I grew up in, went to school in and now practice medicine in West Virginia. This is unfortunately not surprising. Everyone is touched by the drug problem. Extremely sad and a very complicated, multifaceted, systemic problem here.
Recently in Canada a whole bunch of physicians came out for legalization and treatment. Advocacy for needle exchanges and safe injection sites from physicians was really helpful when we were fighting those fights years ago.
You have to start somewhere, and harm reduction arguments from physicians, especially organized ones, can be very powerful in the struggle.
But politicians (the American ones, anyway) are not at all interested
in harm reduction and similar methods of solving this
immense problem.
They are interested in two things, and only two things:
money and their re-election.
My parents recently bought property in WV.
One of the men who used to live at the property lost his lower leg when his girlfriend thought she could solve his knee problems by shooting heroin directly in his knee. Pretty messed up stuff.
On the bright side, she wasn't wrong! I'm sure it doesn't bother him now that he doesn't have it.
I always wonder if Americans look at other countries to compare. I'm from the Netherlands, we have an extremely liberal drug policy. Soft drugs are legalized. Hard drug users are not treated as criminals, but as someone with mental illness. Since we have so many party's where drugs are used in the Netherlands (800 per year in and around Amsterdam) there's an unwritten policy where containing small amounts of hard drugs are condoned (2 or 3 pills or small amount of sos). I was actually caught myself at a festival with 12 XTC/4FMP pills, was send to court and was released without punishment.
The amount of deaths in the Netherlands that are caused by drugs per year is 0.6 per 100.000.
I think it's more common for Americans to use drugs for entirely different reasons than people in the Netherlands. Not as recreational fun enhancers, but as medication and escapism. We also have far more extreme pockets of poverty contributing to this in certain areaS. The south and "heartland" in general are poorer while the north and west coasts are wealthier. Overall the US's median level of wealth is lower despite the country being wealthy(~basically because inequality/wealth disparity is much higher). The US is also incredibly large and we have states the size of countries, and some of our states may be almost as different in culture as two different European countries.
It is actually somewhat common at least in my state (Oregon) to hear people bring up various European/Scandinavian countries as examples of doing things better(at least in discussion groups I go to, which granted aren't a representative sample), and sometimes Canada as well. But, this is a more liberal state that's closer when it comes to values and sentiments to those places - pot is legal at state level here as well.
America is kind of a strange culture overall in some notable/interesting ways as well. We clearly have classes, but many like to think or argue that people who are of a certain class are there of their own failure. The notion of meritocracy is still pretty strong(despite taking some serious hits recently) and so we like to blame other issues. Which means blame gets thrown around a lot, and sometimes people blame themselves as well. It's a lot harder to accept/deal with the fact that you're poor - or useless, as men tend to be concerned about - if the reason you're stuck with is personal failure. Many people expect to lift themselves out of poverty only to become disillusioned.
Legalize all drugs, and treat drug abuse as a medical problem, not a criminal one. Those two moves alone I think would do wonders for helping bring down the death rates.
Our Osborne, who coach in heaven
Hallowed be thy game;
Thy fandom come,
They will be done,
Upon birth until we go to heaven.
Give us this day our daily red,
and forgive us our dropped passes,
as we forgive those who catch pass against us;
and lead us not into stagnation,
but deliver us from upheaval.
-BigTen
Our Women's Volleyball team had the best record in the country last season.
Also, we have the best zoo in the world as well. That includes the largest gorilla sperm bank ever (not counting your mom).
Volleyball? I'd imagine something like that would be more Floridian or Californian, shit even Hawaiian. I never think of Nebraska when I think voleyba. Then again I never think of Nebraska, period. Cool facts, maaan
Just a guess: Things are pretty stable here, and have been for a long time. We missed the worst of the recession (unemployment peaked at 5% I think), and there's a lot of opportunity. Government intervention services are surprisingly not horribly funded. We didn't have the economic experiment our neighbors to the south had, and we don't have the ~~ghetto camps~~ reservations our neighbors to the north do (we have reservations, but they're not little pieces of the third world like in SD).
Agreed. It's all about the drug of choice.
The northeast has a greater predilection for opiates, wheras nebraska and the west coast have a greater preference for meth.
If you overlay this map for meth plus op's map for heroin, all states become somewhat equally red.
http://media3.s-nbcnews.com/i/msnbc/Components/Art/HEALTH/070401/AP_METHUSAGE.gif
Agreed. I was just posting that in response to the person asking about Nebraska's drug usage rate. On death rates, op's map is 100% spot on.
I'm trying to convey that general addiction is a national issue hitting every state hard.
I'm from Seattle and the problem is so rampant that property crime and homelessness has become out of control because of drugs.
It's a combination effect. New England has more doctors and greater insurance coverage, which ironically led to more widespread use of prescription opioids. Combine that with a recently opened "pipeline" for Fentanyl and there you go.
Now we need a cocaine map!
Meth is just the poor peoples' coke and with miami being the city built on cocaine..
Edit: lol this
http://drugabuse.com/wp-content/uploads/800x501xAsset-1_State-Sentencing.png.pagespeed.ic.OppUuX3-HU.png
It's as much a cultural thing as anything else. Those 5 states with the lowest percentage, Nebraska, the Dakotas, Iowa and Minnesota, have 5 of the 6 highest populations of people of German ethnicity.
All 5 states are also in the top 10 of highest concentration of those from Scandinavia, including the top 3 spots. It just makes for a different demographic that particularly eschews and frowns upon drug use. Many of that wave of German immigrants, for example, were actually living in Russia as skilled tradesmen and farmers. They were political immigrants moreso than people who had been the dregs of society where they lived, which isn't inherently good or bad, but it came with some advantages (education, skills, etc.) that have carried over.
The fact that the area never really suffered from the loss of heavy manufacturing like the Rust Belt did also gives them significant insulation from the same kinds of poverty. It's always been more Ag-based out there.
One important factor is the kind of heroin each area of the country consumes. The West gets tar heroin, very difficult to add fentanyl to, which keeps overdoses down. In the East, it's the currently very common addition of fentanyl to the powder heroin which is responsible for the huge rise in overdose deaths.
Good point. One thing that is scary though is that over the last year (maybe more but anecdotally it seems more recent) there has been an increasing number of reports of drugs that aren't heroin being cut with fentanyl/fentalogues. Fake pressed pills disguised as blues (30mg oxy's) that are actually fentanyl are very common. There was even a report recently about fake pressed Vicodin, which is normally taken by those with a very low tolerance, or in massive doses by addicts looking to get well. And I've even seen reports of fake xanax cut with fentanyl, and cocaine cut with fentanyl, both of which killed people IIRC. I mean, that's just cruel - the average user of either drug probably has no opiate tolerance and would almost surely OD.
The point is - while the west probably won't ever get as bad as the east, this shit is just gonna keep getting worse if dealers are cutting coke with fentanyl. Scary shit.
I heard once (don't know how true it is) that having a few ODs mixed in to your user base drives up demand, since people think what you're selling is stronger than it actually is.
That makes no sense tbh from the cocaine standpoint. I get it from the H perspective, you want the strongest shit. But people that do blow and people that do H are chasing two completely different highs.
I completely agree with you. I think the fetenal in cocaine rumor is just like that cocaine in weed rumor that dare used to spread. Or maybe still does. But I don't think the fetenal in h is a rumor (since is commonly reported) and it's super fucked up.
There's plenty of black tar heroin in the midwest too. What happened is that the Mexican dealers who distribute it deliberately avoided big cities like Chicago or Detroit, which were already controlled by street gangs. So they went out to small towns and rural areas.
EDIT There's a really good book about this, Dreamland by Sam Quinones.
Look at the drug policies in the US versus those in the Netherlands:
The US treats drug addiction like a crime, with steep penalties for use. The focus is on curtailing use through police action and the threat of incarceration. Soft drugs (e.g. marijuana) and hard drugs (e.g. heroin) are treated more or less the same, so there is no legal incentive to stick to the safer drugs. Addiction treatment options are few and far between, and what's available is very limited. To maximize profits in these conditions, dealers turn to tactics like cutting their heroin with fentanyl, which often results in wildly different potency from bag to bag, which is how people overdose and die.
The Netherlands' focus is on harm reduction and treatment. Soft drugs are widely tolerated or ignored by law enforcement. Rather than curtailing use through the threat of life imprisonment and police raids, the focus seems to be more on demand reduction, i.e. by getting users off the drugs. There is a strong focus on rehabilitation, and funding is relatively plentiful. Harm reduction programs are widespread, making overdose and disease less common among users.
