“I don’t know what’s going to become of him,” he said. “I hope that someone will look after him the way I do.”
I assume NYT will publish a follow on article about Mr. Muir sometime late Fall or early Winter?
10
I have been off heroin for 7 years. Suboxone saved my life. Suboxone should be much much easier to get and should be offered to anyone who needs it. I run a multi-million dollar company now and I contribute to society. Without suboxone I'd be dead or still a leech on society, but most likely dead.
19
The chart is unclear. Does the UK data exclude Scotland?
6
I am in the age range of the 'Trainspotting' generation and having witnessed both on a micro and macro level the effects of drug addiction there is something which daily runs through my mind; there is no romance in any of it. The literature, films and music inspired by this disease reveal the secrets of this human condition and I have to admit as a consumer I was intrigued and entertained by this aspect of counterculture. Now though I almost feel responsible for not affirming earlier to anyone who would listen...there is no romance in any of it.
13
For years drug addicts were blamed for a lot of crime. A scourge on society guilty of burglary.muggings and car thefts / break ins. To now accept that providing "safe injection rooms " or testing illegal drugs for purity is the norm and acceptable requires a major shift in public and police attitudes.
A major problem in Scotland is the methadone programme. The Scottish government introduced a "road to recovery " policy meant to help addicts become drug free . However the M programme has prescribed M to addicts for years. Methadone is highly addictive and associated with higher mortality rates if prescribed for more than one year. Methadone was never meant to be prescribed for life.
Austerity etc is blamed. This does not explain why the rate of addiction in Scotland is x2 that of England and the death rate is x50 that of Portugal. Some blame the minimum alcohol pricing policy which means that some drugs (eg,street Valium )are cheaper than the cheapest alcohol drinks. Not sure.
The statistics are alarming.
22 drug deaths per week compared with
15 suicides
3 deaths in road traffic accidents
1 murder.
The Scottish government will increase funding for recovery and rehabilitation of addicts. The road to recovery for Scotland is just beginning.
6
Is it possible for a journalist to report on the scapegoating and demonization of opioids for society's ills? Is it possible to get outside the "opioid epidemic--treatment services trope." Could some explain why society forces opioid users to ingest opioids in squalid surroundings and without access to uninhibited medical help. How about the opioid users that ingest opioids in nice safe surroundings? Opioids do not have agency, but human's presumably do. No medical evidence that opioids "high-jack" the brain. Why is it that most people that are prescribed opioids do not get "addicted?" Any journalists out there that can interrogate this "opioid epidemic? Something new, rather than inflammatory misleading graphics and misleading death rates?
6
The long and short of it is that these are terrible drugs that do terrible things to your body - and happen to be highly addictive after even one dose. Sure, “we” can manage the crisis better, but 1) legalization is completely irresponsible and 2) people need to get the message to never get near the stuff unless they intend to doom themselves to a life of misery. Even prescription meds. Err on the safe side with Advil and some pain vs. post-op bliss but risking a lifelong (and life shortening) addiction. I understand that too late for too many, but I hope that this crisis fades through education and not safe injection sites.
7
I’m just in the midst of finishing the book Chasing the Scream by Johann Hari. He gives a history of the drug war and shares lots of stories and data about various approaches to addiction. Based on Hari’s findings (backed up by lots of data), Scotland would see a massive decline in ODs and deaths from ODs through decriminalization of opioids, providing safe injection sites monitored by doctors who would prescribe quality controlled opioids/heroin to by used only on site. Additionally, providing drug rehab programs and support for addicts rather than throwing them in prisons or treating them like outcasts helps reduce rates of addition. Helping addicts back into a community tends to keep them healthy and part of society. This, of course, seems counter-intuitive, and Hari talks addresses these feelings throughout the book. Prohibition makes for an unhealthy society. Decriminalization and even legalization with the same kinds of regulations we have for alcohol and cigarettes makes for a better society. I encourage everyone to read this book and see Johann’s TED talk. It really changed the way I think of drugs and addiction.
4
I was once addicted to opiates in 2009. Despite the market crashing, and the horrible homework load I had in college at the time, it was in the depths of an abysmal Oregon Winter along with getting arrested for marijuana possession by the cruelest cop I had ever met (who gleefully told me I had committed a felony because I was within 1000ft of a school, which was a bald-faced lie.)
I wasn't able to kick my habit until the summer and it was enormously difficult, even then, despite the fact that I had 'tapered off.'
Personally, I couldn't get off opiates without sunshine, until the beautiful Oregon summer rolled around. I really don't think that Western culture understands how important sunlight is to your mood. We call this 'seasonal affective disorder', with the ironic acronym SAD.
I loved Trainspotting, but it made Scotland look exceptionally bleak. The warmth and pleasure of opiates is certainly an alluring drug, if you are physically and emotionally miserable.
These days I actually make a point to leave Oregon in the Winter, live in LV or SoCal instead.
If you cannot easily relocate, I would recommend sunlamps, Vitamin D and exercise. You need to learn how to boost your body's natural level of endorphins, which is not easy if you don't even know what it is. I don't have the space to go into detail, but your body manufacturers natural morphine analoges, but you need to maintain the proper diet, and specific activities, like sex, and/or exercise (preferably both.)
107
@dad Thank you for your comment. People use alcohol and other horribly destructive drugs to cope with mood disorders like SAD, depression and myriad other emotional problems. Understanding what is going on and starting to take care of oneself, as you describe, is key to breaking these cycles. Drugs do nothing but anesthetize us temporarily, and when we come to, our problems are even worse. This winter will be my first time coping with SAD without addictive chemicals. I will no longer have the burdens of poor health and guilt adding to the effects of SAD, so I'll be able to take better care of myself. If find that I need professional help, I won't have chemicals clouding the picture and making things more difficult for me or my doctor.
