QA问答:为什么美国的鸦片制剂危机,越来越严重?
2023-09-03 xky 8518
正文翻译
Why is the opiate crisis in the United States getting worse?

为什么美国的鸦片制剂危机,越来越严重?

评论翻译
Susanna Viljanen
USA is basically what happens when Jean Calvin meets Oliver Cromwell meets Ayn Rand.

当约翰·加尔文 遇到 奥利弗·克伦威尔 再遇到 安·兰德,基本上就是美国这个情况。
约翰·加尔文:欧洲宗教改革家,基督教新教加尔文宗创始人。
奥利弗·克伦威尔:17世纪,英国资产阶级新贵族集团的代表人物,曾经逼迫英国君主退位,解散国会,将英国转为资产阶级共和国,建立英吉利共和国,出任护国公,成为英国事实上的国家元首。
安·兰德:“客观主义”哲学流派的创立者,主张理性的自私。


I have never seen this kind of squalor in any First World country - and I have travelled a lot.

我经常旅行,但我从未在任何一个第一世界国家,见过这种脏乱的环境。

United States, as a society, is incredibly callous, ruthless, indifferent and negligent as a society. It was like that when Upton Sinclair wrote The Jungle, and it is the same today. United States is a winner-takes-it-all society, where losers are treated with hard hand and where losing in this societal dog-eat-dog struggle of existence is basically your own fault. And in this mindset, for every winner, there must always be a plenitude of losers. American “freedom” is essentially indifference.

美国作为一个社会,是一个令人难以置信的冷酷无情、冷漠和疏忽的社会。
厄普顿·辛克莱写的《丛林》,就是这样的一个社会,这就是当今的美国社会。
美国是一个赢家通吃的社会,失败者会受到严厉对待,在这个你死我活的社会中,斗争失败都是你自己的错。
在这种心态下,每出现一个胜利者,必然会出现大量的失败者。美国人的“自由”,本质上就是漠不关心。

Now opiates are painkillers. They are downers. They numb down pain. Not only physical pain, but also social and societal pain. This is what makes them so dangerous.
Opiates are not party drugs nor protest drugs nor psychedelics. They are essentially loser drugs. They are not used to getting high. They are used to keep the pain away. Heroin is the ultimate so-what drug. Opiates are used to keep the cruel world away - to keep the pain, the shame, the agony, the knowledge you are bottom dregs of the society, human waste - away. To be comfortably numb. Opiates are the alternative for committing suicide. For the really downtrodden and broken, the opiates give a reason to live for tomorrow.

现在,鸦片制剂就是止痛药。他们沮丧又悲哀,他们需要麻木痛苦。不仅是身体上的痛苦,还有社会和交际上的痛苦。这就是他们变得如此危险的原因。
阿片类药物既不是派对D品,也不是抗议D品,更不是迷幻药。它们本质上是失败者的D品。它们不是用来保持情绪高涨的,它们是用来止痛的。
海洛因是终极D品。阿片类药物是用来让残酷的世界远离的自己的——让痛苦、羞耻、烦恼、你是社会底层渣滓、人类的废物这样的认知远离自己。
舒服地麻木。阿片类药物是自杀的替代品。对于那些真正被压迫和快要崩溃的人来说,阿片类药物给了他们明天继续活下去的理由。

The seeds of the opiate crisis were sowed in the 1980s during the era of Ronald Reagan and the Neo-Liberalist economic policy and Neo-Conservative societal politics. They initiated the polarization of the American society into filthy rich and dirth poor, and they initiated the erosion of the middle class. Ever since USA was founded, each generation was wealthier than their parents. This finally ended with the Generation X - it is the first generation which will remain poorer than their parents. The reason is the erosion of the middle class and the polarization of the society into winners and losers, and there is no guarantee any more for social ascension via hard work, education or entrepreneurship.

