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When it Comes to Drug Abuse, What do Other Countries do Better?

The opioid crisis has frequently been in the news lately. Almost 60,000 Americans died from opioid overdose last year. Overdose deaths in the US account for about a third of fatal overdoses worldwide. The US leads the world in illicit drug use, especially cocaine, which Americans use at four times the rate of second place New Zealand. This is despite relatively severe drug laws. The Bureau of Prisons estimates that about half of prisoners are incarcerated for drug-related crimes. About 16 percent of those were non-violent offenses. If we can’t jail our way out of the opioid crisis, what can we do?

Comparing countries is always difficult and imperfect. Different countries have different cultures, different attitudes toward drugs, different forms of government, and different community structures. Despite the difficulties, it’s worth looking for clues in what they do differently.

A report on the topic by the RAND Corporation notes that many European countries, including Italy, Switzerland, the Netherlands, and Spain tend to look at drug abuse and addiction as a health issue rather than a criminal one, and therefore emphasize treatment over punishment. Some exceptions are Germany and Sweden, where drug abuse is treated as a criminal offense, but not not as aggressively as it is in the US. It is perhaps worth noting that Germany has the second highest fatal overdose rate in Europe, behind Great Britain.

Great Britain is an interesting point of comparison because it is the European cousin or perhaps parent, of the US. Fatal overdoses in Great Britain account for about one third of all fatal overdoses in Europe. Despite this dubious honor, Britons die from overdose at a much lower rate than Americans. Out of every million people, about 121 Britons die of overdose compared to about 187 Americans, about a 50 percent higher rate.

UK laws bear some similarities to other European countries by emphasizing treatment for users and some similarities to the US in harsh sentences for sale and distribution. You might call this a “chips to crisps” comparison because of our cultural similarities, but it’s hard to pin down exactly what makes the difference. Many people would point to the greater availability of healthcare through the NHS and that’s certainly a likely factor. Other factors might include a better social safety net and more centralized communities–meaning fewer populations are underserved.

It doesn’t seem to matter much whether drug laws are permissive or prohibitive. Both Spain and the Netherlands have permissive laws, but the Netherlands has much lower rates of abuse. Similarly, both Norway and the US have prohibitive drug laws but Norway has very low rates of abuse while the US is the highest in the world.

What seems to matter most is whether people have access to treatment and support. In the US, more than half of the people who need help don’t seek it because they believe they can’t afford it or they don’t know where to get it. It would be great if the US made treatment and mental health services more widely available. In the meantime, treatment options do exist and they may be more available than you realize. Gardens Wellness Center can help you with your addiction. Call us today at 844-828-1050 or email us at