14
@dad Scotland is a bleak country. it's cold and it rains a lot. I initially moved to England when I was 16 (from Scotland) Now i live in NC and a big part of that was / is for better weather. A cold wet climate can be very depressing.
Also England has always used Scotland as a preverbial toilet and a resource to be plundered, hence the poverty, hence the drugs, hence the crime and unemployment. "
26
@dad Excellent post. Sympathy is in order but I like your focus on taking responsibility for your mood. A well-balanced post, free of judgement or sanctimony.
30
I can identify 110%. I am a "recovering" addict and alcoholic. In 1972, I was 18, and had never even smoked weed. 1 year later, I had tried every pharmaceutical opiate made; many of which are not made anymore. A friend of mine called those 'Lord Have Mercy", drugs. He was right. One of them was a pill form of the what people now call fentanyl. It was so strong, even a hard core junkie (like myself) could only inject 1/2 a tablet, and even that was dangerous. I really wanted to stop, but didn't know how. I had never heard of "detoxes", or "addiction treatment".Fortunately, in 1985 I got busted at a pharmacy with forged prescriptions. This was in Louisiana, and I was facing 40 years at hard labor. Down here, when they say 40 years, they mean it. I went into a 30 day in-patient treatment program. It was a brand new facility (less than 1 month old), with the newest treatment techniques, etc. I was a sponge. I embraced it. I stayed clean and sober for over 12 years without ever picking up a drink or a drug. I still haven't had any, pot, alcohol, etc. in 34 years. Unfortunately, I had kidney stones and 2 abcessed teeth. This was on 3 different occasions. 1 kidney stone was 9mm. That is huge; the worst physical pain I have ever been in my entire life (so far). At a hospital, on their "pain chart", it is only surpassed by childbirth, and not always. 9 months later I relapsed on opiates. It had twisted my brain around. I got back on track. I quit smoking cigarettes over 25 years ago.
135
@Easy Goer , may the going continue to get easier. I congratulate you for the work you've done so far, and wish you all the best. X
76
Suboxone ...now in generic...is the Silver Bullet for this crisis...Give It away like candy...don’t make junkies jump through hoops to get this miracle cure!
7
@Over The Transom, please don't say that. If it helped you, then I'm really glad to hear that, but it's not a "Silver Bullet" and it's not a "miracle cure."
I've had friends addicted to Suboxone, and it was very difficult to kick. Until they were able to get off it, it affected their mental abilities subtly, but noticeably. It can also be dangerous when misused.
It might be the option someone needs, and it is obviously safer than heroin, particularly when used under a doctor's care. I'm not trying to discourage anyone who needs it. But it's no miracle cure. I don't think this problem has one.
10
"The Dead Pile Up"? An unfortunate and disrespectful headline, conjuring up literal images of death camps & mass graves. I know this is a horrible affliction, one which a family member of mine went through (& thank God survived), and the reality shouldn't be sugar-coated.
But please, respect the dead, and those who love, worry for, and mourn them.
9
Known plenty of people hooked on things. Never met one that didn't have a reason or someone to blame. "Lost a job." Didn't get a job." "Don't like my job." "My parents didn't guide me." My parents pushed me too hard." "My parents spoiled me." It's never: "I'm a jerk, a fool, a dope, a slob, lazy, witless, self-indulgent, a user by choice..." Nope, it's never them. Now, "It's the drug companies and the doctors... They made me do it. They got me hooked." Huh... Really? I've always been around cigarettes and alcohol and any drug you could imagine. I ALSO heard for years, "That stuff is bad for you." They heard it too. Choices? Read a book. Take walk. Choke the chicken. Bet on two ants dragging a dead cricket. Watch the cars go by... Wrong choice? Taking any drugs at all. Duh. Not even worth talking to such fools. Waste of time. Spend a few decades at it and see where it gets you.
18
@Johnny Woodfin Plenty of frugal, hardworking, god-fearing, churchgoing, flag-waving, manual-laboring and military-serving people were prescribed opioids to get through an injury or a surgery and never got off them. It is unreasonable to expect a layperson to know better than their doctors.
8
Noting that Scotland is a part of the UK, though the graph lists “U.K.” as a separate data entry. Is that line the UK minus Scotland?
4
Re: "Tony Nugent, rear, and a friend, James Muir, shooting up in a stairwell popular with addicts in Glasgow..."
Are we winning the, (so, called), 'war on drugs', yet?
I have dispensed oceans of narcan to repeat customers over my (22 yr.) EMS career, and NO, MATTER how big the latest, 'record seizure' of allegedly, 'illegal', mood altering substances...there has NEVER been a time when 'drugs' were any less plentiful then they could possibly, (otherwise...), be!
9
Would be useful to know what the Germans do to have these record low numbers.
12
@John
I took a look at the source data.
Germany has 105k opioid users out of 80M people, and a total OD count of 1700. So, 0.13% of the population are addicts and of those about 1.7% OD.
UK has 341k opioid users out of 66M people and a total OD count of 3256. So, 0.5% of population are addicts in the UK and of those about 0.9% OD.
So, UK has a higher rate of addiction than Germany but Germany has a higher rate of OD within its addicted population.
3
Editorials/news reports about Brexit always elicit a steady stream of commentators who claim that Brexit will be a disaster because Scotland will leave the UK. I love the Scotts people but good luck to Brussels if they have to pick this one up.
As an aside, I'm always bemused that the same commentators claim that Brexit will cause Northern Ireland to break away from the UK and form a united Ireland. And that's a bad thing?
@Mike Edwards anybody who predicts that NI will leave over Brexit and unite with the Republic has no idea what he/she is talking about. None. Zero. Zip.
There are plenty of hardline Orange Loyalists left. They’ll fight hard before that ever happened.
2
@Mike Edwards It is if you're a hard line Protestant who wears orange every July 12. Many would rather leave the EU (alongside what remains of the UK) than face home rule from Dublin. Believe it.