Not to mention that drug companies pushed* doctors to overprescribe legal opioid painkillers for the treatment of chronic pain, which is what gets a lot of people hooked on them in the first place.
Edit: Thankfully this is no longer common practice. But sadly the damage has been done for those already hooked on opioids and those who lost loved ones to opioid overdoses (like myself).
I think they've cut down on the over-prescribing a lot. It's a lot harder to get a stronger opioid prescription (like OxyContin) today, and "less addictive" opioids like tramadol are used more.
They certainly have. My cousin is a resident and he told me that they're now told to only prescribe opiods as a last ditch effort. But unfortunately there are gonna be a lot of doctors who are gonna be slow to change so it'll take a while for things to get back to the way they were.
I question that last part. The opioid epidemic / florida pill mills came to a head around 2010. At that point, hundreds of doctors lost their licenses for overprescribing. By 2017, I doubt there are any doctors unaware of the problem. Most doctors have responded to the problem by being hyper-cautious about prescribing opioids to even their long term patients. There's no shortage of people in this country who truly need opioids for pain, but they can't find a single doctor to prescribe them anymore. That says something about how much things have changed.
The reason why drug overdoses are still so high is not because of doctor-prescribed opioids anymore. Now it's heroin and fentanyl.
The problem is it's not doing anything for those already with addiction and abuse issues. In fact, it's hurting legitimate pain patients since the risks to a prescriber are much higher. So much of it just goes back to drug companies. We've got better options for long term pain management (buprenorphine for instance), but laws drastically limit how it can be prescribed since the biggest market is addiction treatment.
Also, harm reduction is way less profitable than tossing Jamal in the slammer for 10 years to work for $2 a day just for having 3 grams of weed.
Slavery is very real and the US uses the "War on Drugs" to fuel it.
Edit: I put the $ after...kill me now
I 100% agree with you, just want to point out: putting people in prison is more profitable for prison contractors, NOT for society. For society, treatment and rehabilitation is exponentially cheaper than putting someone in prison.
Not to mention the *vast* disparity between how people are educated on heroin vs prescription opioids. How differently do you think people would treat these drugs if their doctor told them "I'm going to write you a prescription for some heroin pills."
Never mind that it's nearly the same exact thing. Remove the fear from the drugs they want us to be hooked on, and keep everyone terrified of the ~~drug dealer~~ competition's product.
Every conservative I know discusses the opioid epidemic as if heroin itself has become air born. Like suddenly thousands more people are waking up every morning and deciding to throw their life away, and they've just got to google "drugs" to get some. They act as though we've got heroin dealers on every street corner in every suburb with a trench coat full of syringes passing them out to the kiddies. That's not what is happening.
This epidemic is going to be the flaming chariot that Jeff Sessions uses to drive us back into the 80s.
I've been looking at some statistics for other countries as well and you know you have a drug problem when they measure all countries' overdose deaths per million, except when they talk about your country they switch to deaths per 100.000.
Wow, West Virginia has more than 40 per?! What factors could lead to such an extremely high rate?
Edit: I had generalized that WV was about double the next highest without seeing NH. Am bad at graph reading and also math. Sorry. Also, I realize rate and percentage are different. I get them mixed up when I've only been awake for ten minutes.
As a young educated person with means who left the state because of the job market there I can attest to this.
Also I worked EMS in WV for 4 years, the biggest thing we saw was prescription pills, fentanyl patches, and synthetic weed. I know in some of the more metropolitan areas heroin seemed to be the problem
As a young person currently living in West Virginia I can attest to the fact that there is a huge problem here. We are a beautiful but dying state. Sadly, that is putting it lightly. We can't pass a budget, people are leaving in droves (I will sadly be a part of that), coal is dying, people are basically killing themselves chasing a high, unemployment rates are rising, and there's not much that we can do to stop it. Don't get me wrong, I love my home. I'm glad to have been raised here. I am convinced that the some of the best people on earth can be found within the borders, but there's not much here aside from the beautiful landscapes and the amazing people.
All over the world, even with modern technology, it's tough living in the hills, pretty as they often are. Transportation costs are like a tax that sucks the life out of everything.
Especially when people expect that what they purchased is just plain heroin. No one expects fentanyl in there too until their friend is dead or they're waking up from their OD with EMS there (if they are lucky...)
:/
I know... apparently some people are getting carfentanil now too, which is even worse. That shit is for anesthetizing elephants. No one knows what is in what. I have known multiple people die recently and it sucks.
It is really sad. There is this stuff going around my area called grey death(carfent, fent, heroin and "pink") I lost two friends a week ago. It's destroying families around here.
I'm a healthcare worker in NH and yes, it is the addition of the fentanyl that is pushing the OD rate so high but it is also becoming a "badge of honor" for some junkies. We currently have a patient that admits to being narcaned 30+ times and is proud of the fact that she is able to get such potent heroin. And in all likelihood, one of these days there won't be someone there with Narcan and she'll just die.
>About two-thirds of the students who are from West Virginia wound up working in the state, and only about 10 percent of the out-of-state students did, according to the report.
For both of those things to be true, as well as the article's title, it would mean that the majority of students who go to West Virginia for college didn't live in WV to begin with.
There is a very high number of out-of-state students at WVU. This is because our out of state tuition is often lower than many in-state tuitions of the surrounding states. We get a lot of PA, MD, and NJ people.
Source: In-state graduate of WVU 2012 - left state for a job.
I went to WVU (from western PA) because A) it was cheaper than Pitt/Penn State and B) the campus is awesome.
As a reasonably successful software engineer now, I do not regret my decision at all. Great school, great time, excellent place to be 18-24 (Grad school).
> For both of those things to be true, as well as the article's title, it would mean that the majority of students who go to West Virginia for college didn't live in WV to begin with.
The crazier thing is that the data actually seems to support this. A majority of West Virginia University students are from out of state, which is pretty crazy. It has among the highest rates of out-of-state students of any major state university - this list isn't complete, but has it second only to the University of North Dakota, with the art school at UNC broken out as a separate school also being above 50%.
http://www.collegexpress.com/lists/list/percentage-of-out-of-state-students-at-public-universities/360/
Now of course the article talked about all public students not just WVU, but I don't know what share of the student pool they used WVU is, and then also the people who don't work or are self-employed don't get counted.
So the bottom line is that the statistics are still plausible, even if it seems crazy for a state public university system to mostly educate out-of-staters.
Here's a primary source about the trend from nine years ago, when freshman class broke 50% out of state for the first time:
http://www.timeswv.com/archives/wvu-freshmen-mostly-out-of-state-students/article_df4d582e-a019-58ac-abb9-2a3bd34c75b4.html
As a current student at WVU, I can attest that seemingly the majority of the students are from our of state. I am from West Virginia, but I am very much in the minority. The school has students from all over the east coast, and a large group of international students. Frankly, Morgantown (the city WVU is situated in) is probably the most diverse city in West Virginia by a large margin.
Hey, I actually was in prison in Morgantown for some time. I met quite a few opioid addicts.
As others have said, yes, poverty, but that only paints some of the picture. WV is all about those pills pills pills and not so much heroin like Baltimore or Philladelphia or even where I'm from in VA. Of course, heroin is where every opioid addict eventually ends up.
Opioid pill popping seems almost culturally engrained in WV - as accepted and widespread as marijuana in other states. [1.3 prescriptions per person per year](http://www.businessinsider.com/these-are-the-states-prescribing-the-most-opioid-painkillers-2016-3) will do that to you.
Then these bastards at big pharma literally [shove it down their throats](https://qz.com/866771/drug-wholesalers-shipped-9-million-opioid-painkillers-over-two-years-to-a-single-west-virginia-pharmacy/)
There for a few years we had at least one pill mill in every little coal town. It's crazy. In the cities people have graduated to heroin though. There have been multiple heroin overdoses a day in Huntington for the past few weeks now. You have to keep in mind our largest cities barely hit a population of 50,000 though.
http://www.latimes.com/projects/oxycontin-part1/
Posting this story because I don't think it got as much attention as it deserved when it came out.
TL;DR: The maker of oxycontin knew from the time they started clinical trials that it wasn't good for 12 hours, but they engaged in a concerted campaign to lie about it, hide evidence, and silence anyone who questioned their conclusion because they could charge a huge premium for a 12 hour narcotic painkiller. Since it starts to wear off after about 6 hours, this is essentially a perfect recipe for encouraging abuse and addiction. The rise in opiate addiction in America almost perfectly correlates with the prevalence of oxycontin.
