Portugal decriminalized drugs and overdoses dropped 93%. We chose prisons, profits, and blame. Here's how policy (not willpower) created the opioid crisis, and what real accountability would look like.
I appreciate how you pull addiction out of the shadows of shame and place it in the wider context of systems, stories, and unmet needs. It reads like someone gently turning the camera angle so we see people, not just “problems.” It made me rethink how often we confuse moral judgment with understanding.
You are so spot on. As an American living in Portugal I often tell people what Portugal did. Now the town I live in doesn’t have people strung out and living on the street.
I remember the documentary of how they approached others as human beings. It’s sad to see how politicized drug addiction has gotten and the see places like Chicago where I once lived struggle.
Wow! That was an unexpected comment… i'm an American that's going to be living in Spain within the next 10 years and I love portugal.. I would love to hear more about this because the natural reaction to and in front of an American as you know is to just doubt it because it's so different than our experience and what we've been told… it's the same thing when we look at the way Norway handles prison . Americans will say where's the punishment .. The 20% recidivism rate kind of does all the Talking you need it to do when our quote on quote punishment has an 88% percent of his own rate…
I love that you're a passion collection of palm trees on the American ideal as we have slowly walked away from it
You are ABSOFUCKINGLUTELY spot on. Something else to add: Since the ‘80s kids have been raised on drugs because of “diagnoses” like adhd, add, etc. Physicians and parents started drugging their kids when they were in kindergarten, if not earlier. Easier to control them. These kids have never NOT been on drugs. They have no idea how to live free of some kind of medication. Just another thought.
That's right. I could have been much more cynical and pointed out that it almost seems like the War on Drugs is designed to put poor people in jail but I didn't go there because I don't like to jump to the conclusions that can't be proven but drug use definitely shouldn't be a criminal offense. It cost more money to jail than to rehabilitate.
I didn't even know that. I assumed that was just my cynical side. I did realize that you get 10 years for crack cocaine and there is no minimum sentence for possession of regular cocaine which is a rich person drug versus the crack which affects the inner cities and I knew that was very odd.
The trope has always been that Black & Brown, men, particularly, were addicts, addicts adjacent, criminals & dealers. The woman were all believed to be drug addicted prostitutes. There was no in between. The sub-strata message about “Crime” & “ Criminals” has always been racist. No one got particularly excited until a lot of poor Whites started flooding the zone.
Excellent analysis, thanks for this. Don’t forget that prisons are big business in the US and I’ve heard that some have minimum inmate quotas that have to be contractually met. The war on drugs helps with this. Awful. Gabor Maté has a great book discussing addiction as illness (In the Realm of Hungry Ghosts).
I've been involved with the opioid recovery community since 2003. Two of my college roommates developed addictions. One was forced to leave during our sophomore year, the other during junior year. One eventually got clean. The other died within three years of us graduating in 2008. His name was Sean Roenbeck.
I'm from New Jersey, and I watched the opioid epidemic explode around the time I graduated high school in 2001. It devastated families for years, and then fentanyl arrived, followed by COVID. I lost a couple of friends in 2020 alone.
The medication that ultimately saved my life was an injectable form of buprenorphine. I was fortunate enough to get into an early trial while I owned a restaurant. At the time it was called Sublocade, and today there are additional options like Brixadi. Unlike Suboxone, which you take every day, these are long-acting injections. That made a huge psychological difference for me because I wasn't waking up every morning feeling like I still needed to "take something."
After several months, I found that when it was time for my next injection, there really wasn't the withdrawal cycle I'd feared. The medication slowly tapers in your system because of its long half-life, and doctors can step you down gradually. Brixadi, for example, offers both monthly and weekly doses, making it much easier to taper when you're ready. Everyone's experience is different, but for me it was life-changing.
A big part of why I started writing is exactly what you mentioned: challenging assumptions.
If you read my work, you'll notice that's the common thread. Sometimes I'll challenge ideas you've never questioned. Other times I'll put words to thoughts you've already had but couldn't quite articulate. My goal is to fulfill the promise that independent media was supposed to deliver.