2
Data scientist here: if these graphs were interactive and allowed readers to hover/reveal the countries represented that would be much better.
As it currently stands your presentation of the data effectively censors or redacts a lot of information. Maybe not critical to the central thesis of your story, but I think it is not great to censor data from the reader.
10
The chart raises the question: Is Sweden doing something right? If so, what is it. Next story. I hope.
7
Scotland is an integral part of the United Kingdom. Did the writer include the Scotland statistics within the broader UK statistics?
4
I happen just to have read an article about MS-13 in the Central Valley of California in Calmatters.org, and I'm recalling a Politico article on Hezbollah's drug trafficking activity through Central America as well. Now my conspiracy mill is running. Could fentanyl from China, heroin from Afghanistan, cocaine from Colombia, and so on, be modern Trojan Horses from hostile countries whose militaries aren't strong enough to bring the Western world down? Maybe true, maybe the plot for a bad movie. Or an Opium War with the direction reversed?
5
I worked for some years in Glasgow. One of the things I noticed is the almost nihilistic view of a lot of younger Scots, social problems are national but drug and alcohol use is off the planet in Scotland, one of the worst places I've ever been is Sauchiehall Street in Glasgow on a Saturday night in early summer when football is over.
We employ casual labour - term contract labour across Europe to back up projects. In Scotland we had to bring in English people as the Scots were totally unreliable - Monday and Friday they were drunk or shot up.
I'm part Scot but I've never blamed everyone and everything for my daily lot - which is what a lot of them do as they get drunk, beg, fight and take heroin
11
I am very annoyed with how this whole opiod crisis is presented.
I would flatly reject this statement
“It’s our history, it’s the way we consume drugs, it’s the chronic underfunding and underperforming treatment services we have. Underline that with austerity and welfare cuts in recent years, and you’ve got the perfect storm for this to happen.”
as just another attempt to find a scapegoat and get the responsibility off the shoulders of actual abusers. I repeat, abusers, in most cases that is what they are.
Here in USA, it is much worse. Right now, the media is lynching the pharma companies (there is no austerity here since the concept of health insurance is at the level of 1920s in Europe) accusing them of killing people left and right. Abusers are not mentioned at all. The articles in NYT unmistakably present things the following way - you take those opioids as prescribed, 3 a day or so, and after a few weeks some users drop dead. Abusing is never mentioned and people who die never brought it onto themselves, it was the pharma who killed them. Obvious rubbish.
By relinquishing the responsibility from the abusers and doctors who apparently super-carelessly prescribe the drugs, the society will never solve this issue except by withdrawing the opioid drugs entirely and returning to good old Tylenol and such.
7
It is disgusting to me that political leaders think providing controlled injection sites for the safety and treatment of intractable drug addicts somehow encourages or even glorifies drug use, as though a teenager using drugs for the first time WANTS to end up somewhere like that. In a way, it's all magical thinking, a way to convince ourselves that our emotional, irrational opinions must be correct.
1
I'm less surprised about the US being a leader in this category, where the solution to everything is thoughts & prayers.
But it's odd to me how Scotland deviates so much from other countries in this statistic. It's part of the UK, but very different in this category. Since alcoholism was mentioned, Scandinavian countries have quite rampant alcohol (ab)use but that doesn't seem to translate into drugs. Further, I'm sure if we look at various drug policies we will find many other countries with spotty records. Not sure I recognize the driving factor from the article.
2
I think when you compare NHS treatment between England and Scotland, it is worth emphasising that health funding and strategy in NHS Scotland comes from St Andrew’s House (Scottish govt) and not Westminster. The clue is in the name, but such is the familiarity of the term “NHS” with the UK that that nuance may be lost to a casual reader.
9
If China won't check the illegal manufacture and export of fentanyl to Western countries, the Western governments must do it for them - and now. No previous illicit drug import over the decades has been more potent at killing, and in such minute amounts.
If the U.S government should be engaged in any trade war with China at this time, it should be this one. And it won't hurt American soy growers, pig farmers or Harley Davidson makers.
85
@Peggy Rogers While drugs from China might be cheaper, the problems, first, are that it's a matter of demand (as any market-driven economy like ours works), so that's what we should really be fixing, and second, cutting off China would only open up other sources, including domestic, since these are synthetic drugs (unless 'Made in USA' fentanyl is somehow preferable). Moreover, in the case of opiods, those were completely legal.
8
@Peggy Rogers Much of the fentanyl that has been killing people in the USA was actually made and marketed by US pharmaceutical companies.
13
@Peggy Rogers
If there are any lessons from the "War on Drugs" is that trying to cut off supply is not the way to solve drug (use) epidemics.
5
Two things we could do today to sharply curtail overdose deaths: (1) medically supervised injection sites in every major city, (2) full decriminalization of drug possession. We need to stop treating addiction as a crime and start treating it like the medical problem it actually is. Punishment and shame do nothing but exacerbate this epidemic.
73
@Will
The devil is in the details: It would be fine if drugs were decriminalized if stoned people simply stayed at home. But they don't. They work, they raise kids, they go to school and worst of all, they drive cars. Their behavior while stoned impacts the public so any plan that includes decriminalization needs to have a plan for how to deal with the collateral damage. And then of course there is the issue of where do these unrestricted drugs come from? Is dealing decriminalized too? If not, we still have the problem of drug cartels and gangs and of course the high cost of drugs for the drug user who then commits crimes to buy them. So, somebody has to come up with the complete plan that accounts for all these things before I can say yes or no.
9
Looking at the graph, I noticed something unusual: all of the countries illustrated are either Northern European, or are essentially derived from Northern Europe. Significant??
2
As often happens, austerity is mentioned in relation to this crisis. We had a much better world when governments invested in their citizens, providing meaningful jobs which instilled dignity and pride in people. This is how you reduce drug addiction and crime. It's really quite simple. I was a product of that investment at an earlier age and, in my opinion, an investment with a good return.