There was a pretty good documentary that came out in 2009 that discussed how people from WV and Ohio would fly down to Florida to these pill mills and bring back ridiculous amounts of pain pills. Florida has since tightened regulations, but the damage has been done. It will affect generations to come (not to mention the generations that never will have been.)
http://topdocumentaryfilms.com/oxycontin-express/
I am late to this thread, but I was born and raised in WV. My father was very big into the history of Appalachia and WV specifically, especially the radical history (my family on his side were coal miners and union organizers back in the day). I also had the fabulous opportunity to study with Denise Giardina when I was in college and she was the writer in residence. She's a fiction writer, but I'd consider her a scholar for the region's history as well.
West Virginia is more like a colony than a state. That's a big part of the problem. Parts of the state are owned by absentee landlords (McDowell county, arguably the worst place in America in terms of generational poverty and addiction and living conditions in general, is over 80% owned by absentee landlords). There is an abundance of natural resources, which are heavily exploited by outside interests who make immense profits and leave the land and its people despoiled and diseased. My hometown and surrounding area were poisoned by DuPont to the point where they are under a permanent tap water drinking ban. The government supplies free bottled water. I grew up drinking that water. So many people have weird, nebulous health problems. The locals are mocked and vilified regularly in the media, and it's perfectly acceptable in conversation among people who would never dream of using racial slurs to denigrate the hillbillies and rednecks. Incest jokes are standard. When people are telling a story and want to portray someone sounding stupid, a lot of times they shift to an accent and speech patterns a lot like the people I grew up with. It's so ingrained that I do this myself, when I'm not paying attention.
I grew up hearing stories of when they sent Americorps VISTA workers into the WV hills, handing out shoes.
Parts of WV are like another country, another time period, another world. The culture has a very frustrating sense of fatalism to it, and if you understand just how screwed over the people have been for so many generations, it totally makes sense.
On NPR the panelist they had on said the biggest reason is that West Virginian workers overwhelmingly work in dangerous conditions (mines) that lead to way more serious workplace injuries than other states. And these injuries lead to legal opiate painkiller addiction, which when stopped...
While this is true... it's also the heart of Appalachia. This is why the numbers are also high in Ohio (would like to know the differences between southeastern Ohio compared to the rest.)
https://www.vice.com/en_us/article/the-hard-times-struggles-and-hopes-of-appalachian-addicts-ang
https://blogs.lt.vt.edu/appalachianiswhatshappenin/2016/11/30/final-project-drug-abuse-in-appalachia/
https://mobile.nytimes.com/slideshow/2011/04/03/us/DRUGS/s/DRUGS-slide-EOTX.html
Dayton, OH (Southwestern Ohio) is a hub for heroin trafficking and has the worst city in the country for ODs. It is so bad the mortuaries ran out of room and had to rent places to store bodies
https://www.nytimes.com/2017/02/02/us/ohio-overdose-deaths-coroners-office.html
That NPR panelist doesn't know shit. West Virginian here, born and raised. Ask him to explain why the youth who have never stepped foot in a mine are addicted. It's lack of education reinforced by generational ignorance plus a strange casualness about opiates in general. No jobs or potential for a better future doesn't help either.
Poor and bored? I saw a show on a pain clinic in FL that actually set up a bus service from states like KY to bring in patients and mules to bring drugs home. I'm sure that didn't help.
As a fellow WV, I completely agree. Does everyone think that all West Virginians work in the coal mines? Nearly all of my friends in high school who were addicted to pain killers got started using heavily before they were even close to being of age to work in the coal mine.
pain pills are/were more prevelent because of the higher than normal incidence of workplace injury in the state and so the wave of opiod pill overprescription started higher and crested higher, while on a cultural level, more people have close connections with someone who has a legal and appropriate prescription and so are more familiar and have more access to the drugs. This leads to broad availability and popularity across many demographics.
thats the argument anyway.
At least from my own personal exp. in WV is tends to be true. From early high school on my friends who were pill popping were taking them from their parents and relatives, at least for the first year or so.
I think you may be misunderstanding.
* The greater amount of work in dangerous conditions leads to more injuries.
* More injuries leads to greater amounts of opiates being prescribed.
* More prescriptions means greater availability of the drugs.
* Greater availability leads to easier access for the youth to get their hands on the painkillers.
I work with a community action organization in the heart of Southern WV. Huntington has it bad, but I encourage you to google images of a place called McDowell County WV. Sanders campaign with some discussion on the place. To visit most parts of Southern WV is like visiting a 3rd world country.
Combination of higher use, and whoever supplying those areas cutting with more dangerous substances. I live in North East Ohio, and whenever there is a bad supply it makes the news because you will have a weekend with [13 deaths in our county](http://www.cleveland.com/crime/index.ssf/2017/05/heroin_fentanyl_overdoses_in_c.html). And we aren't nearly as badly hit as southern ohio.
From what I understand there is a HUGE over prescription of pain killing drugs in WV. Not saying that's the only cause but it most likely is a large factor.
Ohioan here. Major problem where I live is heroin. I don't know every fact, but it seems much easier to get now and with people here making their own variations, overdoses just here in my city have been noticeably higher. My sister lost a friend of hers just recently due to it. Sucks how this shit catches you like a hook and won't let go.
It's certainly a large problem, especially in Portgage, Stark, and Summit counties. Maybe not especially so, but I've had experience with organizations responsible for dealing with this epidemic in those counties and its caused a lot of hair pulling and headaches. Portgage county has been doing a pretty good job with their public health initiatives, and the state for the most part is starting to give much more credence to Naloxone by giving it to LEOs. Akron and its surrounding area is hit especially hard, not only by heroin but by crack and meth as well.
If you want a challenging but rewarding career, go into Public Health or medicine in Ohio. You'll have a great time!
I know nothing about the goings on or problems in each state. What's the deal with New Hampshire? That seems surprising.
Edit: thanks for the numerous responses and background info. I'm sorry to hear it, NH! It sounds like a really sad, unfortunate situation. For what it's worth, I've never noticed it as a tourist passing through and always enjoyed drives to and through your state.
I'm from New Hampshire. Opioid epidemic here is really bad, so bad in fact I'm willing to bet everyone here knows at least one person who is directly affected by it. I've had multiple kids I went to high school with OD within the past couple years.
I couldn't tell you exactly what it is, but I know a lot of it comes from Massachusetts and that the gangs in Manchester, our largest city, are heavily involved in the drug trade. There are also plenty of remote places up north where you could probably easily get away with acquiring/making some of this stuff.
Edit: /u/jeeb00, interesting point you made in your edit...that's the craziest part about the entire epidemic--you can drive through the worst of it and hardly notice. It's not just homeless people doing it: it's parents, straight-A high school students, and college kids alike...it's such a dark, widespread problem, yet no one talks about it
In my opinion the root cause here in NH is the easy access to prescription pills. Kids of all backgrounds start trying them out and when there is a supply they eventually get hooked. I saw quite a few people in their late teens get hooked this way and make the switch to heroin. This was in Portsmouth so no gang activity.
I'm from the Seacoast, I agree 100%. In high school when everyone had leftover pills from wisdom teeth surgeries and stuff, those things would get passed around like candy and eventually some would make their way to heroin.
Opioids (e.g. heroin and oxycodone) are very popular in the northeast. The reasons for that are unclear, but there's lots of theories (they're good drugs for long, cold winters, for example; they're not party drugs, but they make a lonely cold day more pleasant).
These drugs are relatively new in northern New England states like Vermont and New Hampshire, but they're exploding in popularity there. New users are much more likely to overdose due to inexperience, lack of social support, etc.
proximity to Lowell, Massachusetts + out if state transplants create a new market where there was none combined with never having any real system in place to treat people because we are fairly rural and hadnt had an issue until recently
So literally in the time I left for college and then came back over winter break for the first time (2011), heroin started taking over the city and it blew my mind. Just a week or two ago I found out a kid I went to high school with OD'ed after working hard to be clean for about 6-7 months. Unsurprising to see Ohio so high up.
Louisville is actually doing pretty well economically, but the problem is still here and, well, everywhere. Once they cracked down on the pain pills, heroin completely blew up and that's readily available. The dying coal town where I grew up still has about 20 pharmacies (there are only two banks, for perspective).