鸦片制剂危机的种子,在20世纪80年代、里根的时代、新自由主义经济政策和新保守主义社会政治时期就已经播下了。
他们引发了美国社会的两极分化,出现了超级富人和赤贫穷人,他们让中产阶级被侵蚀。
自美国成立以来,每一代人都比他们的父母更富有。这样的情况,最终会在X一代结束——这一代人会成为比他们父母更穷的人。原因是中产阶级被腐蚀,社会被分化成为赢家和输家,再也不能保证通过努力工作、教育或创业来提升社会地位。

With the erosion of the middle class came the erosion of the support pillars of the society. The loss of middle class jobs meant erosion of the nuclear family. That came with erosion of the traditional religiosity of the US. That came with the polarization of politics - Dems were overrun by the progressive wokes and Reps by the MAGA folks. I cannot say who are more lunatic, but the pragmaticism and common sense disappeared. Trump is not the cause, he is the symptom.

随着中产阶级被腐蚀,对社会支柱的侵蚀也随之而来。中产阶级工作岗位的流失,意味着核心家庭的流失。随之而来的是美国传统宗教信仰被侵蚀。随之而来的是政治两极分化——民主党人被进步派的觉醒人士、MAGA的代表所淹没。我不能说谁更疯狂,但实用主义和常识消失了。特朗普不是原因,他是症状。

Generation Y and Z (the Millennials) will remain still even poorer than the Gen X. They are the first American generations with no future. And they realize it. Usually people become more conservative with age - because of gentrification. This has not happened with Gen X, Y nor Z. It is said Gen X is the great so-what generation - totally disillusioned and totally dreamless - and the younger generations are outright Nihilstic about their futures.

Y和Z一代(千禧一代)仍然将比X一代更穷。X一代是没有未来的第一代美国人。他们意识到了这一点。通常人们会随着年龄的增长而变得更加保守——因为被中产阶级化。但这在X、Y和Z世代都没有发生过。据说X世代是表现得最显著的一代——完全幻灭、完全没有梦想——而年轻一代对自己的未来完全是虚无的。
原创翻译:龙腾网 https://www.ltaaa.cn 转载请注明出处


This “no future” realization, however, is not enough to create a drug problem - in the UK it created the punk subculture. What is needed is a cheap supply of safe drugs. And that happened with the Purdue Pharma. They developed a process to manufacture oxycodone cheaply from thebaine and a form of compound which releases slowly the oxycodone into metabolism - and named it as Oxycontin.

然而,这种“没有未来”的意识,不足以造成D品问题——在英国,它创造了朋克亚文化。
要造成D品问题,还需要廉价的安全的药物供应。普渡制药公司就在这样的情况下出现了。他们开发了一种从蒂巴因和一种缓慢释放羟考酮进入代谢的化合物中廉价生产羟考酮的工艺,并将其命名为奥施康定。

Thebaine can easily be converted into just any source of drugs. Mind you heroin is diacetylmorphine, and synthesized from morphine by treating it with acetic acid anhydride. The molecule of oxycodone is dangerously similar as that of heroin.
Purdue Pharma marketed Oxycontin ruthlessly and disregarding its addictiviness. The company got rich - and also a lot of the product went to clandestine hands. The drug addicts realized it was both cheaper than heroin and safer to use - oxycodone eventually pretty much has superseded illicit heroin on the market. Purdue Pharma dug too deep and unleashed the balrog.

蒂巴因可以很容易地转化为任何药物。请注意,海洛因是二乙酰吗啡,由吗啡经醋酸酐处理合成。羟考酮的分子与海洛因的分子非常相似。
普渡制药无视其成瘾性,无情地推销奥施康定。该公司变得富有,而且很多产品都落入了暗中交易之中。吸毒者意识到它既比海洛因便宜,也比海洛因更安全——羟考酮最终几乎取代了市场上的非法海洛因。普渡制药公司挖得太深,释放了炎魔。


This figure pretty much explains it all. The first wave began with Purdue Pharma unleashing the balrog with Oxycontin in the 1990s. It also coincided with the closure of coal mines and deindustrialization of the Rust Belt and the desperation and hopelessness of the poor people there.
The second wave began with heroin in 2010. It was only a temporary rise - the even stronger and stranger stuffs - emerged. That is, synthetic opioids like fentanyl, tramadol and other similar stuffs. The Russian scourge, krokodil, never got a foothold in the US, though - the American addicts are not that desperate.

