Perhaps the wording is a bit harsh - not everywhere is a cesspool, a lot of places have bounced back, but the rust belt is particularly bad in area of opioid abuse - that is fact and very accurate.
I'm seeing similar increases in heroin use in my small midwest hometown. Multiple overdose deaths monthly, as well as arrests.
I honestly don't get what most of the other commenters are going on about. The stats are pretty widely reported on the massive increase in opioid abuse.
They must live on the coasts or otherwise have avoided what has been plaguing many states in recent years
Bro my old city's opiate overdose death rates have doubled annually for several years now. I have several friends whose lives have been claimed by opiates in that span of time. It's most certainly a thing. No offense but you shouldn't talk completely out of your ass.
What was your point if not propoganda? Just to let us know drug abuse is bad? Is this new information? Your comment doesn't offer interesting information, a solution, not even a personal experience. That's why I think it's right wing propaganda.
Just like foxnews you repeat something over and over in order to imprint it on the ding dongs who base their knowledge off hearsay instead of facts.
"Oh look a post about something bad that happens everywhere but I can increase the association level with cities run by democrats in order to justify my political support. Because if the opposition is suffering worse than me then I'm not wrong in who I support...even if it's not true"
I've been reading Dreamland by Sam Quinones, which goes into detail and background of the past ~50 years or so about how we got into this situation. A large part of the WHY you're referring to I'll summarize as
1. Pain being identified as a vital sign and hospitals/institutions new-found focus on tracking and treating pain
2. Deceptive pharmaceutical marketing that painkillers are a be-all solution to pain and also non-addictive (Purdue/Sackler seem to be worst offenders here)
This lead to doctors prescribing opioid painkillers to many of middle-class americans who would likely have otherwise not come in contact with drug addiction. The book so far has been a really good read and also goes into detail around how heroin started spreading through the rust belt as well (feeding on the existing prescription addiction). I highly recommend it (about 65% through it right now).
I'm not sure anyone really knows why the demand is so huge.
Unemployment seems obvious, but it's not. New Hampshire, for example, if often cited as one of the areas hit the worst by opiate addiction. Yet, it's doing well with unemployment, in relative terms.
My business is in a county with high drug addicts. This used to be a growing county in the mid-70s with a high number of manufacturing jobs with good pay. As manufacturing started to decline, drug usage started to go up.
I moved from California. One thing I noticed that doctors in this area will easily prescribe pills compare to Calfornia. Everyone takes pain killers. Pretty much everyone carries pain killers all the time.
I only have my one anecdote in response to this story, which does not translate into data I know. I'm from one of the counties in western NC where overdose deaths have gone from 4-8 in 100K to 20+ in 100K. I graduated from high school in 2001 so I have grown up with the rise of drug use in my home county and surrounding areas and the people affected are people that I've known all my life. I no longer live in NC and, in fact, haven't lived in the area since I was 16 (went to a live-in magnet high school and then went elsewhere for college + career).
2001- my graduating class goes off into the world, half to college, maybe 1/4 to trade school, the rest go to join a family business or into an apprenticeship into a trade. A few go into the military. A few have no idea what to do and get low-level jobs wherever they can find them.
Pre-2008- The economy is booming, people who've gone to college are either 3 years post graduating, establishing themselves in their young careers, or just graduating from grad school, or for those that have entered a trade they've worked long enough to start having some standing in their chosen line of work.
2008-2010 economy explodes. Layoffs, bankruptcies, consolidations, offshoring. Immensely decreased consumer spending hits trades particularly hard- welders, mechanics, electricians, construction workers- all take massive hits to their profits. Business is scarce. People who've graduated from college and who are establishing their careers get laid off and have to move back into the county because that's where their safety net is- grandma and grandpa can take care of the kids while they hunt for work or work a low-paying job because that's all they can get. Military service men and women get done with their tour and come back to nothing- no job prospects, community college has closed, trade schools have closed, the factories where their fathers and mothers worked have all outsourced to 3rd world countries and closed.
In my rural county suddenly there's way more idle middle to late 20-somethings with no job and no prospects. No jobs to be found, no money to move. What I saw among the people I know/knew is that it only took a few people trying meth before it was like a powder keg going off- idle hands are the Devil's plathings, after all. People I went to high school with no hope for the future were doing meth because it was 3 minutes of bliss in stark contrast to the whirlpool of suck their lives had become. Grandma and grandpa were taking it because they couldn't afford painkillers. Teenagers were taking it because they were shithead teenagers and it was more accessible than pot. The "smarter" of the people I knew were cooking it because it was the only way they knew to make money. Once the door was open to meth then "fancier" stuff like painkillers started coming in and it was a way to feel like you were "better than" everyone else you knew who was doing meth. Oh yeah you were a drug addict, but at least your pills had a brand name. Enough meth labs blow up and the more enterprising of drug distributors can come in and sell addicts anything and everything they want, so if heroin is cheap enough that's what gets sold.
