Why did only 17 people die from drugs in Bulgaria in one year while the opioid crisis ravages America?
In 2015, the last time fatal overdoses were counted in Bulgaria, 17 people died, while 52,000 died in America.
Let’s get the Borat jokes over with. Yes, there are more than 17 people in Bulgaria and no, we are not all related.
In 2015, the year that 52,000 Americans died of drug overdoses—a number that would climb to over 100,000 during the pandemic—exactly 17 individuals in Bulgaria died of illegal drug overdoses. Bulgaria has a population of just six million. That’s 3.6 deaths per one million. In Great Britain, it’s over 40 deaths per one million. In the US, in 2021, it was 320 lives per one million. In Bulgaria, the highest number of overdose deaths occurred in 2008—70 people died from illegal drugs in the entire country.
I had to take a quadruple look at these numbers. When controlled for population, the US overdose death rate is almost 100 times higher than Bulgaria. Ohio, which has roughly the same size population as Bulgaria, had 3,310 deaths that year. I’m sure there are errors in the reporting on both sides. A lot of overdoses are actually suicides. And a lot of overdoses don’t get coded as such. But just 17 deaths? Bulgaria, clearly, is not in the midst of an “overdose epidemic” like the US.
Bulgaria is the poorest and most corrupt country in the European Union. Not only does it have high rates of inequality, but it has a sizeable population that remembers far lower rates of inequality. For all of the abuses and incompetence of the socialist regime, inequality was statistically lower up until 1989—the start of the end of the Cold War—than it is today. And all the nomenklutura bandits that embezzled from the country couldn’t show off their wealth with mansions so instead they stashed it away prior to the fall of the Soviet Union. In the 1990s, these cronies made up for lost time, shoving their wealth in struggling people’s faces with giant cars and massive villas.
Based on economics and politics, one might think Bulgaria ought to have a worse drug problem than the US. But it doesn’t. The opioid crisis simply doesn’t exist there.
“How’s the opioid crisis here?” I asked some Bulgarian friends over dinner.
“There isn’t one,” they said.
I’ve rolled all this over in my head trying as best I can to be objective and not fit these facts into my preexisting notions. I considered that, maybe, it was some massive misreporting or a statistical error. I considered the culture: It’s considered unseemly for women to drink to excess; that’s men’s prerogative. And surely the same applies to illicit drugs.
But there’s another explanation. Bulgaria doesn’t have anything approximating the Drug Enforcement Administration. Nor does it have centuries long history of drug wars on various substances, which are almost always linked to racial panics. Once prohibition of a substance is instituted, lucrative black markets follow, along with a more dangerous supply.
We all know the drug war was/is a stupid response to the perceived threats of substance use. But it never quite viscerally hit me just how much our own government, good ole Uncle Sam, is responsible for the 100,000 Americans who died in 2021 from drug overdoses.
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