恶（2013）

Vice S04E14

Part 2 May 7, 2021, 11:29 a.m.

were far less addictive
那么容易让人上瘾
than all previous medical science had shown.
现在事实上
Now, in fact, the rate of addiction
被医生治疗的疼痛患者的上瘾率
amongst pain patients who are treated by doctors
远小于百分之一
is much less than one percent.
被多次引用的数据显示
The statistic that was used over and over again
远小于百分之一的病人会上瘾
was much less than one percent of patients would get addicted.
但是你会发现大家引用的实际上
But what you would find is that what everybody was citing
并不是一篇期刊文章
wasn't actually a journal article.
而只是给编辑的一段信
It was a one-paragraph letter to the editor.
然而我们却把这作为依据
And yet, that's what was used as evidence
该领域的专家还引用了成百上千次
and cited hundreds of times by experts in the field
用来证明我们不必担心
as proof that we shouldn't be worried
病人会上瘾
about getting our patients addicted.
一些你必须了解的东西是
Something you have to understand
当我们谈论阿片类止痛药时
is that when when we talk about opioid pain medicine,
本质上就是在谈论海♥洛♥因♥
we're essentially talking about heroin pills.
从阿片类药物成瘾泛滥开始
From the beginning of the opioid addiction epidemic,
那些对阿片类药物上瘾的年轻人
the young people who were opioid-addicted
便不能从医生那里得到足够的药丸
who were having trouble getting enough pills from doctors,
他们就去黑市
would go to the black market,
如果他们在容易获得海♥洛♥因♥的地区
and if they were in a region of the country
他们便转而吸食海♥洛♥因♥
where heroin was available, they switched.
我能问问你是如何开始使用毒品的吗
Can I ask you how you started using?
你在那之前碰过海♥洛♥因♥吗
Had you ever touched heroin before that or...?
为什么转向海♥洛♥因♥了呢
Why'd you switch?
恩
Ah.
关于阿片类药物成瘾最为有害的是
What's particularly insidious about opiate addiction
身体会迅速产生一个耐受量
is how quickly the body develops a tolerance,
需要不断增加剂量
requiring increasing amounts
才能产生相同的效果
of the drug just to generate the same effect,
很显然这也增加了
which, obviously, also
意外用药过量的机会
increases the chance of accidental overdose.
你弄出这些粗条
You're making these big lines.
如果你开始吸食了比如
If you had just started, like, how big a...
你要吸食多大量这样啊
...how big of a bump are you doing? Okay.
像普渡制药这样的药企
While pill makers like Purdue teed up all this madness,
至少他们的产品是符合规格的
at the very least, their product was regulated.
如果你吃了80mg的奥施康定
If you took an 80mg OxyContin,
你清楚地知道你正在吃多少奥施康定
you knew exactly how much oxy you were taking.
海♥洛♥因♥的情况就不一样了
This is not the case with heroin,
海♥洛♥因♥的药效因批次而异
whose strength can vary from batch to batch,
甚至每包之间也不一样
and even bag to bag.
最重要的是海♥洛♥因♥必须被加入辅料
On top of that, heroin has to be cut,
因为纯海♥洛♥因♥可以杀死一个老道的吸毒者
because pure heroin alone would kill even a veteran junkie.
但是用什么来作为辅料是每个人都在猜测的
But what it's cut with is anybody's guess.
如果你加入辅料能卖♥♥多少
And how much could you sell it for if you cut it?
那些那些是什么是电影票吗
Are those-- What are those? Are those movie tickets?
奥是彩票
Oh, lottery tickets.
那么你用什么来作为辅料呢那个吗
So, what do you cut it with? Is that--
不能说好的
No. Okay.
嗯
Mm-hmm.
你说药片是说止痛药吗
When you say pills, do you use painkiller pills?
-那基本上和海♥洛♥因♥是一样的东西不是吗 -是的
-Well, it's basically the same thing as heroin, isn't it? -Right.
使用最多的辅料是芬太尼
The strongest cutting agent of all is fentanyl,
它是现有的最强的阿片类止痛药
which is the strongest opioid painkiller in existence,
是纯海♥洛♥因♥功效的50多倍
up to 50 times the strength of pure heroin.
你认识用芬太尼作辅料的人吗
Do you know anybody who cuts with fentanyl?
恩
Yeah
真的吗
Really?
他们故意让某人过量吸毒
They were intentionally trying to get someone to overdose.
-是的 -好吧
-Yes. -Okay.
偶然的用药过量者长♥期♥被作为
Accidental overdoses have long served
一种畸形的毒品广♥告♥手段
as a perverse form of advertising for heroin dealers.
然而毒贩使用治疗药物
But the fact that they're
来引诱吸毒者的事实
using pharmaceutical drugs to induce them
显示了他们对药物的极端需求
shows just how extreme the demand has grown.