This article is written from a scholarly point of view and has a lot of conjecture but I definitely don't think they had any boots on the ground to make the conclusions that they did, particularly with regards to saying the epidemic in Appalachia is a result of on the job injuries. There are no jobs to get injured on anymore.
[Edit] I also absolutely agree with onetwotree's comment downthread, this is another ENORMOUS contributor to increased and sustained drug use in my tiny county: "Recovery is hard in tiny communities. All your friends are doing drugs, there are maybe 2 or 3 12-step meetings a week, no outpatient programs that you can attend while working, no sober living facilities, and treatment involves a trip to the big city." Also worth mentioning is that often those 12-step meetings are held in the basement of a church, which in my hometown means it's either your church which your whole family goes to and you grew up in (pretty damn hard to walk in there and admit to being an addict) or your friend's church that his whole family goes to and he grew up in- in both cases it's impossible to be anonymous.
Thanks for the reading suggestions, I'm pretty intrigued by this topic.
The opioid epidemic is seriously bad here in the US and its negative effects are definitely magnified by the Appalachian malaise that existed before oxycontin.
I mean, they have recently run out of morgue space in South Eastern Ohio (also Appalachean).
It’s amazing that when the opioid crisis hit “rural America” people blame the distributors and called it a “disease”. But when it was rampant in the “inner cities” it was about “moral failings” and the lack of discipline. Even though the drug problem in the inner city was also caused by the government actively propping up governments where it was being produced in service to the Cold War.
(1) The prevalence of drug overdose deaths and opioid prescriptions has risen unevenly across the county, with rural areas more heavily affected. Specific geographic areas, such as Appalachia, parts of the West and the Midwest, and New England, have seen higher prevalence than other areas.
(2) Poverty, unemployment rates, and the employment-to-population ratio are highly correlated with the prevalence of prescription opioids and with substance use measures. On average, counties with worse economic prospects are more likely to have higher rates of opioid prescriptions, opioid-related hospitalizations, and drug overdose deaths.
(3) Some high-poverty regions of the country were relatively isolated from the opioid epidemic, as shown by our substance use measures, as of 2016.
Still as 3 can attest and as you said, it isn’t simple.
I can not understate how much of my little West Virginia town has been destroyed by opioid addiction. There doesn't seem to be a perfect solution to fix the problem, but I hope this will shed some light on the situation and at least bring it to the forefront so hopefully real changes can be made to combat this
The opioid epidemic is a symptom of underlying socioeconomic and societal issues. That is why it concerns me so greatly. It’s a canary in the coal mine, if you will.
It's weird that everyone points to the opiate epidemic as somehow signifying something major, when it's just the same drug epidemic that has already ravaged the inner cities decades ago. The only difference with the opiate epidemic is the drug dealer is the neighborhood doctor, so the risk barrier has been lowered to fit the middle class more subdued risk palate.
Same weird thing as will the mass shootings. Mass shooting has been going on for a very long time in the inner cities, but it's only a big thing once middle class kids and adults start shooting everyone up.
Opioid addiction is because opioids make you feel really good and they are really addictive and they had a tendency to be overprescribed. Blaming the economy for opioids is like blaming airplanes for AIDS.
As far as the wasteland heartland, I am not sure if Texas is included in the heartland, but the Texas economy is one of the biggest in the world — about as large as the GDP of Canada and larger than that of South Korea. Basically Texas is the 9th or 10th largest economy in the world. California is 5th or 6th. The state of Ohio’s economy is only slightly smaller than the entire country of Belgium.
The desolate wastelands are in the non-major cities and towns of Europe. Avignon France, for example, in the city center, has blocks and blocks of boarded up storefronts. Unemployment in Avignon is over 15% and only 35% even earn enough to have to pay income tax. Gary, Indiana, about as heartland as it gets, has a 7.6% unemployment rate — a rate that is declining. By European standards of GDP, disposable income and unemployment, Gary is a boomtown.
Don’t just consume the NPR-worthy stories of the death of the US heartland. Remember, most media outlets in the vein of the Atlantic, NPR, etc., they are typically coastal elites who have barely ever visited the heartland, let alone actually lived or worked there. They are also an echo chamber pushing an when’d a of a certain political persuasion, so it helps their narrative when “fly-over country” isn’t doing well.
Anecdotally, I believe the converse is true.
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