这个数字很好地解释了这一切。
第一波浪潮,始于普渡制药公司在20世纪90年代推出了奥施康定这个炎魔。那个时候,又正好发生了煤矿关闭,以及铁锈地带的去工业化,那里的穷人只有无望和绝望。
第二波浪潮,始于2010年的海洛因。这只是一个暂时的崛起——更强大、更陌生的东西出现了。也就是合成阿片类药物,如芬太尼、曲马多和其他类似物质。然而,俄罗斯的祸害鳄鱼从未在美国站稳脚跟——美国的瘾君子还没有绝望到那种地步。

Eventually the synthetic opioids bypassed both oxycodone and heroin. The drug misuse problem is greatest where desperation, hopelessness and bleak outlook in the life are hardest - rural America, traditional industrial areas and poor quarters of the cities. In 2020, the age-adjusted rate of drug overdose deaths increased 31% compared to 2019. Adults aged 35-44 (Gen Y) experienced the highest rates of drug overdose deaths while young people aged 15-24 (Gen Z) experienced the greatest percentage increase in deaths.

最终,合成阿片类药物,绕过了羟考酮和海洛因。在美国农村、传统工业区和城市贫困地区,绝望和黯淡的生活前景最为严重的地方,泛滥得最为严重。
2020年,药物过量的标准化死亡率比2019年增加了31%。35-44岁的成年人(Y世代)的药物过量死亡率最高,而15-24岁的年轻人(Z世代)的死亡率增幅最大。

原创翻译:龙腾网 https://www.ltaaa.cn 转载请注明出处


Fentanyl is both extremely potent painkiller and rather simple to synthesize in a clandestine laboratory. Fentanyl has been synthesized from a simple phenylethylamine by four step sequence. The key part of this synthesis involves an efficient construction of phenylethylpiperidone skeleton via aminomethano desilyltion-cyclization followed by Swern oxidation. This is known as the Gupta method.

芬太尼是一种非常强效的止痛药,而且在秘密实验室合成起来相当简单。以简单的苯乙胺为原料,采用四步合成芬太尼。该合成的关键部分,包括通过氨基甲烷脱硅基离子环化和斯文氧化反应有效的构建苯乙基哌啶酮骨架。这就是古普塔方法。

………………

此处作者非常详细的解释了怎么四步合成芬太尼,就不翻译了吧,英文部分也删除了,我也看不明白。主要的意思就是:合成非常安全,但是需要的化学品比较罕见,比《绝命毒师》中那种制毒方式安全,但会产生很多副产品。
原创翻译:龙腾网 https://www.ltaaa.cn 转载请注明出处


The result is now that balrog roams free and there is no simple solution for this problem. United States is slowly decaying and disintegrating, but not with a bang but with a whimper. The current opiate and opioid crisis is a symptom of this decay - including all the social evils connected to it.
Russia has a similar crisis, but with really dangerous stuffs, such as krokodil, which is basically home-cooked very impure desomorphine. The Russian youth experiences the similar hopelessness, lack of opportunities, bleakness and desperation as the Americans, and they have it even worse. Needless to say, Putin’s politics have certainly not eased it. Russia is basically another petrostate with Mongol legacy, and Russian rulers have always treated their peasants as expendable. In Russia, human life has never had any value whatsoever. See 'Muting The Horrors': Experts Warn Of Addiction Crisis As Russian Soldiers Return From Ukraine
We here in Europe live with a cold circle under our butts: which will collapse first, USA or Russia - and what will it mean to us?

现在的结果就是,炎魔可以四处乱跑,这个问题没有简单的解决方案。
美国正在慢慢地衰落和瓦解,但不是砰的一声,而是一声声的呜咽。
当前的鸦片制剂和阿片类药物危机,包括与之相关的所有社会罪恶,都是这种衰落产生的症状。
俄罗斯也有类似的危机,但有非常危险的东西,比如:鳄鱼,它基本上是家常菜,是非常不纯的二氢脱氧吗啡。
俄罗斯的年轻人,和美国人一样经历着绝望、缺乏机会、凄凉和无望,而且他们的情况更糟。
不用说,普京的政治肯定没有缓解这种局面。俄罗斯基本上是另一个拥有蒙古遗产的石油国家,俄罗斯统治者一直把他们的农民视为可有可无的。在俄罗斯,人的生命从来没有任何价值。
看这个链接:“静默的恐怖”:俄罗斯士兵从乌克兰返回,专家警告成瘾危机 。
我们欧洲生活在一个冷战循环中:美国和俄罗斯哪个会首先崩溃——这对我们意味着什么?