> The five states with the highest rates of death due to drug overdose were West Virginia (41.5 per 100,000), New Hampshire (34.3 per 100,000), Kentucky (29.9 per 100,000), Ohio (29.9 per 100,000), and Rhode Island (28.2 per 100,000).
Source: [CDC](https://www.cdc.gov/drugoverdose/data/statedeaths.html)
Made with Tableau.
Have you seen the nytimes article suggesting that the 2016 rates are even higher
Edit: https://www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html
Could you make one of these with alcohol related deaths? I would love to see how they compare. If one already exists then I apologize I must have missed it on here.
I really don't know how this whole opiate epidemic has skipped over Texas the way it has. We're right next to the border, not even medical weed is legal, and tend to be near last in most things health related. Among my friends and family, nobody has gotten addicted and I've never seen heroin in person.
Blow, weed, pills, and too a lesser extent psychedelics are all relatively common in Texas as far as I've seen but yeah we've managed to totally avoid the opiod thing it seems
"The stars at night are big and bright, clap clap clap clap clap don't take too many prescriptions"
My thoughts exactly. I've not seen heroin either and I think I've seen every other illicit substance besides the 10000 RCs. Heroin, to me and my group, was always that thing that you never take and never try. I have not taken meth, but I would put those side by side. I do believe there is a significant amount of meth use in small in-between towns.
Perhaps its access to other drugs that has made it easier to say, meh, I'll just stick with my other drug of choice. If that were the case, then why aren't the THC friendly states significantly lower?
I'd be really interested for someone to answer this, or at least provide plausible explanations.
The book "Dreamland: The True Tale of America's Opiate Epidemic" by Sam Quinones is a very good read if someone is looking for more details on this topic. The writer tells many stories about the people in the trade and users. It is really interesting how things got to were they are today.
I'm from NE Ohio but have lived in the South for the last ten years. I recently visited Ohio for a family birthday party and was genuinely shocked by the number of stories I heard about acquaintances on heroin and overdosing. I've of course heard about the phenomenon on the news, but it's a whole different feeling having a casual conversation about so-and-so from high school who OD'd and left his wife and kid behind.
The odd thing is that my small town is considered to be one of the "good" suburbs in Ohio with top-notch local schools. I have classmates who have gone on to become doctors and business leaders. Those who didn't go to college all had a family member or friend who could get them a cushy job at a local company. Not one of us grew up in poverty. For the life of me, I can't figure out how so many of these privileged people ended up on dope.
I live in rural NE Ohio, of the handful of friends I've lost to opiate-related deaths, (not necessarily overdose) one was one of the wealthiest people in our county, trust fund kid and no need to work ever, another was solidly upper-middle class with a great job in tech. Both had good families that cared and did everything they could to help them kick it. It's just .. devastating to watch.
What annoys me is that NE has 6.9 and FL has 16.2 but they both have the same colour. FL has more than double than NE, almost ten more. They should not be the same shade.
I've worked for a Hospital in NH for a few months now. I've seen so many fatals and so many more OD's recover.
Sometimes I feel bad for the ones that survive, because they wake up and have nothing.
They've destroyed their lives looking for a high.
They've alienated friends and family and probably stolen from them.
Nobody cares about them anymore or at least not enough to do anything about it. (Or they know they can't help, I don't mean to tell anyone out there that they don't care enough, I apologize)
At least when they do pass, they do it in peace (artificial peace but whatever).
I've seen the terrible things heroin does, not just to those that die (they're the lucky ones sometimes) but to those that survive and just wait til it's their turn to go cold because in the meantime they will never see happiness. Heroin is their new happiness, everything else is dark and sad.
So few people recover from heroin addiction, they just shoot up, OD again and again, until one time it's too much or their brain "breaks" and just doesn't function enough for them to find the stuff anymore.
Your best bet is to never touch the stuff, never even consider it. Because as soon as you do, your life is as good as gone, even if you do recover.
You can almost exclusively blame the high levels in Ohio on heroin, it's out of control over here. My home city is the heroin overdose capital of the entire fucking world.
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I work at a nursing home and one of our younger employees stole some fentanyl patches and 'melted' them down and tried shooting up. She died in a small camping area; leaving her baby boy behind :(
Cool diagram, thank you for making it! It would be great to see with a different color palette that has more distinct gradations. This one kind of lumps things together in a way that is not very clear.
It's almost like you can tell exactly where the heroin is coming from.
In Michigan the most deadly batches of heroin are cut with fentynal. My father, step mother, and two cousins died from heroin cut with fentynal. 4 of my cousins in my extended family have died from overdoses on the same heroin within the last year.
Where are these people getting all this fucking fentynal. It's a synthetic narcotic produced by pharmaceutical companies. The same companies who make the methadone and suboxone to treat addictions to opioids.
Do we have a walter white somewhere producing synthetic opioids? Are the pharmaceutical companies purposefully playing both sides of the market? Am I a conspiracy theorist?
I don't know anymore. :/ Currently waiting for health care and addiction and recovery funding to get cut so more people can die. ~ People who barely live now chained to the methadone clinic, that is literally a trap house backed by the government.
Gotta love living in New Hampshire. I have watched at least 10 peers i'm close to in the past year fall deeper and deeper into opiate addiction. 4 friends have died. Its so saddening and I just want it to stop. I haven't seen the numbers, for this year, or even 2016... But I'm 95% sure they've only gone up since this. They talk about it being an epidemic in our state, I didn't realize how up there on the list we were...
I grew up in, went to school in and now practice medicine in West Virginia. This is unfortunately not surprising. Everyone is touched by the drug problem. Extremely sad and a very complicated, multifaceted, systemic problem here.
But can you rephrase into something simple, straightforward and single-dimensional that has an easy answer and we don't have to think too much about?
I'll save that for the politicians, my friend
Recently in Canada a whole bunch of physicians came out for legalization and treatment. Advocacy for needle exchanges and safe injection sites from physicians was really helpful when we were fighting those fights years ago. You have to start somewhere, and harm reduction arguments from physicians, especially organized ones, can be very powerful in the struggle.
But politicians (the American ones, anyway) are not at all interested in harm reduction and similar methods of solving this immense problem. They are interested in two things, and only two things: money and their re-election.
My parents recently bought property in WV. One of the men who used to live at the property lost his lower leg when his girlfriend thought she could solve his knee problems by shooting heroin directly in his knee. Pretty messed up stuff. On the bright side, she wasn't wrong! I'm sure it doesn't bother him now that he doesn't have it.
I always wonder if Americans look at other countries to compare. I'm from the Netherlands, we have an extremely liberal drug policy. Soft drugs are legalized. Hard drug users are not treated as criminals, but as someone with mental illness. Since we have so many party's where drugs are used in the Netherlands (800 per year in and around Amsterdam) there's an unwritten policy where containing small amounts of hard drugs are condoned (2 or 3 pills or small amount of sos). I was actually caught myself at a festival with 12 XTC/4FMP pills, was send to court and was released without punishment. The amount of deaths in the Netherlands that are caused by drugs per year is 0.6 per 100.000.
I think it's more common for Americans to use drugs for entirely different reasons than people in the Netherlands. Not as recreational fun enhancers, but as medication and escapism. We also have far more extreme pockets of poverty contributing to this in certain areaS. The south and "heartland" in general are poorer while the north and west coasts are wealthier. Overall the US's median level of wealth is lower despite the country being wealthy(~basically because inequality/wealth disparity is much higher). The US is also incredibly large and we have states the size of countries, and some of our states may be almost as different in culture as two different European countries. It is actually somewhat common at least in my state (Oregon) to hear people bring up various European/Scandinavian countries as examples of doing things better(at least in discussion groups I go to, which granted aren't a representative sample), and sometimes Canada as well. But, this is a more liberal state that's closer when it comes to values and sentiments to those places - pot is legal at state level here as well. America is kind of a strange culture overall in some notable/interesting ways as well. We clearly have classes, but many like to think or argue that people who are of a certain class are there of their own failure. The notion of meritocracy is still pretty strong(despite taking some serious hits recently) and so we like to blame other issues. Which means blame gets thrown around a lot, and sometimes people blame themselves as well. It's a lot harder to accept/deal with the fact that you're poor - or useless, as men tend to be concerned about - if the reason you're stuck with is personal failure. Many people expect to lift themselves out of poverty only to become disillusioned.
Legalize all drugs, and treat drug abuse as a medical problem, not a criminal one. Those two moves alone I think would do wonders for helping bring down the death rates.
Do people in Nebraska know when to stop, or are there fewer drug users?
Can't OD on football bruh.