Ironically, I've learned that if I simply pandered to either the political left or the political right, I'd probably grow five times faster. Outrage is profitable. Tribalism sells. But that's not the audience I'm trying to build.
I'd rather have a smaller community made up of people who are thoughtful, curious, and willing to question their own beliefs than a massive audience that only wants validation. Among my subscribers are people who have lived through addiction like you have, veterans, people from every political background, and people who simply believe we've forgotten how to talk to one another.
When I talk about "revolutions," I don't mean violence. I mean a series of cultural revolutions: how we think, how we debate, how we treat each other, and how we solve problems. I don't just teach. I learn. I discuss. I debate. I change my mind when the evidence changes.
That's the community I'm trying to build.
Too much of what calls itself "independent media" has become another echo chamber. It's often the same outrage, repeated every day, just wearing different team colors. Outrage gets clicks, but it rarely changes anything.
I'm more interested in finding the common threads that unite people than the labels that divide them. If we can get enough people thinking critically instead of tribalistically, I think real change becomes possible. That's the mission behind everything I write.
Thank you for what you do. My daughter had a relapse a few months ago but I think she is on the injectable monthly one now. I am going to her home later and I will find out. She went back into a rehab facility when it happened. She is grateful to this one for challenging her. At least that’s what she has told me. I want to talk to her about everything but I don’t want to put pressure on her. I lost my husband, her father, in 2023. He was an alcoholic who developed colon cancer. Addiction runs on both sides of our family. I do believe that genetics play a part that’s why I am concerned about my grandchildren. I don’t think any studies have been done on children born addicted. We live in WV. Huntington area to be exact. We have Lily’s Place which is for babies born addicted. My son and daughter have lost so many friends to this disease. Kids they grew up with that I cared deeply for so I get traumatized every time one of them dies. I have talked too much. I guess I just needed to be heard
That's not "too much," that's exactly what this space is for. Everything I write about is something I feel needs a revolution or already has a revolution underway that needs momentum to continue and sustain.
I would cautiously say that we have crossed the worst point of this epidemic for now...
Doctors are more and more fearful of their recklessness that the leads people into this, and the attention to addiction and the preparedness of EMTs with Narcan and recovery clinics accepting Medicaid and offering really high cost effective drugs as a solution... That all adds up with something we can really be optimistic about.... even though it's happened far too late...
I'm so sorry about your husband. Losing him in 2023, on top of everything addiction has already taken from your family, that's a lot to be carrying at once.
On your daughter: if she is on the monthly injectable now, that's genuinely the best possibille news and outcome. From my own experience, that shot does something a daily pill/strip under your tongue can't do psychologically or physically. You're not negotiating with yourself every morning india taking that mental component completely out of the equation for most of the month and you're doing it immediately. That alone removes a huge amount of the noise. And the flexibility is real too, whether she's goes from weekly or monthly, monthly to weekly, or off it directly after a few months... it just buys her one more stretch of stability at a time until she's ready to taper off, which people absolutely do.
On wanting to talk to her about everything without pressuring her: in my experience, pressure rarely opens that door, but a standing, quiet invitation does. Something as simple as "I'm here whenever you want to talk about any of it, no rush" said once and then just lived out, tends to land better than circling back to it. She already knows you're safe to talk to. She'll come to it on her timeline, not because it was asked of her.
On genetics: you're right, and it's not just a feeling. Twin and family studies put the heritability of addiction somewhere around 40 to 60 percent depending on the substance. It runs in families the way heart disease or diabetes does. That's biology, not a character flaw passed down.
On children born into it: you're more right than wrong. It's called Neonatal Abstinence Syndrome, and the research on it is real but still young, especially anything tracking kids long-term into adulthood. Places like Lily's Place are part of why that's changing. That kind of program is often where this research actually comes from.
On the fear for your grandchildren: the most encouraging thing I can offer is that normalizing it early, telling people about the family history matter-of-factly instead of hiding it, tends to produce better outcomes, not worse ones. Counselors who are open about their own history, "I used for ten years, I've been clean for fifteen," get better responses now than they would have even a decade ago. Society is slowly getting closer to treating this like the flu instead of a moral failing. Your grandchildren are more likely to grow up on the better side of that shift than you think... 25 years ago if you would have said this was a disease you would have gotten pushed back from 9 out of 10 people even though these studies were already there for addiction...