182
@Concerned
...so says the Conservative spin, anyway. The reality is that billions are currently being spent on Brexit prep, millions has been promised to farmers and additional billions promised to the health sector, police and defence.
The money’s always been there, it’s the Tory Party that has held it back - now, however, a shaky government breaking constitutional norms feels there is a need to buy support, so thus the Treasury taps are open! Austerity is and always was a choice and a deliberate ploy to curb public spending.
And that’s before we even get into the conservative scheming around the Barnett Formula. Extra money? For the Scots? Goodness, whatever next! ;)
12
@Concerned Citizen
The United States after World War II made an investment in returning veterans via the GI Bill. It is easily the best return on investment this country has ever made.
22
When you are hitting the bottle constantly life does seem bleak...but that is the Scots for you. They have always had drink and drug problems for years and years...more so then any other UK country.
They also tend to blame the English for all there woes...not the fact the Barnett Formula which all UK countries contribute to gives them a good living.
There are many good Scots...but I have to be truthful and say that many just love the old drink.
11
When black Africans in America were suffering under the weight of opioid addiction, making and dealing it was treated as a ignorant, immoral, lazy and violent crime wave worthy of criminal justice prosecution, conviction and mass incarceration.
Since white Europeans in America have been faced with opioid addiction, making and dealing it has been treated as a crisis and epidemic deserving of compassion, empathy, sympathy and treatment.
And among the biggest American opioid drug makers and dealers are and were the likes of Purdue Pharma, Johnson and Johnson, CVS and Walgreens their are corrupt crony capitalist corporate plutocrat oligarch welfare explanations and excuses.
Who knew that Scotland was still dealing with opioids as though they were in America?
15
when I was 18 an older guy on my street asked me if I wanted to try heroin and told me that I could not "...get addicted the first time...".
I knew better. I declined. Abruptly and in a determined fashion. he never asked me again. Ten years later, I went to his funeral. Overdose.
Sorry, I have zero sympathy for addicts. That is whether they are here in Philly overwhelming Kensington, down in Appalchia shooting up, voting for Trump and waiting for coal to come back- or in Glasgow.
Every single one of them made a choice. Every single one of them could make a choice now. AT some point, they are not the responsibility of the rest of us.
36
@Lefthalfbach But why does that choice even exist, for teenagers, anywhere? It is the adults of society who have allowed this to occur, particularly those in power. Same with the guns that have flooded our streets here in the US. We do not make a concerted effort to protect potential addicts and gun victims because drugs, guns and ammunition are sources of revenue and the people in charge of the spigot are getting their share. Greed and no concern for the collateral damage are most responsible. Yesterday, walking around posh areas of San Francisco, I passed two individuals openly preparing injecting drugs, right there on the sidewalk. The choice they once had not to use is long gone, and very few will find a berth in a treatment program because the powers that be find more profits in supporting addiction than in ending it.
5
@Lefthalfbach. I befriended a heroine Addict. I loved her.
4
@Kathy
For him, that choice existed because he had serious addictions already- notably to alcohol. Like a lot of kids in Philly in those days, he started drinking-heavily- at 12 or 13.
He was also burdened with unrealistic expectations regarding his prospects as an athlete. He was good, but not big enough.
However, he was an Irish kid with Union connections. He got into a good union and got a good job. He married one of the neighborhood's catches. Needless to say that did not work out. Neither did the job.
Obviously, he was already running with the wrong crowd when we were still youngsters. Things just spiraled out of control for him.
As for treatment programs and so forth? Honestly, that is a panacea, largely created because most insurances will pay for 28 in-patient days. The reality is that most addicts are going to die young and unpleasantly. I am sorry for their loved ones, but I have zero sympathy for the addicts themselves.
Zero.
2
Scotland and poverty are long entwined. It was said a farmer in the south lived as well as a king in the north.
11
Poverty and idleness breed crime and addiction in Scotland just as in Appalachia.
Now that its North Sea oil fields are depleted, Scotland is a welfare state supported by the taxpayers of England and Wales. Northern Ireland is an English-supported welfare enclave that is overdue for union with the Irish Republic.
Brexit may provoke an amicable and beneficial breakup of the United Kingdom that will rid England of the political contrariness and financial burden of Scotland and Northern Ireland. Foisting those two trouble-makers onto the EU dole should vastly improve England’s chances of resurrecting its economy after the impending Brexit immolation.
15
@AynRant The oil fields are far from depleted. The tax revenue from them still goes directly to Westminster. So actually it is Scotland's oil which still largely supports those English taxpayers you mention. Oh, and we also house your weapons of mass destruction (against the wished of our people and parliament.
8
@AynRant Scotland may opt for Independence, but not without litigating fiercly over the legacy proceeds from the North Sea Oil.
Northern Irelnad is a much more complex problem. A significant subset of the Orangemen will oppose unification with the Republic by violence. Organized, well-armed violence.
You do, however, touch on an underlying reality. Tory England wants to be rid of NI and will not dry id the Scots go. Another issue, frankly, is whether the North of England stands for being reduced to political irrelevancy by the Tory SouthEast if Scotland goes.
1
@Ian Cargill
All true. But you will need a Navy if you want to hold those oil fields. You may even need subs with nasty weapons on them.
Or do you think that England will just let you take the fields free and clear if you go?
On the plus side, maybe Scotland and Orange Ulster can combine? Then building the Joint Scots/Orange Navy can provide work at Harland and Wolff.
Don't get me wrong. I am sympathetic and I have seen the tattoo. But nothing is free in this world.
1
It's too bad you didn't include your neighbours to the North. Opiod related deaths according to Government Canada stats in 2018, were 4,460.
The death rate in Canada was 12.0 per 100,000 population for the selected year.