Laren Cook
Life is pretty boring in the rural US. There’s no longer the struggle to maintain the farm and feed the family. Cost of living is low in rural areas - easy enough to buy food and necessities - housing is inexpensive. When the struggle of farm families to maintain the crops and animals and feed the family ended, there was no purpose to replace it with. Rural life became meaningless, and nobody starved if you slacked off and checked out. Working as a cog in a large industrial farm is nothing like maintaining and protecting your own property and growing your own food. And into the vacuum of boredom and meaninglessness entered opiates.

美国农村的生活相当无聊。再也不用为维持农场和养家糊口而苦苦挣扎了。农村地区的生活成本很低,很容易买到食物和必需品,住房也很便宜。
农场家庭现在不需要维持作物和动物,也不需要为养活家庭而苦苦斗争,漫无目的的活着。农村生活变得毫无意义,如果你松懈下来,也没有人会挨饿。在一个大型工业农场里做一个齿轮,与维护和保护自己的财产以及种植自己的食物完全不同。进入了无聊和无意义的真空,鸦片制剂就这样进来了。

Phil Marsh
I’m originally from a very rural area. Yes, cost of living is “low” but “low” means that mostly it’s the housing expense that’s low. The other expenses are similar to the rest of the USA. The one thing there that is low are salaries. Coupled with very few jobs. And those jobs are mostly things like retail and farm labor. Yes, you can be a tradesperson there too. The low incomes can be seen in the decay and rot of the town’s infrastructure as well as the rotting housing.

我来自一个非常农村的地区。是的,生活成本是“低”的,但“低”的主要意思是住房费用低。其他费用与美国其他地区类似。那里的一件事是工资低。再加上工作很少。这些工作主要是零售业和农场劳动力。当然,你也可以在那里做生意。低收入可以从城镇基础设施的腐朽和住房的腐烂中看出。

People talk about “boredom” and lack of opportunity. Yet, plumbers and electricians are well-paid. Demand for knowledgeable engineers and people who and design, build, and maintain things appears to be strong. I’m still getting interest from headhunters even at my advanced age. People have real needs and are willing to pay for real work that solves real problems.
As for boredom, the world is full of hard problems to solve and things to discover.

人们谈论“无聊”和缺乏机会。然而,水管工和电工的工资很高。。对知识渊博的工程师和设计、建造和维护人员的需求似乎很旺盛。
即使我年事已高,猎头公司仍对我感兴趣。人们有真正的需求,愿意为解决真正问题的真正工作付费。
至于无聊,这个世界充满了难以解决的问题和需要发现的东西。

Yet, USA society keeps pushing everyone to get a college degree and when you do, get a “cushy” job in a big company which requires a great skillset in office politics.
But that won’t work for everyone.
I just don’t “get” why so many people want to commit slow suicide by drugs

然而,美国社会一直在推动每个人都去获得大学学位,当你获得大学学位时,在一家大公司找到一份“轻松”的工作,这需要在办公室政治方面有很好的技能。但这并不适合所有人。
我只是不明白为什么这么多人想通过药物慢慢自杀。

原创翻译:龙腾网 https://www.ltaaa.cn 转载请注明出处


Laren Cook
Not everyone can find meaning and purpose - they wonder what's the point? At the opposite end of the spectrum you have someone like Elon Musk, who seems to believe his purpose is to enhance and preserve life, and spread it through the universe if possible. He works passionately for it (right or wrong) and I doubt he's tempted to zone out for more than brief periods, because he's always on to the next challenge in what he perceives as improving life (again, right or wrong - its a matter of opinion and a great experiment to some extent - trying to make the next step to a better future).

不是每个人都能找到意义和目的——他们想知道这有什么意义?
在光谱的另一端,有埃隆·马斯克这样的人,他似乎相信自己的目的是增强和保护生命,并在可能的情况下将生命传播到宇宙中。
他为此充满激情地工作(对还是错),我怀疑他是否会有短暂放松的时候,因为他总是在他认为已经改善生活的过程中,迎接下一个挑战(同样,对还是错——这是一个有争议的问题,在某种程度上是一个伟大的实验——试图朝着更美好的未来迈出下一步)。

George Baggs
Some are saying the US may split because the polarization within American society has become so wide, that there is no longer much common ground between the two sides. If this occurs the American hegemony will come to an end.