Now it's more common that somebody is not aware of this... I would say that in 10 I think 15 years people opposed to this thinking will be very similar in number to the people opposed to gay marriage or interracial marriage inside of my lifetime and when it turns that corner it never goes back. That's the good thing about progress.. people can argue until they're blue in the face but once they see the actual outcome is true Lee not what they feared that that it's very unlikely that they ever try to re-establish that old point of view.
On losing so many friends, and getting hit by it every time: that kind of grief doesn't get easier with repetition, it just gets more familiar. It's allowed to still hurt every time.
It takes a village. You're clearly a significant part of your family's.
Stay in touch and know that I'm a resource for you for anything that you need. I'll do my best
Yes. It's sad. I have a lot of experience in this area and I want even know that anyone that wants to talk about addiction every chapter and talk to me because I have a network on here some pretty informed and powerful people that can help
The War on Drugs is one of the root causes for violence. Incarceration means kids grow up in fatherless homes. Less discipline and stability, more daycare ... raised by not parents. Single parents can't devote much time and attn, so kids grow up in the same system that leads to drugs, crime, etc ... a self-fulfilling cycle that feeds/eats itself.
I appreciate how you pull addiction out of the shadows of shame and place it in the wider context of systems, stories, and unmet needs. It reads like someone gently turning the camera angle so we see people, not just “problems.” It made me rethink how often we confuse moral judgment with understanding.
You are so spot on. As an American living in Portugal I often tell people what Portugal did. Now the town I live in doesn’t have people strung out and living on the street.
I remember the documentary of how they approached others as human beings. It’s sad to see how politicized drug addiction has gotten and the see places like Chicago where I once lived struggle.
Wow! That was an unexpected comment… i'm an American that's going to be living in Spain within the next 10 years and I love portugal.. I would love to hear more about this because the natural reaction to and in front of an American as you know is to just doubt it because it's so different than our experience and what we've been told… it's the same thing when we look at the way Norway handles prison . Americans will say where's the punishment .. The 20% recidivism rate kind of does all the Talking you need it to do when our quote on quote punishment has an 88% percent of his own rate…
I love that you're a passion collection of palm trees on the American ideal as we have slowly walked away from it
You are ABSOFUCKINGLUTELY spot on. Something else to add: Since the ‘80s kids have been raised on drugs because of “diagnoses” like adhd, add, etc. Physicians and parents started drugging their kids when they were in kindergarten, if not earlier. Easier to control them. These kids have never NOT been on drugs. They have no idea how to live free of some kind of medication. Just another thought.
Did you read my ADHD post? It's a real deep dive with pretty unprecedented overall coverage.
https://uncomfortable.rxansmithmedia.com/p/adderall-vyvanse-and-speed-oh-my
I have not read it yet. I will! Thank You!
It’s ridiculous. This is what I’ve been saying! What they did in Florida with the pain pill epidemic! All for profit and power
I'm shaking my head.
It's a really messed up situation… I lost a lot of friends and a lot of time to this issue.
Addiction is a Medical problem, not a Judicial one. Full Stop.
That's right. I could have been much more cynical and pointed out that it almost seems like the War on Drugs is designed to put poor people in jail but I didn't go there because I don't like to jump to the conclusions that can't be proven but drug use definitely shouldn't be a criminal offense. It cost more money to jail than to rehabilitate.
I do believe that Richard Nixon intended the so-called “ War on Drugs” to be a full throated “War on Black & Brown People.”
He, Haldeman & Ehrlichman were stone racists & cynical about it.
I didn't even know that. I assumed that was just my cynical side. I did realize that you get 10 years for crack cocaine and there is no minimum sentence for possession of regular cocaine which is a rich person drug versus the crack which affects the inner cities and I knew that was very odd.
The trope has always been that Black & Brown, men, particularly, were addicts, addicts adjacent, criminals & dealers. The woman were all believed to be drug addicted prostitutes. There was no in between. The sub-strata message about “Crime” & “ Criminals” has always been racist. No one got particularly excited until a lot of poor Whites started flooding the zone.