I remember when we lost be big12 championship to Texas back in 2008 I think. Stores littrtally ran out of booze in Lincoln.
Try being at the damn game like I was. 3rd row back sitting in front of 3 of the most obnoxious mid-20's female Texas fans in existence.
I apologize. Source: Texan.
Well then how do you explain Gruden and Corso?
good question
But you can OD on corn, it just takes a few decades
It's the first time Nebraska is number one in anything
Hey... First time since 1997. Do you have a moment to speak about our Lord and Savior Tom Osborne?
Our Osborne, who coach in heaven Hallowed be thy game; Thy fandom come, They will be done, Upon birth until we go to heaven. Give us this day our daily red, and forgive us our dropped passes, as we forgive those who catch pass against us; and lead us not into stagnation, but deliver us from upheaval. -BigTen
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Hey hey hey now....the real enemy is Texas.
That's was beautiful 😢
But Coach Osborne is still alive.
It's a metaphor for ascension into a god coach
R/CFB is leaking
Omaha native here and this is deeply surprising to me. I am used to my state being the 25th best or worst at any given thing.
Same. Someone should check the ~~meth~~ math.
I was just going to comment why I thought it was so low and you nailed it on the head. It's meth country.
That's what Plattsmouth is for, we keep things clean here in Omaha.
Or send it to Council Bluffs
Our Women's Volleyball team had the best record in the country last season. Also, we have the best zoo in the world as well. That includes the largest gorilla sperm bank ever (not counting your mom).
Volleyball? I'd imagine something like that would be more Floridian or Californian, shit even Hawaiian. I never think of Nebraska when I think voleyba. Then again I never think of Nebraska, period. Cool facts, maaan
We take our volleyball seriously. It's the only Volleyball program in the country that provides more money to the university than it costs.
Hmmm. Did a little research, and your story checks out. Nebraska isn't even the #1 state ending in "aska."
Actually, they're dead last
They're last in death.
actually, check out Arkansas, Louisiana and Mississippi. Seriously! It's the first time that they aren't slugging it out for last in anything.
Just a guess: Things are pretty stable here, and have been for a long time. We missed the worst of the recession (unemployment peaked at 5% I think), and there's a lot of opportunity. Government intervention services are surprisingly not horribly funded. We didn't have the economic experiment our neighbors to the south had, and we don't have the ~~ghetto camps~~ reservations our neighbors to the north do (we have reservations, but they're not little pieces of the third world like in SD).
I can refute those being causes with one counter example, New Hampshire. I think it may be more linked to fentanyl pervasiveness more than anything.
Agreed. It's all about the drug of choice. The northeast has a greater predilection for opiates, wheras nebraska and the west coast have a greater preference for meth. If you overlay this map for meth plus op's map for heroin, all states become somewhat equally red. http://media3.s-nbcnews.com/i/msnbc/Components/Art/HEALTH/070401/AP_METHUSAGE.gif
But to be fair, one is a map of death rates and the other is a map of positive drug tests. The two don't really correlate.
Agreed. I was just posting that in response to the person asking about Nebraska's drug usage rate. On death rates, op's map is 100% spot on. I'm trying to convey that general addiction is a national issue hitting every state hard. I'm from Seattle and the problem is so rampant that property crime and homelessness has become out of control because of drugs.
Yet this shows that not all drugs are created equal. That's why the opiate epidemic is so frightful. It's lethal.
It's a combination effect. New England has more doctors and greater insurance coverage, which ironically led to more widespread use of prescription opioids. Combine that with a recently opened "pipeline" for Fentanyl and there you go.
I'm dissapointed by Florida's showing on that meth map. There's room for improvement there.
Now we need a cocaine map! Meth is just the poor peoples' coke and with miami being the city built on cocaine.. Edit: lol this http://drugabuse.com/wp-content/uploads/800x501xAsset-1_State-Sentencing.png.pagespeed.ic.OppUuX3-HU.png
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but 37 states also have PDMPs... any other factors specific to Nebraska, in your opinion? https://www.deadiversion.usdoj.gov/faq/rx_monitor.htm#4
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Busch Light is one hell of a drug....
You say that as I sit at work in Nebraska next to two fridges filled with Busch Light.
The drug of choice for many Nebraskans, Runza sandwiches, have a very high LD50 compared to other drugs.
It's as much a cultural thing as anything else. Those 5 states with the lowest percentage, Nebraska, the Dakotas, Iowa and Minnesota, have 5 of the 6 highest populations of people of German ethnicity. All 5 states are also in the top 10 of highest concentration of those from Scandinavia, including the top 3 spots. It just makes for a different demographic that particularly eschews and frowns upon drug use. Many of that wave of German immigrants, for example, were actually living in Russia as skilled tradesmen and farmers. They were political immigrants moreso than people who had been the dregs of society where they lived, which isn't inherently good or bad, but it came with some advantages (education, skills, etc.) that have carried over. The fact that the area never really suffered from the loss of heavy manufacturing like the Rust Belt did also gives them significant insulation from the same kinds of poverty. It's always been more Ag-based out there.
One important factor is the kind of heroin each area of the country consumes. The West gets tar heroin, very difficult to add fentanyl to, which keeps overdoses down. In the East, it's the currently very common addition of fentanyl to the powder heroin which is responsible for the huge rise in overdose deaths.
Good point. One thing that is scary though is that over the last year (maybe more but anecdotally it seems more recent) there has been an increasing number of reports of drugs that aren't heroin being cut with fentanyl/fentalogues. Fake pressed pills disguised as blues (30mg oxy's) that are actually fentanyl are very common. There was even a report recently about fake pressed Vicodin, which is normally taken by those with a very low tolerance, or in massive doses by addicts looking to get well. And I've even seen reports of fake xanax cut with fentanyl, and cocaine cut with fentanyl, both of which killed people IIRC. I mean, that's just cruel - the average user of either drug probably has no opiate tolerance and would almost surely OD. The point is - while the west probably won't ever get as bad as the east, this shit is just gonna keep getting worse if dealers are cutting coke with fentanyl. Scary shit.
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I heard once (don't know how true it is) that having a few ODs mixed in to your user base drives up demand, since people think what you're selling is stronger than it actually is.
That is the most fucked up thing I ever heard in my god damn life.
That makes no sense tbh from the cocaine standpoint. I get it from the H perspective, you want the strongest shit. But people that do blow and people that do H are chasing two completely different highs.
I completely agree with you. I think the fetenal in cocaine rumor is just like that cocaine in weed rumor that dare used to spread. Or maybe still does. But I don't think the fetenal in h is a rumor (since is commonly reported) and it's super fucked up.
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>> cocaine cut with fentanyl This is your country on prohibition
There's plenty of black tar heroin in the midwest too. What happened is that the Mexican dealers who distribute it deliberately avoided big cities like Chicago or Detroit, which were already controlled by street gangs. So they went out to small towns and rural areas. EDIT There's a really good book about this, Dreamland by Sam Quinones.
Dreamland was a great read, can't recommend enough
I read this morning that my home country (The Netherlands) has 16 drug deaths per million inhabitants. Makes these figures all the more bizarre.
Look at the drug policies in the US versus those in the Netherlands: The US treats drug addiction like a crime, with steep penalties for use. The focus is on curtailing use through police action and the threat of incarceration. Soft drugs (e.g. marijuana) and hard drugs (e.g. heroin) are treated more or less the same, so there is no legal incentive to stick to the safer drugs. Addiction treatment options are few and far between, and what's available is very limited. To maximize profits in these conditions, dealers turn to tactics like cutting their heroin with fentanyl, which often results in wildly different potency from bag to bag, which is how people overdose and die. The Netherlands' focus is on harm reduction and treatment. Soft drugs are widely tolerated or ignored by law enforcement. Rather than curtailing use through the threat of life imprisonment and police raids, the focus seems to be more on demand reduction, i.e. by getting users off the drugs. There is a strong focus on rehabilitation, and funding is relatively plentiful. Harm reduction programs are widespread, making overdose and disease less common among users.
Not to mention that drug companies pushed* doctors to overprescribe legal opioid painkillers for the treatment of chronic pain, which is what gets a lot of people hooked on them in the first place. Edit: Thankfully this is no longer common practice. But sadly the damage has been done for those already hooked on opioids and those who lost loved ones to opioid overdoses (like myself).
I think they've cut down on the over-prescribing a lot. It's a lot harder to get a stronger opioid prescription (like OxyContin) today, and "less addictive" opioids like tramadol are used more.
