of pills for a headache.
But the Sacklers are billionaires. So when they got sued the US government agreed that it wouldn't be fair to allow their victims to touch any of the billions in personal wealth they got fucking over Americans, and definitely no jail.
Quick science edit:
The difference is our liver enzymes, everyone has different amounts. I'm a rare case where my body can't even break down the normal opioids into their effective parts. Except for morphine, pretty much every opioid is just a chemical out body metabolizes into morphine.
My body sucks so bad at doing that, I get absolutely nothing out of even something like Percocet.
Some livers are really good at it. They're the ones that can burn through a XR in half the time. Meaning if they follow directions they'll twice as doped up at first, then intense pain till their next one.
Sacklers and Purdue *knew" that. But they picked the option that made them the most money, even though it created a generation of addicts
Except for morphine, pretty much every opioid is just a chemical out body metabolizes into morphine
Only codeine and heroin have this as their primary mechanism of action I'm fairly sure? Oxycodone is active itself without metabolism, as are many other opioids.
Yes, metabolism will still make a difference though.
I worked in a pain management clinic in the 2000s. The drug reps came daily, would have lunch catered from every restaurant, would go golfing with the docs and take them out for expensive dinners, and would bring branded gifts. They couldn’t force the docs to prescribe their particular pill but they would stop coming if you weren’t pushing enough of their product. It was sort of an unspoken agreement that they wrote the scripts and the reps would keep showing up.
It’s kind of crazy looking back. We were one of the clinics that took the enormous responsibility seriously and tried to serve the community and I think we did genuinely help people that were suffering. But I think that we were ultimately naive as shit about the drugs we were pushing and there’s no doubt many of those patients we had probably would go on to struggle with addiction problems.
While the drug problem in America is horrifying and deserves highlighting, this whole article is an absolute indictment of America. Most of the increased deaths are young adults and middle-aged people. What an embarrassment, what a tragedy.