I would love what they would say to answer to the opioid epidemic I hit the white suburbia so hard.
It’s when the fecal matter hit the air conditioning.
White people addicted in droves?
O. Clutch my pearls & raise my skirts.
We must DO something.
& then they discovered that the manufacturers, dealers & pushers were domestic Big Pharma & the local doctors & drug chains.
O! The horror.
It did seem very coincidental… and even more crazy that they make the prisoners do labor $0.63/hr...
Excellent analysis, thanks for this. Don’t forget that prisons are big business in the US and I’ve heard that some have minimum inmate quotas that have to be contractually met. The war on drugs helps with this. Awful. Gabor Maté has a great book discussing addiction as illness (In the Realm of Hungry Ghosts).
I lost my son in 2020. My daughter is a recovering addict as is her mate. I worry about my grandchildren
I'm truly sorry to hear about your son.
I've been involved with the opioid recovery community since 2003. Two of my college roommates developed addictions. One was forced to leave during our sophomore year, the other during junior year. One eventually got clean. The other died within three years of us graduating in 2008. His name was Sean Roenbeck.
I'm from New Jersey, and I watched the opioid epidemic explode around the time I graduated high school in 2001. It devastated families for years, and then fentanyl arrived, followed by COVID. I lost a couple of friends in 2020 alone.
The medication that ultimately saved my life was an injectable form of buprenorphine. I was fortunate enough to get into an early trial while I owned a restaurant. At the time it was called Sublocade, and today there are additional options like Brixadi. Unlike Suboxone, which you take every day, these are long-acting injections. That made a huge psychological difference for me because I wasn't waking up every morning feeling like I still needed to "take something."
After several months, I found that when it was time for my next injection, there really wasn't the withdrawal cycle I'd feared. The medication slowly tapers in your system because of its long half-life, and doctors can step you down gradually. Brixadi, for example, offers both monthly and weekly doses, making it much easier to taper when you're ready. Everyone's experience is different, but for me it was life-changing.
A big part of why I started writing is exactly what you mentioned: challenging assumptions.
If you read my work, you'll notice that's the common thread. Sometimes I'll challenge ideas you've never questioned. Other times I'll put words to thoughts you've already had but couldn't quite articulate. My goal is to fulfill the promise that independent media was supposed to deliver.
Ironically, I've learned that if I simply pandered to either the political left or the political right, I'd probably grow five times faster. Outrage is profitable. Tribalism sells. But that's not the audience I'm trying to build.
I'd rather have a smaller community made up of people who are thoughtful, curious, and willing to question their own beliefs than a massive audience that only wants validation. Among my subscribers are people who have lived through addiction like you have, veterans, people from every political background, and people who simply believe we've forgotten how to talk to one another.
When I talk about "revolutions," I don't mean violence. I mean a series of cultural revolutions: how we think, how we debate, how we treat each other, and how we solve problems. I don't just teach. I learn. I discuss. I debate. I change my mind when the evidence changes.
That's the community I'm trying to build.
Too much of what calls itself "independent media" has become another echo chamber. It's often the same outrage, repeated every day, just wearing different team colors. Outrage gets clicks, but it rarely changes anything.
I'm more interested in finding the common threads that unite people than the labels that divide them. If we can get enough people thinking critically instead of tribalistically, I think real change becomes possible. That's the mission behind everything I write.
Thank you for what you do. My daughter had a relapse a few months ago but I think she is on the injectable monthly one now. I am going to her home later and I will find out. She went back into a rehab facility when it happened. She is grateful to this one for challenging her. At least that’s what she has told me. I want to talk to her about everything but I don’t want to put pressure on her. I lost my husband, her father, in 2023. He was an alcoholic who developed colon cancer. Addiction runs on both sides of our family. I do believe that genetics play a part that’s why I am concerned about my grandchildren. I don’t think any studies have been done on children born addicted. We live in WV. Huntington area to be exact. We have Lily’s Place which is for babies born addicted. My son and daughter have lost so many friends to this disease. Kids they grew up with that I cared deeply for so I get traumatized every time one of them dies. I have talked too much. I guess I just needed to be heard
Thank you for sharing all of that.