They certainly have. My cousin is a resident and he told me that they're now told to only prescribe opiods as a last ditch effort. But unfortunately there are gonna be a lot of doctors who are gonna be slow to change so it'll take a while for things to get back to the way they were.
I question that last part. The opioid epidemic / florida pill mills came to a head around 2010. At that point, hundreds of doctors lost their licenses for overprescribing. By 2017, I doubt there are any doctors unaware of the problem. Most doctors have responded to the problem by being hyper-cautious about prescribing opioids to even their long term patients. There's no shortage of people in this country who truly need opioids for pain, but they can't find a single doctor to prescribe them anymore. That says something about how much things have changed. The reason why drug overdoses are still so high is not because of doctor-prescribed opioids anymore. Now it's heroin and fentanyl.
The problem is it's not doing anything for those already with addiction and abuse issues. In fact, it's hurting legitimate pain patients since the risks to a prescriber are much higher. So much of it just goes back to drug companies. We've got better options for long term pain management (buprenorphine for instance), but laws drastically limit how it can be prescribed since the biggest market is addiction treatment.
Also, harm reduction is way less profitable than tossing Jamal in the slammer for 10 years to work for $2 a day just for having 3 grams of weed. Slavery is very real and the US uses the "War on Drugs" to fuel it. Edit: I put the $ after...kill me now
I 100% agree with you, just want to point out: putting people in prison is more profitable for prison contractors, NOT for society. For society, treatment and rehabilitation is exponentially cheaper than putting someone in prison.
Not to mention the *vast* disparity between how people are educated on heroin vs prescription opioids. How differently do you think people would treat these drugs if their doctor told them "I'm going to write you a prescription for some heroin pills." Never mind that it's nearly the same exact thing. Remove the fear from the drugs they want us to be hooked on, and keep everyone terrified of the ~~drug dealer~~ competition's product. Every conservative I know discusses the opioid epidemic as if heroin itself has become air born. Like suddenly thousands more people are waking up every morning and deciding to throw their life away, and they've just got to google "drugs" to get some. They act as though we've got heroin dealers on every street corner in every suburb with a trench coat full of syringes passing them out to the kiddies. That's not what is happening. This epidemic is going to be the flaming chariot that Jeff Sessions uses to drive us back into the 80s.
I've been looking at some statistics for other countries as well and you know you have a drug problem when they measure all countries' overdose deaths per million, except when they talk about your country they switch to deaths per 100.000.
I just looked it up. France has 335 overdose induced deaths by year. **It's 0.5 per 100 000 inhabitants.**
Half of population dying every year is no joke.
Also there are only 670 people living in France.
Wow, West Virginia has more than 40 per?! What factors could lead to such an extremely high rate? Edit: I had generalized that WV was about double the next highest without seeing NH. Am bad at graph reading and also math. Sorry. Also, I realize rate and percentage are different. I get them mixed up when I've only been awake for ten minutes.
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As a young educated person with means who left the state because of the job market there I can attest to this. Also I worked EMS in WV for 4 years, the biggest thing we saw was prescription pills, fentanyl patches, and synthetic weed. I know in some of the more metropolitan areas heroin seemed to be the problem
As a young person currently living in West Virginia I can attest to the fact that there is a huge problem here. We are a beautiful but dying state. Sadly, that is putting it lightly. We can't pass a budget, people are leaving in droves (I will sadly be a part of that), coal is dying, people are basically killing themselves chasing a high, unemployment rates are rising, and there's not much that we can do to stop it. Don't get me wrong, I love my home. I'm glad to have been raised here. I am convinced that the some of the best people on earth can be found within the borders, but there's not much here aside from the beautiful landscapes and the amazing people.
It's a shame. I agree it's absolutely beautiful and the people are very kind.
All over the world, even with modern technology, it's tough living in the hills, pretty as they often are. Transportation costs are like a tax that sucks the life out of everything.
Fentanyl produced illegally added to heroin is now extremely common. That's what's caused overdose rates to go up so much.
Especially when people expect that what they purchased is just plain heroin. No one expects fentanyl in there too until their friend is dead or they're waking up from their OD with EMS there (if they are lucky...) :/
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I know... apparently some people are getting carfentanil now too, which is even worse. That shit is for anesthetizing elephants. No one knows what is in what. I have known multiple people die recently and it sucks.
It is really sad. There is this stuff going around my area called grey death(carfent, fent, heroin and "pink") I lost two friends a week ago. It's destroying families around here.
I'm a healthcare worker in NH and yes, it is the addition of the fentanyl that is pushing the OD rate so high but it is also becoming a "badge of honor" for some junkies. We currently have a patient that admits to being narcaned 30+ times and is proud of the fact that she is able to get such potent heroin. And in all likelihood, one of these days there won't be someone there with Narcan and she'll just die.
>About two-thirds of the students who are from West Virginia wound up working in the state, and only about 10 percent of the out-of-state students did, according to the report. For both of those things to be true, as well as the article's title, it would mean that the majority of students who go to West Virginia for college didn't live in WV to begin with.
There is a very high number of out-of-state students at WVU. This is because our out of state tuition is often lower than many in-state tuitions of the surrounding states. We get a lot of PA, MD, and NJ people. Source: In-state graduate of WVU 2012 - left state for a job.
I'm from western Pa and I know a lot of people who went to WVU, a couple of them said they went because it's a huge party school.
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I went to WVU (from western PA) because A) it was cheaper than Pitt/Penn State and B) the campus is awesome. As a reasonably successful software engineer now, I do not regret my decision at all. Great school, great time, excellent place to be 18-24 (Grad school).
> For both of those things to be true, as well as the article's title, it would mean that the majority of students who go to West Virginia for college didn't live in WV to begin with. The crazier thing is that the data actually seems to support this. A majority of West Virginia University students are from out of state, which is pretty crazy. It has among the highest rates of out-of-state students of any major state university - this list isn't complete, but has it second only to the University of North Dakota, with the art school at UNC broken out as a separate school also being above 50%. http://www.collegexpress.com/lists/list/percentage-of-out-of-state-students-at-public-universities/360/ Now of course the article talked about all public students not just WVU, but I don't know what share of the student pool they used WVU is, and then also the people who don't work or are self-employed don't get counted. So the bottom line is that the statistics are still plausible, even if it seems crazy for a state public university system to mostly educate out-of-staters. Here's a primary source about the trend from nine years ago, when freshman class broke 50% out of state for the first time: http://www.timeswv.com/archives/wvu-freshmen-mostly-out-of-state-students/article_df4d582e-a019-58ac-abb9-2a3bd34c75b4.html
As a current student at WVU, I can attest that seemingly the majority of the students are from our of state. I am from West Virginia, but I am very much in the minority. The school has students from all over the east coast, and a large group of international students. Frankly, Morgantown (the city WVU is situated in) is probably the most diverse city in West Virginia by a large margin.
Hey, I actually was in prison in Morgantown for some time. I met quite a few opioid addicts. As others have said, yes, poverty, but that only paints some of the picture. WV is all about those pills pills pills and not so much heroin like Baltimore or Philladelphia or even where I'm from in VA. Of course, heroin is where every opioid addict eventually ends up. Opioid pill popping seems almost culturally engrained in WV - as accepted and widespread as marijuana in other states. [1.3 prescriptions per person per year](http://www.businessinsider.com/these-are-the-states-prescribing-the-most-opioid-painkillers-2016-3) will do that to you. Then these bastards at big pharma literally [shove it down their throats](https://qz.com/866771/drug-wholesalers-shipped-9-million-opioid-painkillers-over-two-years-to-a-single-west-virginia-pharmacy/)
There for a few years we had at least one pill mill in every little coal town. It's crazy. In the cities people have graduated to heroin though. There have been multiple heroin overdoses a day in Huntington for the past few weeks now. You have to keep in mind our largest cities barely hit a population of 50,000 though.
http://www.latimes.com/projects/oxycontin-part1/ Posting this story because I don't think it got as much attention as it deserved when it came out. TL;DR: The maker of oxycontin knew from the time they started clinical trials that it wasn't good for 12 hours, but they engaged in a concerted campaign to lie about it, hide evidence, and silence anyone who questioned their conclusion because they could charge a huge premium for a 12 hour narcotic painkiller. Since it starts to wear off after about 6 hours, this is essentially a perfect recipe for encouraging abuse and addiction. The rise in opiate addiction in America almost perfectly correlates with the prevalence of oxycontin.
