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PaperclipPerfector  2mo ago (text post)   3357 thread views

Small-Scale Question Sunday for February 18, 2024

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The latest discussion in the Culture War thread about the drug-addicted criminal homeless (in Seattle) made me notice that the ongoing opioid crisis appears to be a uniquely US phenomenon. At least that's my own perception. I have never seen news reports on the growing problem of fatal fentanyl overdoses in, say, Western Europe or Asia, for example. Am I right about this? Are there factors that make US society uniquely vulnerable to such trends?

Numbers are hard to put in context on this, but vibes-wise, I don't know if I'm completely isolated from the affected class of people by my filter bubble, but here in Quebec I don't know a single person taking opioids outside of medical bounds (abusing prescribed or non prescribed). On the other hand the government recently put out a TV ad advising the population that they made an anti-opioid overdose drug available for free in pharmacies and that ad felt to me like a foreign object intruding into my filter bubble.

I don't have much to add to speculation about cultural inoculation against drug use. I will link to some on the ground reporting about the opioid crisis in the Deep South.

Fentanyl hasn't been a problem in India from my anecdotal experience. Opioid overdoses were pretty rare, I can't recall one from my intern days, though I make it a point to stay as far from the ER as possible now. When it happens, it's usually plain old heroin.

If I had to guess why that's the case, well, heroin was enshrined and fentanyl dealers probably couldn't break in, or found selling precursors/smuggling it into wealthier nations more lucrative.

It's not as big a problem in Canada generally, but it is in British Columbia and to a lesser extent Alberta. There is evidence that it spreads through social contact, which would explain how uneven it is. In the US, it's concentrated in the northeast.

The factors

The US healthcare system works differently, in terms of the marketing and advertisement of medical interventions. The opioid crisis is driven not by always-illegal street drugs, but primarily by people getting hooked on prescribed or grey-market pills, which seem safe enough because they are medicine, and then moving to street drugs later on in their addiction.

Whenever I visited the US I was amazed at how their free to air TV advertisements were about drugs. The rest of the western world is not like that.

This is certainly a big narrative point but it doesn't match my experience with boots on the ground seeing patients (which isn't to say it's incorrect, the data is out there, but I want to call out other factors).

Keep in mind that America has additional problems that do not exist elsewhere: our particular brand of inner city life and crime seems to generate a lot of drug addictions (you'd be shocked at how many bangers are also addicts, or maybe not), a lot of the use in the US persists in inner cities that refuse to attempt to solve the problem or economically depressed areas in coal country and so on that don't really exist in the rest of the west I think.

Also research shows that Americans are weirdly pain intolerant in comparison to other countries.

I'd guess that such rust belts are a staple in most First World countries. And I'd be surprised to learn that the US is overall more lenient towards drug crime than other Western countries.

I think what make's the US rust belt different is that it's so large because the country is so damn huge (maybe kinda like Russia in that way?). Canada and Australia are also enormous but much more population focused.

I don't think other countries have something like Kensington in Philadelphia, although I've heard political winds have changed and theirs some thought the situation will be improved soon.

Fair enough. But I'd assume that people getting hooked on prescription pills isn't just an issue in the US.

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