And a lot of that is fentanyl. However our biggest problem these days is Crystal Meth or methamphetamine. On top of the opioid deaths there were 1000 meth related deaths in 2017. It has exploded over the last few years with the greatest number of users being in the 18 to 30 age range. The important thing about crystal meth is there is a major increase in violent incidents, homicides, burglaries, abuse of healthcare workers, etc. How to solve all of this is really a conundrum and a major societal issue.
10
The creation of new poverty areas alone makes both the addiction problem and the wish of Scotland to leave Political Britain understandable.
Our opioid crisis seems due to overprescribing the pain pills. Theirs seems to be a heroin crisis gone metastatic. One can hope some sort of helpful answer is at hand.
Brexit is the least of that island's worries.
2
Will Brexit mean more drugs or fewer drugs in Scotland? Will it be harder to score if there are borders? Will the border in Northern Ireland be a gateway for the flow of drugs into England?
Several of the commentors questioned the data - are these statistics about people who reside in Scotland who died of an "overdose" of an opioid pharmaceutical medicine, or junk made of anything resembling an pharmaceceutical medicine, or are these statistics about native Scots who died?
For me the question is, doesn't Scotland have the same medical resources of England, essentially socialized medicine?
If so, where are these opioids coming from. Interestingly, Germany and Denmark have lower death by overdose rates and in Denmark possession is legal of most scheduled drugs.
Wouldn't a medical treatment for addiction to opioid be available to such individuals in Scotland?
Drug abuse is one of the many consequences of exporting manufacturing jobs to China. Does that policy still seem to be a good idea ?
4
@TonyC
I don't know. There was drug abuse before manufacturing jobs were exported to China.
3
This article made me so sad. Scotland is the country of my birth and I grew up there. I lived just outside Glasgow and never saw anything like that. Lots of drunk men falling down in the street was the worst I ever saw. Maybe I lived a sheltered life. My daughter who moved back and lives in Edinburgh hates Glasgow with a passion now I know why. It will be the UK's loss when Scotland splits from the rest of Britain and gets money from the EU because they will get nothing from Westminster.
3
Great photos. It would be good to see an article like this encompassing a few U.S. cities with the worst problem, showing photos of an array of citizens from different backgrounds and races who are addicted to drugs, and how they live their lives and get help (or not).
1
Funny that this article is about Scotland's problem when clearly the US is in a similar predicament. Why is Scotland therefore the headline? Because its zero surprise that the US has more overdose deaths than other places just as its no surprise that we have more gun violence. America's revelatory preventable deaths paint a grim picture. Surely gun deaths and overdoses are different issues but it seems that being the, ostensibly, most powerful, most affluent country in the world (in general not per capita of course)...surprise, doesn't make people more happy.
Maybe we should focus more on happiness instead of world domination? Just sayin.
2
Couldn’t you quite easily show a connection between the increase in the poorest use of hard drugs and the demonising and taxing of tobacco
1
Many countries in Europe are substituting recreational drugs, allowing addicts to be followed closely by health professionals and reducing drug criminality. Pure repression does not work, this has been proven and is clearly visible in the excellent statistics. And: the US drug-scene is the motor for the drug commerce in Latin-America. A scientifically sound drug-policy would solve many problems, including that of the cartels in Mexico, among others. Recognizing the interdependence of problems is crucial to solving this scourge.
17
Could you clarify why Scotland’s figures are the only ones to go up to 2018; why not the rest, for comparison’s sake?
I couldn’t see an explanation in the piece, but perhaps I wasn’t looking hard enough.
7
Opioids are the panacea for the pain and suffering left by the post industrial void. The loss of jobs by automation and overseas manufacturing models has resulted in deserts of despair.
The new job growth, entry to middle management programming is being served by Indian cartels flooding countries with H1 indentured servants. The market forces of greed and expediency have left a cross generational segment of the population of in the dust. The question is, how do we who have benefited from their demise, by way of cheap goods and an overgrowing corporate sector, help to heal their pain.
37
@j24 Short-term, a form of Universal Basic Income that places the costs on a graduated wealth and income tax. This is not a popular policy at this time, however.
8
@j24
Please many of these addicts never had a job to begin with, and blame their problems on everyone but themselves,
Too busy getting high to pursue any other education.
Same in the USA. with the exception of those who actually had a pain condition, never took opportunities that could have led to training in something else.
Just sat around getting high on the dole, or welfare, and having children that could not be cared for.
That's why the public in the USA is not getting behind any kind of universal basic income, the bar is set much to low to receive it.
Looking at the mess in Europe with people on the dole and not contributing anything to society
8
@j24 Paragraphs such as yours sure were in short supply when Black ppl were suffering through crack due to “voids, greed, and being left in the dust.” It’s rare to hear any White person ponder how they’ve benefited from the demise of Black people and our communities not to mention having any real care about seeking to heal the pain. I don’t disagree with your sentiments, but the compassion with which this opioid crisis is being treated also illuminates an astounding and stubborn callousness toward the pain of non-White people.
13
Life expectancy at birth is meaningless. Coming from a Scots family myself, I have to ask how such a thing could even be measured. People travel. Does some government agency scan the records of the world to discover where someone born in Scotland actually died?
Why can’t this be reported directly as the average age of death in Scotland for those born in the country, or whatever the observed measurement actually is? And why is this even relevant, other than providing some eye candy?
It’s not that I doubt the existence of drug addiction as a problem, but it’s hard to put much confidence in this article.
3
@Global Charm:
did you read the same article I did?
The life expectancy chart was a sort of pointless entry into "facts for no good reason".....dying of old age, cancer, heart disease etc has little to do with dying of opiate abuse.
2
Part of the problem is that an increasing number of people don't feel there is an improved future to look forward to. Without hope there are a wide range of self medications to assuage the hopelessness, at least for a time, at least until the Reaper silences the pain.