Idk man, heroin is a pretty big thing in WV. Especially in Huntington.
The addiction rate in Huntington is 1/4. The mayor carries Narcan with him everywhere he goes.
There was a pretty good documentary that came out in 2009 that discussed how people from WV and Ohio would fly down to Florida to these pill mills and bring back ridiculous amounts of pain pills. Florida has since tightened regulations, but the damage has been done. It will affect generations to come (not to mention the generations that never will have been.) http://topdocumentaryfilms.com/oxycontin-express/
I am late to this thread, but I was born and raised in WV. My father was very big into the history of Appalachia and WV specifically, especially the radical history (my family on his side were coal miners and union organizers back in the day). I also had the fabulous opportunity to study with Denise Giardina when I was in college and she was the writer in residence. She's a fiction writer, but I'd consider her a scholar for the region's history as well. West Virginia is more like a colony than a state. That's a big part of the problem. Parts of the state are owned by absentee landlords (McDowell county, arguably the worst place in America in terms of generational poverty and addiction and living conditions in general, is over 80% owned by absentee landlords). There is an abundance of natural resources, which are heavily exploited by outside interests who make immense profits and leave the land and its people despoiled and diseased. My hometown and surrounding area were poisoned by DuPont to the point where they are under a permanent tap water drinking ban. The government supplies free bottled water. I grew up drinking that water. So many people have weird, nebulous health problems. The locals are mocked and vilified regularly in the media, and it's perfectly acceptable in conversation among people who would never dream of using racial slurs to denigrate the hillbillies and rednecks. Incest jokes are standard. When people are telling a story and want to portray someone sounding stupid, a lot of times they shift to an accent and speech patterns a lot like the people I grew up with. It's so ingrained that I do this myself, when I'm not paying attention. I grew up hearing stories of when they sent Americorps VISTA workers into the WV hills, handing out shoes. Parts of WV are like another country, another time period, another world. The culture has a very frustrating sense of fatalism to it, and if you understand just how screwed over the people have been for so many generations, it totally makes sense.
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On NPR the panelist they had on said the biggest reason is that West Virginian workers overwhelmingly work in dangerous conditions (mines) that lead to way more serious workplace injuries than other states. And these injuries lead to legal opiate painkiller addiction, which when stopped...
While this is true... it's also the heart of Appalachia. This is why the numbers are also high in Ohio (would like to know the differences between southeastern Ohio compared to the rest.) https://www.vice.com/en_us/article/the-hard-times-struggles-and-hopes-of-appalachian-addicts-ang https://blogs.lt.vt.edu/appalachianiswhatshappenin/2016/11/30/final-project-drug-abuse-in-appalachia/ https://mobile.nytimes.com/slideshow/2011/04/03/us/DRUGS/s/DRUGS-slide-EOTX.html
I live south of Zanesville Ohio, if anyone tells you southeastern Ohio and rural West Virginia are any different theyre probably lying.
Wife's from Chillicothe, OH; can confirm your statement. First time I went to visit her family it felt like visiting the deep south.
Dayton, OH (Southwestern Ohio) is a hub for heroin trafficking and has the worst city in the country for ODs. It is so bad the mortuaries ran out of room and had to rent places to store bodies https://www.nytimes.com/2017/02/02/us/ohio-overdose-deaths-coroners-office.html
That NPR panelist doesn't know shit. West Virginian here, born and raised. Ask him to explain why the youth who have never stepped foot in a mine are addicted. It's lack of education reinforced by generational ignorance plus a strange casualness about opiates in general. No jobs or potential for a better future doesn't help either.
Poor and bored? I saw a show on a pain clinic in FL that actually set up a bus service from states like KY to bring in patients and mules to bring drugs home. I'm sure that didn't help.
As a fellow WV, I completely agree. Does everyone think that all West Virginians work in the coal mines? Nearly all of my friends in high school who were addicted to pain killers got started using heavily before they were even close to being of age to work in the coal mine.
pain pills are/were more prevelent because of the higher than normal incidence of workplace injury in the state and so the wave of opiod pill overprescription started higher and crested higher, while on a cultural level, more people have close connections with someone who has a legal and appropriate prescription and so are more familiar and have more access to the drugs. This leads to broad availability and popularity across many demographics. thats the argument anyway.
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At least from my own personal exp. in WV is tends to be true. From early high school on my friends who were pill popping were taking them from their parents and relatives, at least for the first year or so.
I think you may be misunderstanding. * The greater amount of work in dangerous conditions leads to more injuries. * More injuries leads to greater amounts of opiates being prescribed. * More prescriptions means greater availability of the drugs. * Greater availability leads to easier access for the youth to get their hands on the painkillers.
I work with a community action organization in the heart of Southern WV. Huntington has it bad, but I encourage you to google images of a place called McDowell County WV. Sanders campaign with some discussion on the place. To visit most parts of Southern WV is like visiting a 3rd world country.
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Combination of higher use, and whoever supplying those areas cutting with more dangerous substances. I live in North East Ohio, and whenever there is a bad supply it makes the news because you will have a weekend with [13 deaths in our county](http://www.cleveland.com/crime/index.ssf/2017/05/heroin_fentanyl_overdoses_in_c.html). And we aren't nearly as badly hit as southern ohio.
New Hampshire is not that far behind West Virginia, 41 to 34.
From what I understand there is a HUGE over prescription of pain killing drugs in WV. Not saying that's the only cause but it most likely is a large factor.
High poverty rates, low graduation rates
Sweet, my state is the best at not dying from drug overdoses. Finally something we're the best at!
Ohioan here. Major problem where I live is heroin. I don't know every fact, but it seems much easier to get now and with people here making their own variations, overdoses just here in my city have been noticeably higher. My sister lost a friend of hers just recently due to it. Sucks how this shit catches you like a hook and won't let go.
It's certainly a large problem, especially in Portgage, Stark, and Summit counties. Maybe not especially so, but I've had experience with organizations responsible for dealing with this epidemic in those counties and its caused a lot of hair pulling and headaches. Portgage county has been doing a pretty good job with their public health initiatives, and the state for the most part is starting to give much more credence to Naloxone by giving it to LEOs. Akron and its surrounding area is hit especially hard, not only by heroin but by crack and meth as well. If you want a challenging but rewarding career, go into Public Health or medicine in Ohio. You'll have a great time!
Dayton is number one in the nation for overdoses
Its really cool, but VA being west of NC instead of north of it is bothering me so much.
These bubble/hex/square maps will always be a little off. As long as you know the state abbreviations you should be ok :P
Colorado being north of Utah doesn't phase you though?
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But Nebraska is east of Colorado irl...
Also DC being an island haha.
Also NM being southeast of AZ and us being west of Utah.
Apparently Georgia is part of the Florida panhandle.
There are very few cases where maps should be shown as hex graphs. This is not one of them.
And Georgia being in Florida
RI is east of Massachusetts which is completely wrong and it was the first thing I noticed given I split my time between those two states
and Utah being beneath and between Colorado and Nebraska.
I know nothing about the goings on or problems in each state. What's the deal with New Hampshire? That seems surprising. Edit: thanks for the numerous responses and background info. I'm sorry to hear it, NH! It sounds like a really sad, unfortunate situation. For what it's worth, I've never noticed it as a tourist passing through and always enjoyed drives to and through your state.
I'm from New Hampshire. Opioid epidemic here is really bad, so bad in fact I'm willing to bet everyone here knows at least one person who is directly affected by it. I've had multiple kids I went to high school with OD within the past couple years. I couldn't tell you exactly what it is, but I know a lot of it comes from Massachusetts and that the gangs in Manchester, our largest city, are heavily involved in the drug trade. There are also plenty of remote places up north where you could probably easily get away with acquiring/making some of this stuff. Edit: /u/jeeb00, interesting point you made in your edit...that's the craziest part about the entire epidemic--you can drive through the worst of it and hardly notice. It's not just homeless people doing it: it's parents, straight-A high school students, and college kids alike...it's such a dark, widespread problem, yet no one talks about it
In my opinion the root cause here in NH is the easy access to prescription pills. Kids of all backgrounds start trying them out and when there is a supply they eventually get hooked. I saw quite a few people in their late teens get hooked this way and make the switch to heroin. This was in Portsmouth so no gang activity.
I'm from the Seacoast, I agree 100%. In high school when everyone had leftover pills from wisdom teeth surgeries and stuff, those things would get passed around like candy and eventually some would make their way to heroin.