有人说,美国可能会分裂,因为美国社会内部的两极分化已经变得如此广泛,以至于双方之间不再有太多共同点。如果发生这种情况,美国的霸权将结束。

James LaBare
Honestly, I think that ballots should just erase all references to what political party a candidate is from. I feel like many people vote for X candidates simply because they have an R or D next to their names.
Ranked choice would be another viable alternative, but the real problem is that we don't have 1 election in this country, we have 50. Each with it's own methods, and while that might be a viable solution for state or local races, it makes no sense for national elections.

老实说,我认为选票应该删除所有关于候选人来自哪个政党的内容。我觉得很多人投票给X候选人,只是因为他们的名字旁边有一个R或D。
排名选择,将是另一个可行的选择,但真正的问题是,我们这个国家不是1次选举,我们是50次。每个人都有自己的方法,虽然这可能是州或地方选举的可行解决方案,但对全国选举来说毫无意义。

John Keller
America is moving towards authoritarianism though, this is the toxic legacy of the Trump administration. USA is definitely on much stronger ground for now but depending how the next election goes things could quickly go south.

美国正在走向威权主义,这是特朗普政府的有毒遗产。美国目前的实力肯定比俄罗斯,要强大得多,但根据下一次选举的进展,情况可能会很快恶化。

Dave D'Adlerian
The video you posted is from Philadelphia.
I have been living in that city for over twenty years, I worked in the prison system there, and I worked in Kensington, where that video is shot.
I’ve been a psychotherapist for over 30 years and worked in the streets of Kensington. I mean literally patrolling the streets, trap houses, etc.

你发布的视频里面展示的是费城。
我在那个城市生活了20多年,我在那里的监狱系统工作,我在肯辛顿工作,视频就是在那里拍摄的。
我做了30多年的心理治疗师,在肯辛顿的街道上工作。我的意思是在街上巡逻,检查那些空置的会被用来售毒制毒的房子等等。

I developed the Drug Relapse Prevention policy for the state of Pennsylvania.
The drug problem there has nothing to do with drugs. It may loosely have to do with economics but not really. The problem is the breakdown in morality since the 60s.

我为宾夕法尼亚州制定了药物复发预防政策。
那里的D品问题与D品无关。可能与经济学有着松散的关系,但也可能没有关系。问题来自60年代以来道德的崩溃。

Here’s a case study:
A woman I know has been addicted to heroin since age eight.
Her family owned a profitable tattoo studio, sold drugs, and belonged to a biker gang.
This is common, families will addict kids because it’s a family tradition.
They also made money from child prostitution. So, the woman I know was an underground child prostitute. She said that she would be honored when guys would pick her because she thought it meant she was pretty.

以下是一个研究案例:
我认识的一个女人从八岁起就对海洛因上瘾。
她的家族,有一家盈利的纹身工作室,贩卖D品,属于一个飞车团伙。
这很常见,家庭会让孩子上瘾,因为这是家庭传统。
他们还通过儿童卖淫赚钱。所以,我认识的那个女人是一个地下妓女。她说,当男人们选择她时,她会感到荣幸,因为她认为这意味着她很漂亮。

Later, an older lesbian raped her and the woman thought she was a lesbian and started ripping men off for money, doing more drugs, etc.
Her dad was in the famous K&A gang and murdered people then he went to prison for life.
The woman grew up and met a man she liked and had a kid with him. He was a flake and abandoned her. She met another guy, he was a flake and abandoned her.

后来,一名年长的女同性恋强奸了她,这名女子就认为她也是女同性恋,并开始敲诈男性以获取金钱,吸食更多D品,等等。
她的父亲是著名的K&A帮派的成员,他谋杀了人,然后判了终身监禁。
这个女人长大了,遇到了一个她喜欢的男人,并和他生了一个孩子。他是个古怪的人,抛弃了她。她遇到了另一个男人,他是个古怪的人,抛弃了她。

She was in one relationship after another was addicts, lesbians, pedophile drug dealers, etc.
Her one daughter was raped by a guy she dated. She couldn’t stop urinating on herself and later developed self-mutilation behavior.
A few years ago her daughter grew up and moved to a rural southern state to escape Philly crime. In that state, she met a couple who wanted a threesome relationship with her.