44
@MH William Burroughs was an addict most of his life. Most addicts die of other reasons, as long as they don't try to OD. But, we are at the point in time, where Western Civilization is facing a precipice. You can't print money and hand it to greedy Investment Bankers forever. That's why there's no longer any organic growth.
Remember, the UK used to have the global reserve currency and it flourished under that prosperity, but it has been in permanent decline ever since (despite all the rich people who got richer.)
Also, it's time that humanity comes to terms with the natural limits of population growth. All these economic PhDs and they don't seem to understand basic scientific facts, but that's not surprising considering that economics is not based on science. but psychology (false confidence.)
In the real world, everything dies, even civilization itself. Maybe they need to start teaching about reality at these 'elite' schools.
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@MH
Yours is the most important comment on this thread. Let's address the REASON why people are turning to such a powerful drug.
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Sometimes it feels like an endless social services circle that, in the end, will always be seen as guilty of all our problems. The article states that a contributing factor to the rise in addiction was gentrifying ghettos and forcing addicts to move in to new government housing. Now at the time, the millions spent on government housing was part of the solution, but now is framed as the cause of addiction. In the end, we also have to be honest with ourselves if we have any hope of truly ending drug addiction and the suicide of those shooting up.
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Scotland is a naturally poor country with few resources. Its only hope for prosperity is to invest heavily in its people. However, Scotland doesn't have the capital to make all of the necessary investments itself. With a UK government devoted to "austerity", there's no hope of sufficient funding from that source. If Scotland is forced to leave the European Union, and can't immediately rejoin as a separate nation eligible to receive EU funds, the shortage of money is going to get worse. People with hope are less likely to turn to drugs than people without hope, but it's going to be expensive to give everyone in Scotland a reasonable basis to hope, even assuming that sensible policies are developed or are expanded where they already exist. Private investment always will be too concentrated on just some people to do the job. Scotland needs cooperation from larger institutions, whether the UK or the EU or, ideally, both.
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@Stephen Merritt Scotland is not a poor country...they get the Barnett Formula and nice amount it is too.
They also get more capital a head then the rUK. You also forget to mention that Scotland has it's own Scottish Parliament where they decide there own budgets. You also forgot to mention that Scots do not pay for University fees...they do not pay for medical prescriptions...they do not have to pay if they have go into Residential Care...hardly a country is poor.
Please know what you are talking about.
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Scotland does have a major problem with heroin addiction, and not only in the major cities. There is a small underclass within this society who lead such chaotic lives it is quite tragic. As nolongeradoc points out, many of us Scots do have a capacity for self destruction.
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Legalize all opioids and strictly control their production and distribution. No one dies of an overdose, property crime drops dramatically, and opioid addicts can concentrate on getting a job instead of getting their next fix. End of opioid crisis.
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@Bonnie Allen I'm not sure legalizing all opioids would help with overdoses. To keep getting high, opioid addicts have to keep raising the dosage as they develop a tolerance. If it's legal, and the addict's doctor keeps the dosage down to avoid an overdose, the addict will find a way to get more and overdose (there's going to be a black market no matter what you do; it's heavily policed now for example and people still get it). If the doctor keeps updating the addict's prescription, they overdose. As for finding a job ... have you ever been around a junkie? I have. They literally can't stand up half the time. What we need is real social reform, so people aren't so scared, depressed and freaked out they turn to opioids.
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@Bonnie Allen
I'd add to that another positive outcome. Those of us patients enduring lifelong illnesses with debilitating pain would not have lost medicine doses sufficient to provide sustained relief. Many of us used to get it.
Thousands of legitimate and humane, but shell-shocked specialists - practicing under threat of DEA prosecution and new "medical" dosing guidelines set by federal cops and bureaucrats -- have had to make arbitrary, across-the-board cuts in pain medicine to protect their licenses.
There are go-along goons who pretend no one really needs long-term opioids save terminal cancer patients. There are claims pain medicine never really worked for chronic pain in the first place. (I kid you not.)
I've lost my job, my home, most of my functioning and joys in life, to chronic hurt. So many have it so much worse. If we were a relative handful...so be it, I guess. But tens of millions of Americans suffer from one or more periods of months or years-long pain in their lives.
And yet when we're suffering, we are least able to advocate for ourselves. Worse, given the terrible stigmas today to pain medicines, asking for more automatically means you're exhibiting "drug-seeking behaviors." You're not a relief seeker, a wanting-to-keep-your-job seeker, or a wanting-to-maintain-a-functional-and-purposeful-life seeker. More often you're more like a pain pariah to be kept further away from the bottle.
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@Bonnie Allen That seems absurdly naive. Maybe you could tell us where this tactic has worked or is working? And for what currently forbidden substances? And how the production controls are enforced? Also, how do you account for the increasingly overwhelming effects of addiction and increasing organic destruction in a few decades?
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It's so sad to read this about a beautiful land and people I love so much and have looked forward to visit again.
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@ml Maybe that's because you have money and you can leave whenever you want to. Alcoholism is quite prevalent in Scotland, as well.
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@ml
I find Scotland and its people fascinating. Would definitely like to visit there one day.
This is not a drug problem it is the abandonment of compassion and responsibility. Nothing new in British politics. There are undoubtably some in government who see the climbing drug death rate amongst the poor as a source of income savings and a positive trend.
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Is the abandonment of responsibility you reference the abandonment of personal responsibility for, uh, choosing to take heroin? Why should anyone else or any governmental entity be held responsible for people’s individual [bad] choices? Everything in the west is about exercising one’s freedoms until stupid choices are made and consequences are felt and then it’s all someone else’s fault and responsibility to fix.
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@Katie really? No treatment after a car accident because you made an inappropriate lane change. Very puritanical. Okay. 78000 overdose deaths last year in the U S. America at its most heartless.
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I wonder if the age distribution of drug deaths in Scotland might actually reflect something of a public health "success" story - are there proportionally fewer middle-aged Americans dying now because the National Health has kept Scotland's Trainspotting Generation alive long after much of their American peers died?