That's not "too much," that's exactly what this space is for. Everything I write about is something I feel needs a revolution or already has a revolution underway that needs momentum to continue and sustain.
I would cautiously say that we have crossed the worst point of this epidemic for now...
Doctors are more and more fearful of their recklessness that the leads people into this, and the attention to addiction and the preparedness of EMTs with Narcan and recovery clinics accepting Medicaid and offering really high cost effective drugs as a solution... That all adds up with something we can really be optimistic about.... even though it's happened far too late...
I'm so sorry about your husband. Losing him in 2023, on top of everything addiction has already taken from your family, that's a lot to be carrying at once.
On your daughter: if she is on the monthly injectable now, that's genuinely the best possibille news and outcome. From my own experience, that shot does something a daily pill/strip under your tongue can't do psychologically or physically. You're not negotiating with yourself every morning india taking that mental component completely out of the equation for most of the month and you're doing it immediately. That alone removes a huge amount of the noise. And the flexibility is real too, whether she's goes from weekly or monthly, monthly to weekly, or off it directly after a few months... it just buys her one more stretch of stability at a time until she's ready to taper off, which people absolutely do.
On wanting to talk to her about everything without pressuring her: in my experience, pressure rarely opens that door, but a standing, quiet invitation does. Something as simple as "I'm here whenever you want to talk about any of it, no rush" said once and then just lived out, tends to land better than circling back to it. She already knows you're safe to talk to. She'll come to it on her timeline, not because it was asked of her.
On genetics: you're right, and it's not just a feeling. Twin and family studies put the heritability of addiction somewhere around 40 to 60 percent depending on the substance. It runs in families the way heart disease or diabetes does. That's biology, not a character flaw passed down.
On children born into it: you're more right than wrong. It's called Neonatal Abstinence Syndrome, and the research on it is real but still young, especially anything tracking kids long-term into adulthood. Places like Lily's Place are part of why that's changing. That kind of program is often where this research actually comes from.
On the fear for your grandchildren: the most encouraging thing I can offer is that normalizing it early, telling people about the family history matter-of-factly instead of hiding it, tends to produce better outcomes, not worse ones. Counselors who are open about their own history, "I used for ten years, I've been clean for fifteen," get better responses now than they would have even a decade ago. Society is slowly getting closer to treating this like the flu instead of a moral failing. Your grandchildren are more likely to grow up on the better side of that shift than you think... 25 years ago if you would have said this was a disease you would have gotten pushed back from 9 out of 10 people even though these studies were already there for addiction...
Now it's more common that somebody is not aware of this... I would say that in 10 I think 15 years people opposed to this thinking will be very similar in number to the people opposed to gay marriage or interracial marriage inside of my lifetime and when it turns that corner it never goes back. That's the good thing about progress.. people can argue until they're blue in the face but once they see the actual outcome is true Lee not what they feared that that it's very unlikely that they ever try to re-establish that old point of view.
On losing so many friends, and getting hit by it every time: that kind of grief doesn't get easier with repetition, it just gets more familiar. It's allowed to still hurt every time.
It takes a village. You're clearly a significant part of your family's.
Stay in touch and know that I'm a resource for you for anything that you need. I'll do my best
wow, this is so spot on. Big money for some and further repression for most.
Yes. It's sad. I have a lot of experience in this area and I want even know that anyone that wants to talk about addiction every chapter and talk to me because I have a network on here some pretty informed and powerful people that can help
The voice over is the way to read this one!
I love this article!
Have you read my triple dog dare you article?
Send me link
https://emmetttatter.substack.com/p/i-triple-dog-dare-you?r=3y6ezi&utm_medium=ios
The War on Drugs is one of the root causes for violence. Incarceration means kids grow up in fatherless homes. Less discipline and stability, more daycare ... raised by not parents. Single parents can't devote much time and attn, so kids grow up in the same system that leads to drugs, crime, etc ... a self-fulfilling cycle that feeds/eats itself.