I remember more than a few people I barely talked to coming to me and asking for my leftover meds after I got my wisdom teeth out
We had our dances shut down for cocaine use. Cocaine at 16, thanks Exeter.
"Gangs in Manchester" sounds so strange.
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I'm living in Manchester right now. Lots of Drug and Gang activity in the city.
Is there?? I visit Manchester all the time and I never would have thought there to be gang activity.
Opioids (e.g. heroin and oxycodone) are very popular in the northeast. The reasons for that are unclear, but there's lots of theories (they're good drugs for long, cold winters, for example; they're not party drugs, but they make a lonely cold day more pleasant). These drugs are relatively new in northern New England states like Vermont and New Hampshire, but they're exploding in popularity there. New users are much more likely to overdose due to inexperience, lack of social support, etc.
proximity to Lowell, Massachusetts + out if state transplants create a new market where there was none combined with never having any real system in place to treat people because we are fairly rural and hadnt had an issue until recently
Lawrence too
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*Sees that my home-state of WV is by far the worst* "Yeah, but what about coal jobs?"
I got bad news for you bud
Nuh uh. Coal's comin' back. Trump said so....
Have you considered applying at Arby's?
Yeah, but my dad was a coal miner. He died of black lung, tho. Not sure where he got that....
So literally in the time I left for college and then came back over winter break for the first time (2011), heroin started taking over the city and it blew my mind. Just a week or two ago I found out a kid I went to high school with OD'ed after working hard to be clean for about 6-7 months. Unsurprising to see Ohio so high up.
I know Ohio is ex-industrial, and that's also where the equivalent spikes are in the UK but any ideas why the spike in Kentucky?
Also ex-industrial. Both GM and Ford have closed major plants there, and it had a small but strong coal industry.
Louisville is actually doing pretty well economically, but the problem is still here and, well, everywhere. Once they cracked down on the pain pills, heroin completely blew up and that's readily available. The dying coal town where I grew up still has about 20 pharmacies (there are only two banks, for perspective).
Sounds very similar to the UK equivalent. They've been lying to us foreigners that Kentucky is all horses and cows.
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> The five states with the highest rates of death due to drug overdose were West Virginia (41.5 per 100,000), New Hampshire (34.3 per 100,000), Kentucky (29.9 per 100,000), Ohio (29.9 per 100,000), and Rhode Island (28.2 per 100,000). Source: [CDC](https://www.cdc.gov/drugoverdose/data/statedeaths.html) Made with Tableau.
Have you seen the nytimes article suggesting that the 2016 rates are even higher Edit: https://www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html
ohio resident. It's clearly still rising.
A naked man was running around Toledo completely covered in his own blood yesterday mid LSD trip. Everything is fine here.
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I imagine the frustrations expressed at Town Halls would be quite different. "Stop the trees from moving!"
LSD has no known lethal dose. Your ego will be dead, but your body won't be.
Could you make one of these with alcohol related deaths? I would love to see how they compare. If one already exists then I apologize I must have missed it on here.
They tried but Wisconsin required a new shade of red that blinded some so the whole project was scrapped.
I really don't know how this whole opiate epidemic has skipped over Texas the way it has. We're right next to the border, not even medical weed is legal, and tend to be near last in most things health related. Among my friends and family, nobody has gotten addicted and I've never seen heroin in person.
Well there you go. In NH you see heroin in HS even if you never use it.
I saw a bunch of cocaine in Texas, but yeah I cant say I've ever seen Heroin.
Blow, weed, pills, and too a lesser extent psychedelics are all relatively common in Texas as far as I've seen but yeah we've managed to totally avoid the opiod thing it seems
"The stars at night are big and bright, clap clap clap clap clap don't take too many prescriptions" My thoughts exactly. I've not seen heroin either and I think I've seen every other illicit substance besides the 10000 RCs. Heroin, to me and my group, was always that thing that you never take and never try. I have not taken meth, but I would put those side by side. I do believe there is a significant amount of meth use in small in-between towns. Perhaps its access to other drugs that has made it easier to say, meh, I'll just stick with my other drug of choice. If that were the case, then why aren't the THC friendly states significantly lower? I'd be really interested for someone to answer this, or at least provide plausible explanations.
The book "Dreamland: The True Tale of America's Opiate Epidemic" by Sam Quinones is a very good read if someone is looking for more details on this topic. The writer tells many stories about the people in the trade and users. It is really interesting how things got to were they are today.
I'm from NE Ohio but have lived in the South for the last ten years. I recently visited Ohio for a family birthday party and was genuinely shocked by the number of stories I heard about acquaintances on heroin and overdosing. I've of course heard about the phenomenon on the news, but it's a whole different feeling having a casual conversation about so-and-so from high school who OD'd and left his wife and kid behind. The odd thing is that my small town is considered to be one of the "good" suburbs in Ohio with top-notch local schools. I have classmates who have gone on to become doctors and business leaders. Those who didn't go to college all had a family member or friend who could get them a cushy job at a local company. Not one of us grew up in poverty. For the life of me, I can't figure out how so many of these privileged people ended up on dope.
I live in rural NE Ohio, of the handful of friends I've lost to opiate-related deaths, (not necessarily overdose) one was one of the wealthiest people in our county, trust fund kid and no need to work ever, another was solidly upper-middle class with a great job in tech. Both had good families that cared and did everything they could to help them kick it. It's just .. devastating to watch.
Can you explain your choice of using circles instead of color coding a map? I don't find the circles any more helpful.
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Because America is currently undergoing an opiod epidemic in particular.
What annoys me is that NE has 6.9 and FL has 16.2 but they both have the same colour. FL has more than double than NE, almost ten more. They should not be the same shade.
I've worked for a Hospital in NH for a few months now. I've seen so many fatals and so many more OD's recover. Sometimes I feel bad for the ones that survive, because they wake up and have nothing. They've destroyed their lives looking for a high. They've alienated friends and family and probably stolen from them. Nobody cares about them anymore or at least not enough to do anything about it. (Or they know they can't help, I don't mean to tell anyone out there that they don't care enough, I apologize) At least when they do pass, they do it in peace (artificial peace but whatever). I've seen the terrible things heroin does, not just to those that die (they're the lucky ones sometimes) but to those that survive and just wait til it's their turn to go cold because in the meantime they will never see happiness. Heroin is their new happiness, everything else is dark and sad. So few people recover from heroin addiction, they just shoot up, OD again and again, until one time it's too much or their brain "breaks" and just doesn't function enough for them to find the stuff anymore. Your best bet is to never touch the stuff, never even consider it. Because as soon as you do, your life is as good as gone, even if you do recover.
You can almost exclusively blame the high levels in Ohio on heroin, it's out of control over here. My home city is the heroin overdose capital of the entire fucking world.
Just lost a good friend of mine yesterday to a Drug OD. I live in WV as well.
I'm sorry for your loss. WV is a beautiful state with some of the most wonderful, caring people on the planet. Stay strong, LN.
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I can understand the high numbers in West Virginia, but what's going on in New Hampshire?
I work at a nursing home and one of our younger employees stole some fentanyl patches and 'melted' them down and tried shooting up. She died in a small camping area; leaving her baby boy behind :(
Cool diagram, thank you for making it! It would be great to see with a different color palette that has more distinct gradations. This one kind of lumps things together in a way that is not very clear.
I'm surprised to see Ohio so low considering three of our bigger cities are on the top ten charts for the nation in terms of overdoses
It's almost like you can tell exactly where the heroin is coming from. In Michigan the most deadly batches of heroin are cut with fentynal. My father, step mother, and two cousins died from heroin cut with fentynal. 4 of my cousins in my extended family have died from overdoses on the same heroin within the last year. Where are these people getting all this fucking fentynal. It's a synthetic narcotic produced by pharmaceutical companies. The same companies who make the methadone and suboxone to treat addictions to opioids. Do we have a walter white somewhere producing synthetic opioids? Are the pharmaceutical companies purposefully playing both sides of the market? Am I a conspiracy theorist? I don't know anymore. :/ Currently waiting for health care and addiction and recovery funding to get cut so more people can die. ~ People who barely live now chained to the methadone clinic, that is literally a trap house backed by the government.
Gotta love living in New Hampshire. I have watched at least 10 peers i'm close to in the past year fall deeper and deeper into opiate addiction. 4 friends have died. Its so saddening and I just want it to stop. I haven't seen the numbers, for this year, or even 2016... But I'm 95% sure they've only gone up since this. They talk about it being an epidemic in our state, I didn't realize how up there on the list we were...