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@Jeff P -- My earlier comment goes for just such attempts at optimism.
"Let no one in the U.S. take hope from the fact that Scotland's escalator to O.D. Death is slightly steeper at present. Both rates are obscene and with China's entrepreneurs spewing out cheap, illegal fentanyl at unchecked levels now, desperate addicts in all these nations' streets and dens could be taking the elevator shortly."
Additionally, we must know that at any moment, these numbers could flip flop. Several elements feeding America's addiction crisis will have to change radically before anyone can pronounce us on the path to effective treatment, not to mention success.
4
The opioid crisis will haunt us for years to come, and my sense is that the federal government is not going to do anything about it. We're in for a long, painful decline for these people.
It has already brought on an early death for one of my siblings. The worst though, are his children, who continue to bear the pain of their father's abuse and death.
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Okay it’s sad. There is indeed more than enough sadness and suffering in the world as the Buddha tried to inform us. However the amount of lives damaged or destroyed by heroin and opioids are just a few drops in the bucket compared to “legal” drugs like alcohol and nicotine, not to mention the toll wrought by pharmaceuticals. These stories make good headlines. What they lack entirely is any sense of perspective.
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@Chuck Burton
You don't seem to understand the extent of the opioid problem, it's rampant, intractable, and deadly.
Many opioid addictions stem from written prescriptions for pain relief, so they account for part of the "toll wrought by pharmaceuticals". (See: Purdue Pharma)
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@Chuck Burton
People do drugs for a reason. In this case, I bet that they are emotionally and physically depressed and have nothing better to do with their time.
You need exercise and you something to do with your life, watching TV will never replace having a life to look forward to. Inevitably, drugs becomes the easy way out.
We don't focus on physical and mental health, and we blame everything on the individual.
Scotland suffers from alcoholism to an astonishing degree, but because it is legal, people don't consider it a crisis. They should consider legalizing all drugs so people can get treatment without the stigma. Almost nobody wants to be an addict, it happens for ancillary reasons, and then they can't quit. That's usually when their life goes down the tubes, and it becomes impossible to return to 'normal.' At that point, something has to give.
Scotland needs to adopt a progressive attitude, but generational stigma generally prevents that from happening. The entire world needs to get with the times, and embrace change. The old way of doing things is just not going to cut it, anymore.
"Time's up."
4
This is heartbreaking. Nick is right, more compassion and empathy are needed for these poor souls.
One question... why are the victims of this epidemic so often men, and white men in particular? I know addiction touches all genders, races, socio-economic classes, etc., but both Trainspotting and this article suggests a disproportionate amount of white men are the victims, at least in Scotland... would be interested in seeing the gender breakdown of the opioid epidemic both in Scotland and the US along with some analysis...
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@Emily I do wonder if it's bias in reporting, actually. So your call for numbers and analysis is a good one.
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@Emily
I believe that society is hard on both men and women - but in different ways.
Granted it's a long time ago now, but I watched my younger brothers as teenagers try to deal with ungodly amounts of peer pressure to drink to excess.
As a teenage girl, I was never subjected to that sort of pressure.
Maybe it's different now.
8
@Concerned Citizen
Nope. Twice as many men OD in the US. Why? My opinion: Men are subject to a lot of pressure in our world, and they don't have the emotional support that women get. Stats linked below.
https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-gender/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
Let no one in the U.S. take hope from the fact that Scotland's escalator to O.D. Death is slightly steeper at present. Both rates are obscene and with China's entrepreneurs spewing out cheap, illegal fentanyl at unchecked levels now, desperate addicts in all these nations' streets and dens could be taking the elevator shortly.
14
I was, shall we say, quite reckless with these things in college and a bit beyond (mid-to late-80's). I was blessed in that I never became addicted. I went on to work with drug-users, most of them with AIDS, in various agencies and clinics in the late '80's/early '90's. If I had had anything but utter compassion for the people who were not as lucky as I'd been, I would have been a hypocrite. One of the programs I most admired back then was the Lower Eastside Needle Exchange Program. It stunned me, working directly with people who were dying of AIDS in droves, that there would be resistance to needle-exchange programs or anything that might help. But there was.
I've always given out cash freely to people on the street, without asking what it was for. I figured that giving whatever someone needed to make a freezing night sleeping outside more comfortable was the least I could do (I never bought into the admonition that withholding money would magically force people into treatment).
But along came Fentanyl, which I'd never heard of until my mom got cancer. My friends on the street tell me they can get a hit of heroin/fentanyl for $4--I can't believe it! And they are OD'ing on a regular basis. So these days I'm more likely to buy someone a sandwich, or get him or her some warm clothes, or donate directly to the most helpful and least judgmental programs for the homeless and people with substance issues. And if someone wants to go into detox, I will do what I can to help.
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@NGB
I was in the habit of buying a sandwich and a beverage for people I passed by on the street who were begging.
But I learned the hard way that some of them were just scammers - pretending to be down and out.
Now my charity consists only of giving to charitable organizations that I feel do good work and who are legitimate.
8
@Astrid , my assumption is always that people must be hard-up at least to SOME extent in order to stand around on the street begging from strangers. My personal credo is that if someone asks, and I have something to give, I give--no questions asked (which is one of the reasons I don't like "charitable" organizations that demand some acceptance of their religious doctrines in order to provide help).
And be very careful in making donations--not all charities are as transparent about where the money goes as they should be. Sites like Give.org are a good place to get a better idea of how much of donations goes to actual services to those who need it, and how much goes to "overhead," which can be kind of a nebulous concept.
Give freely, and give wisely, and with kindness and an open heart. I believe it benefits the person who gives as much as it does the person who receives.
I give to local organizations in my town where I can actually SEE how the money and other donations are used.
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@NGB Your honesty and compassion are inspiring.