因奥施康定泛滥引起的海♥洛♥因♥泛滥
So now the heroin epidemic that the OxyContin epidemic started,
进而导致了芬太尼的泛滥
has itself turned into a fentanyl epidemic.
他们不懂为什么要用芬太尼作为海♥洛♥因♥的辅料
They didn't understand why they're cutting heroin with fentanyl,
毕竟芬太尼这么贵
because fentanyl is really expensive.
就我的想法
And I kind of have this idea
他们没把芬太尼作为海♥洛♥因♥的辅料
that they're not cutting heroin with fentanyl.
而是在用海♥洛♥因♥作为芬太尼的辅料
They're cutting the fentanyl with heroin.
随着毒性越来越强的海♥洛♥因♥
With an increasingly toxic, and seemingly inexhaustible
源源不断地涌入这个国家
supply of heroin entering the country,
政♥府♥终于开始把
the government has finally started making overtures
这一问题摆上台面
towards addressing the problem on the demand side.
每年因吸毒过量致死的美国人
More Americans now die every year from drug overdoses
比因交通事故致死的还多
than they do from motor vehicle crashes.
奥巴马总统今天来到查理斯
President Obama has come to Charleston today
提及了海♥洛♥因♥问题
to address the heroin problem.
但是讽刺的是
But there's an ironic note in the fact
这个问题早在2007年
that this is a crisis that started in 2007,
奥巴马执政之前就存在了
before the Obama presidency,
结果直到他执政还剩两年
and it's taken till the second-to-last year of his administration
才开始正式表态
to address a problem that's been in plain sight
这个问题已经存在了超过八年
down here for over eight years.
我将这一问题作为我政♥府♥的当务之急
I've made this a priority for my administration.
这和其他疾病不同
With no other disease do we expect people to wait
不能等待这些自我伤害的人
until they're a danger to themselves
去自觉意识到问题并需求医治
to self-diagnose and seek treatment.
在座各位应该都明白西维吉尼亚州的情况
You understand that here in West Virginia.
我们要确保
We want to make sure the whole
全国都能意识到问题的紧迫
country understands how urgent this problem is.
西佛吉尼亚州毒品危机有一个很严重的问题
One big part of the problem with the opiate crisis in West Virginia
这是他们第一次处理麻♥醉♥药♥事件
is they've-- this is basically their first time dealing with it.
这其实是美国各州面对毒品时
This is actually a big part of a larger problem
都有过的问题
with America's response to drug problems.
对于成瘾性普遍缺乏经验
It's just general inexperience with addiction,
就像如何算是个瘾君子
like what it means to be an addict,
他们为什么会在
why people behave the way they do
迷上海♥洛♥因♥和奥施康定及其他毒品后变成这个样子
when they're hooked on heroin or OxyContin or other opioids.
米奇一个瘾君子
Mickey, the addict who
从开始嗑药就次次过量
overdosed at the very beginning of our piece,
谢天谢地他活了下来
he survived, thankfully,
也很幸运的在康丁顿镇
and was lucky to find a bed
接受过戒毒治疗
at a treatment facility here in Huntington.
怎么样过得如何兄弟
What's up? What's going on, bro?
你之前是在这儿接受治疗对吧
Now, you've been here before, though, right? You were telling me.
对我第一次来的时候
Yeah, the first time I was in here,
就想随便过来混混让法官闭嘴
I just wanted that damn judge off my back.
第二次来的时候
The second time I came in, I just...
我想学会如何控制毒瘾
needed to learn how to manage,
然后恢复到正常的生活
to get back to where I was able to use and still work,
赚钱养家付医药费之类的
and pay bills and all that shit.
啊但是呢并没有按那样发展
Yeah. And, yeah, it don't work that way.
就像是让一个公♥关♥去戒酒对吧
That's like trying to be, like, a social drinker for alcoholics.
是的我也试过很不幸失败了
Yeah. I was trying... Yeah, I failed miserably.
然后我就遇见你们了
That's when I met you guys.
你以前有吸过量几次
How many times had you overdosed before that?
大概七次
About seven.
我意思是我其实还嗑昏过很多次
I mean, I've overdosed a bunch more than that,
但是这七次我必须接受抢救
but seven of them, I had to go to the hospital for.
原来是这样
Right. Okay.
我醒来的时候就感觉喉咙里有根管子
I woke up with everything from hoses down my throat,
注入肾上腺素纳洛酮等
to adrenaline shots, to Narcan.
上帝给我们平静
God, grant us the serenity
去接受那些改变不了的事情
to accept the things we cannot change...
老天我在街头河岸帐篷都睡过
Hell, I've lived on the streets, riverbanks, and tents,
还是大冬天的