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Comment by xrd | Hacker News Reader

I'm curious, does anyone from Portugal or Amsterdam have any comments on this story? Obviously, easy access to drugs is one side of this story. But, that's also the case in Portugal and Amsterdam, right?

Are narcoterrorists from Central and South America the difference? Is this a new heroin, why the 10x leap in needles in five years?

Is the difference that mental health is left to someone other than the state?

As a native Portlander and someone that thinks the city should be involved in helping people get out of addiction and homelessness, this story is riveting, tragic, hopeful and maddening all at once.

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> Is this a new heroin, why the 10x leap in needles in five years?

1. Hand out opioids like candy. Everyone has pain now and then(backpain, dentist, etc), so everyone gets to try them.

2. People become habitual users and in some cases junkies.

3. Restrict the supply of OTC opioids, while continuing to lose the war on illegally supplied drugs.

4. Addicts and people looking to avoid getting dopesick look to heroin for its low-cost and relative abundance.

Now you have a major spike in heroin users. From what I've heard, a lot of people switch to heroin because it's available. They switch to shooting up because it's cost effective.

When you're high as a kite, sleeping in the street or being covered in shit really doesn't bother you. When you're obsessed with getting another fix, you tend to lower the priority of 'non-essential' activities like bathing or eating.

Note that not all addicts end up sleeping in gutters. I learned via a friend that there are many hidden addicts in society. There are professionals who shoot H just to maintain and avoid getting dope sick. I think the perceived lack of opportunities for low-skilled and older workers has contributed to a situation where many would rather get high and be homeless than struggle holding down a 9-5 just to go broke at their first health crisis.

> I learned via a friend that there are many hidden addicts in society. There are professionals who shoot H just to maintain and avoid getting dope sick.

A typical daily heroin addiction costs $100-$200 a day, or ~55k/yr. Some professions can cover the expense, but it costs serious money. When continuing with your career while addicted the user is put into a hard situation. Too many sick days from an empty bank account, a bad deal, or a lack of access can cost someone their career.

If that is how much it costs, how can people afford it?

They generally cannot, which is why so many users resort to high-risk, high-reward ways to make money like prostitution, theft, etc.

This is someone talking about a "typical addiction", which is not a thing that actually exists. There is a wide range of maintenance doses and they don't all cost the same.

In the Netherlands everyone is required to have healthcare by law. It's less likely that people with mental illnesses end up on the street. For people who do end up on the street or addicted there are safe places to use drugs, recovery programs, employment services, and public housing. Almost all of this is run by the government.

I'm interested in the statement "safe places to use drugs." Can you share any more details on that?

I don't know about Amsterdam but we have places they can shoot themselves. S place where they also get needles and other stuff necessary.

Have (a few) here in Berlin as well. Basically, it’s a room to inject. There’s usually a social worker to help guide people to programs, medical assistance, etc. when asked.

There are also “needle exchanges” where you can get new ones when you return used ones, to keep them off the street. Some may be operated in those rooms, but there are also automated boxes (basically vending machines) out on the streets.

My guess is an increase in drug use is only part of the reason. I imagine another is an increase in homelessness in Portland. (probably due to a combination of increased rents and just being a cool destination for 20 somethings)

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