3
I originally come from Seattle where there’s a big heroin problem. The heroin deaths chart makes me think that cold, cloudy places bordering water = more likely to die from heroin. I suspect the correlation is false, but why Seattle, Latvia, Scotland, Sweden and Denmark?
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@Andre , I wholeheartedly agree, and thank you for saying it.
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@Andre There are a lot of factors in this crisis that researchers are just not paying attention to. Location is one of the most obvious.
I mean, the research relating lack of sunlight to depression has been around since the 80s, or even the 70s.
13
@Andre I also wonder about the role of genetics. A lot of Scots, have Scandinavian roots (as do Estonians, and Estonia was next after Scotland).
10
Poor guys.
We need to have more compassion with drug addicts.
That's the only thing that will change the situation.
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@Nick , I originally accidentally replied to the wrong post. What I said was that I wholeheartedly agree, and thank you for saying it.
4
@Nick
I live in a city where there's an awful lot of crime committed by drug addicts. I find it hard to sympathize with that sort of behavior.
But I do understand that the underlying cause of most drug addiction is unresolved trauma. And for that, I do feel badly for them.
7
@Astrid
Drug addicts commit crimes because they're desperate to get drugs. If you can understand that the cause of addiction is trauma and misery, then you can just as easily extend that sympathy another step.
2
I'm English but I lived in Scotland, worked there, raised a family there and I have huge respect and fondness for the country and for the Scottish people. Did you know that the majority of Nobel prizes awarded to the UK (or Great Britain, depending on which century) were won by Scots? Or that Scotland was far more invested in the European Enlightenment than England. Or that Scotland enjoys more public spending and has better public services, (including, still, a first rate health service) than the rest of the UK? Or that it was Scotland, principally, that serviced the United Kingdom's short lived but immensely profitable oil boom of the 1980s?
That said, it seemed to me that Scottish people had a capacity for self destruction unique in the British Isles.
NOTE to graphics designer - Scotland is part of the UK. At least, for now.
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@nolongeradoc't
Anyone can become an addict. The older the culture, the less of a chance it occurs. I believe it is a combination of a chemical imbalance in my brain, and my actions. If you give a Percocet for a toothache to 18/19 out of 20 people, they don't become addicts; however, 1 or 2 will have a different reaction triggered in their brains. It helps with the pain, but for that 1 or 2 people, it can become a way of life. It did for me. From age 19 to 31, my life was very, very much like the Gus Van Sant film "Drugstore Cowboy" (1989). We broke into pharmacies, stole doctor's bags (we were experts at this), and everything imaginable. In the Bible Belt, it was hard to get heroin;. Plus knowing exactly what drug you were taking really is better. We got a new PDR ("Physician's Desk Reference") every year. There was always a doctor who would write rx's. It was funny in a dark humor type of way. Everyone in the waiting room knew each other. We knew exactly what to say to get what we wanted from other doctors. With the exception of pharmacy break-ins and doctor bag thefts, all of the doctor rx's allowed us to legally get incredibly large amounts of the strongest opiates available. Thank god I was busted and got help. In those days, health insurance companies would give you "treatment upon demand", which quickly disappeared over the next decade or so. You almost had to be dying to get approval for inpatient treatment, which as addict, I can say is the best to help drug deaths.
24
I was going to point out the same thing about the graphic. Makes me wonder whether they included Scotland in the UK total or not.
13
@nolongeradoc
"NOTE to graphics designer - Scotland is part of the UK."
I'm sure they're aware. It's instructive to contrast the rate of overdose in Scotland with that of the UK overall, is it not?
10
What explains the sudden decline in drug-related deaths in Estonia — anything to learn?
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@P Cobb i think the wild swings or variability may be distorted by low numbers. if estonia is less populated than the other countries listed, there is no "smoothening" to the data
5
Just to follow-up on Lora's astute observation, in 2017, 110 people died of drug overdoses in Estonia (EMCDDA), and 70,237 people died in the U.S (NCHS). As mentioned, because the population of Estonia is just a little over a million, small changes in raw numbers can appear amplified when attempting an apples-to-apples comparison. I deal with healthcare statistics all the time in my job and am forever feeling like I need a second brain to see the forest.
6
The photos in this piece are amazing - stunning and sobering.
58
I'm glad Etizolam is not available here. It's ten times stronger than valium, and causes (or is involved with) half of these deaths in Scotland. I hope fentanyl doesn't become available there. I hope they can increase their treatment funding. Sigh.
30
@Charlie Messing
Etizolam isn't 'available' in the UK - that is, it isn't available as a prescription drug. So, any getting into Scotland must be being smuggled. Benzodiazepines aren't particularly easy amateur lab syntheses; it's not like brewing meth, converting cocaine to crack or making MDMA out of common cold remedies. That begs the question as to why it's NOT being smuggled into the US. In any case, Etizolam doesn't sound much different from Xanax, TBH.
No fentanyl in Scotland? That must mean illegal fentanyl. The drug itself was discovered and commercialised in Europe in the 60's. It's in standard clinical use for pain management and cancer/terminal care currently and is extensively deployed in the UK. I first saw it used in British hospitals in the mid 70's. One of my anesthiologist colleagues was addicted to stolen supplies of it. You didn't talk about that sort of thing back then..
40
@Charlie Messing
Thanks I stated that in my comment because it is NOT clear what kind of an opioid caused the deaths. There is street level "junk" with any number of chemicals and dirt mixed in, and then there is the authentic pharmaceutical drug - and I doubt these Scottish overdosers/ users had access to pharmaceutical grade opioids.
1
@nolongeradoc
Well, that's not cheery news, but thanks for the update - all I knew was in this article. Yes, Fentanyl should have stayed in the operating room (along with propolol). If more deaths in Scotland are Not due to it, they are lucky. Hope they never get it. And I hope we can somehow get rid of it. I looked it up online and in five minutes was looking at a recipe.
2