她在一段又一段的关系中,是瘾君子、女同性恋者、恋童癖毒贩等等。
她的一个女儿被她约会过的一个男人强奸了。她无法停止尿在自己身上,后来发展出自残行为。
几年前,她的女儿长大了,为了躲避费城的犯罪,搬到了南部的一个农村州。在那个州,她遇到了一对想要和她建立三人行关系的情侣。

The daughter had two kids for the older couple. They got tired of her and took the kids. She figured that she was a lesbian and out in the middle of a rural nowhere BUT she met some super fat lesbian girl who sold meth.
They sold it to the wrong person and they died. Now the daughter is looking at 26 years in prison.
The woman I know got heavily into drugs after learning this about her daughter. She was doing drugs with some black guys and they raped her while she was passed out.

女儿为年长的夫妇生了两个孩子。他们厌倦了她,带走了孩子们。她以为自己是一名女同性恋,生活在一个偏僻的农村,但她遇到了一个卖冰毒的超级胖的女同性恋女孩。
他们把它卖给了错误的人,卖D品的人死了。现在,她的女儿将面临26年的牢狱之灾。
我认识的那个女人在得知她女儿的这件事后,染上了毒瘾。她和一些黑人一起吸毒,他们在她昏迷时强奸了她。

Now the woman is pregnant and wanted to get an abortion but she couldn’t bring herself to do it. Now she is AS OF THIS MINUTE running around Philly pregnant smoking crack and shooting drugs.
That is ONE person I know from Kensington and everyone I’ve met has similar stories, The stories aren’t about drugs and money but about immoral lives from childhood that they could not stop as they got older.
What you posted is a “white people” academic view of life and not real.

现在,这名妇女怀孕了,想堕胎,但她无法让自己堕胎。现在,她在费城四处奔波,一边抽烟一边吸毒。
这是我在肯辛顿认识的一个人,我遇到的每个人都有类似的故事,这些故事不是关于D品和金钱,而是关于他们从小就无法停止的不道德生活。
你发布的是“白人”的学术人生观,而不是真实生活。

What you wrote SOUNDS GOOD but is really an isolated bourgeois fantasy about how life works.
If we just fix A and B—-everything will be great!
It’s all Reagan’s fault!!
It’s not and it’s not about drugs, a political party, or economics.
I have never been a religious person, but I have come to notice that rejected traditions were seen as stupid, but that’s because people forgot why they existed, to begin with. Kensington is why religion existed.
After it was made irrelevant, everything in the story I told reemerged.

你写的听起来不错,但实际上是一个关于生活如何运作的孤立的资产阶级幻想。
“如果我们只要做好A和B,一切都会好起来的!”
“都是里根的错!!”
这与D品、政党或经济无关。
我从来都不是一个信教的人,但我注意到,被拒绝的传统被视为愚蠢的,但那是因为人们就忘记了,最开始的时候,传统是因为什么而存在。
肯辛顿是宗教为什么存在的原因。
在宗教变得无关紧要之后,我讲述的故事中的一切都重新出现了。

Tom Simunovic
Is the Chinese drug policy way to go?

可以走中国对于D品(处理)的道路吗?

Jan Veselý
It is not. Repression won't stop anything. It will just make the stuff even less safe, less accessible, more expensive and produce more prisoners and more suicides.
Better to spend money on rehabs, psychologists, social workers, substitution therapy and overall improvement of the society.

不行,镇压不会阻止任何事情。这只会让这些东西变得更不安全、更不容易获得、更昂贵,并导致更多的囚犯和更多的自杀。
最好把钱花在康复、心理学家、社会工作者、替代疗法和社会整体改善上。

Susanna Viljanen
No. Prohibitions do not work. It would basically be a repeat of the Volstead

不。禁止是行不通的。这基本上是沃尔斯特德法案(禁酒法案)的重演。

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