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Comment by tunichtgut | Hacker News Reader

"And frankly so, Germany doesn't have an opioid problem."

You are very uninformed obviously. As far as i know for my town, Paderborn (NRW), we have about 1.000 people receiving opioid replacement drugs under government supervision (~90.000 city population).

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> As far as i know for my town, Paderborn (NRW), we have about 1.000 people receiving opioid replacement drugs under government supervision (~90.000 city population).

Whoa, that's an outsized proportion - entire Germany has 77k people in methadone substitution: http://www.bfarm.de/SharedDocs/Downloads/DE/Bundesopiumstell...

Also, the numbers are 500 methadone substituters (of total ~1k opiate users) in Paderborn (http://www.nw.de/lokal/kreis_paderborn/paderborn/paderborn/1...). What would interest me is the background why ~1% of the population are opiate abusers, though.

While opioid abuse is rising, yes even in Germany, situations are not really comparable. In the US 20.5 Million people have a substance abuse disorder. Of which 2M have a problem involving prescription pain relievers, and roughly 600k people are addicted to Heroin. [0] For Germany data on this matter is generally less available, but reports range from 1.5M to 1.9M users of prescription drugs for Germany, that number includes sleep-aids and Benzos as well though. Zolpidem based drugs actually make up for 3/4 of German prescription drug abuse. [1] The official drug report mentions 160k high-risk opioid users and 77k in substitution programmes. [2] (That's actually far far less than the 1/90 rate you report for your city. Talking about uninformed...) Also for comparison of the problem, let's look at the death rates in the US [3] and Germany [2]: 33k vs 1.2k now in relation to the population (age 15-64):

US: 0.000160 %

Germany: 0.0000226415 %

US death rate is 7 times higher than the German, while population is only 4 times bigger. That said, a look at the opioid users in Germany (160k) and US (2M+600k) is way clearer. We are talking about 16 times the abuse rate in the US compared to Germany. So yeah, Germany doesn't have an opioid problem, compared to the US.

So while Germany has heroin addicts, the US actually has a drug addict training program running. In the US there are 290M opioid prescriptions per year. [4] And while Germany doesn't have those outstanding numbers, Big Pharma is pushing for change in Germany [5 (German)]

[0]: https://www.asam.org/docs/default-source/advocacy/opioid-add...

[1]: http://www.dw.com/en/medication-abuse-a-growing-concern-in-g...

[2]: http://www.emcdda.europa.eu/system/files/publications/4528/T...

[3]: https://www.cdc.gov/drugoverdose/index.html

[4]: https://addiction.surgeongeneral.gov/surgeon-generals-report...

[5]: http://www.spiegel.de/gesundheit/diagnose/oxycodon-fentanyl-...

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