Addicts Are Dying While America Profits and What Portugal, Switzerland, and Iceland Already Know

Brainz Magazine
5 days ago
8 min read

Written by Amber Soiland, Nurse Educator & Public Advocate

Amber is a nurse educator, public advocate, and entrepreneur with experience in emergency nursing, simulation-based training, and harm reduction. Owner of The RTI, she specializes in critical care education, mock codes, and national certifications. Passionate about leadership and public health, she leverages social media to educate and inspire.

In the United States, we punish addiction with handcuffs and funerals. Other countries have figured out how to save lives, and it’s time we stop pretending our system works.

Hand holds a small white packet and cigarette near a cracked glass. A dollar bill floats. Smoky atmosphere, dark background, tense mood.

America doesn’t have an addiction epidemic; it has an empathy crisis

In the United States, addiction isn’t treated like a health condition, it’s treated like a moral failing. You can be arrested for carrying life-saving Narcan, yet there’s no accountability for a system that lets thousands die preventable deaths every single year. In several U.S. states, fentanyl testing strips are criminalized as “drug paraphernalia,” making it illegal to even check your drugs for contamination before you use them. Let that sink in: 'You can be jailed for trying not to die.'

This isn’t just outdated policy, it’s a public health failure rooted in criminalization, inaccessibility, and political greed. And the numbers prove it.

Since 1999, drug overdose deaths in the U.S. have skyrocketed with a 453% increase in the last decade. Even as prescription opioid deaths peaked in 2017 (17,029) and declined to 13,026 by 2023, the crisis didn’t slow because it was never just about prescriptions. It was about the rise of illicit synthetic opioids, like fentanyl, driving the deadliest wave of overdoses in U.S. history.

Nearly 70% of stimulant-related overdose deaths now involve fentanyl, according to the CDC. Cocaine-involved deaths rose 85% from 2019 to 2023, primarily due to fentanyl contamination. Psychostimulant overdose deaths, like methamphetamine, more than quintupled from 5,716 in 2015 to 34,855 in 2023, again, fentanyl was the common denominator.

But it doesn’t stop at opioids or stimulants. America’s crisis is evolving into a polysubstance nightmare, where people unknowingly ingest a toxic cocktail of substances. Emerging threats like xylazine, a veterinary tranquilizer not approved for humans, have shown a fourfold increase in fentanyl-related deaths in just three years (2019-2022), devastating entire regions, especially in the southern U.S., with Tennessee, Texas, and Alabama leading the unfortunate statistics.

Despite this mass death toll, access to effective treatment remains abysmal. In 2020, only 11% of Americans with opioid use disorder (OUD) received any form of medication-assisted treatment. Compare that to 87% in France, 86% in Norway, and 51% in Scotland. Here, treatment is often a revolving door; people cycle in and out of for-profit rehab centers while Big Pharma lobbyists keep life-saving interventions out of reach, and “Wellness Gurus” profit off false hope.

If you’re lucky enough to survive your overdose and make it to an ER, your battle isn’t over. Many hospitals discharge people back to the street without connecting them to care, that is, if they don’t deny you treatment outright by labeling you a “drug seeker.” I’ve worked in ERs where patients get called ‘frequent flyers’ instead of people with complex, unmet needs.

America doesn’t just stigmatize addiction, it systematically profits from it. People struggling with substance use are criminalized, ignored, and then blamed for their own deaths. Meanwhile, the healthcare system gets richer, the prison system gets fuller, and the body count keeps climbing.

America isn’t broken by addiction but by its refusal to understand it

We don’t have a cohesive national strategy. We have 51 different rulebooks and hundreds of local policies, where the state you live in decides whether you live or die. In some states, you can get free Narcan at the pharmacy. In others, you have to beg your doctor for a prescription, you’ll likely have to pay out-of-pocket, with astronomically inflated rates. You can purchase a single fentanyl testing strip for $1 through Dose Test, but if you walk into a CVS pharmacy, you’ll pay $16.99 for the exact same product, that’s an outrageous 1,599% markup. Life-saving harm reduction tools shouldn’t be treated like luxury goods, but in America, even your survival comes with a price tag.

How is anyone supposed to survive when it’s a geographical lottery?

It doesn’t matter if you vote red or blue, this system is rigged against you. Because addiction doesn’t care about your political party, your religion, or your values. It cares about the holes inside people, the trauma, the loneliness, the untreated mental health conditions, the unbearable need to escape. And when people go looking for relief, they don’t get therapy, they get criminal charges. They don’t get treatment, they get a bed in a county jail, or a for-profit rehab that spits them back out in 28 days with a $30,000 bill.

Let’s talk about who profits from addiction – it’s not those dying in the streets

We’ve built an entire industrial complex of suffering, where wellness centers and luxury rehabs rake in millions from the rich, offering spa services, equine therapy, and Instagram-worthy recovery retreats. Meanwhile, people on Medicaid get thrown on waiting lists so long they die before their name comes up; if their state even funds treatment at all. How is it “care” if only the wealthy can access it?

The truth no one wants to face is this: addiction isn’t the problem, unhealed pain is. People are using it because they are escaping. Escaping trauma. Escaping mental illness. Escaping hopelessness. Escaping a life with no safety net and no second chances. Fix the reasons people use, and you stop the epidemic at its root.

America could lead the world in compassionate, effective care, but instead, we lead the world in overdose deaths, incarceration rates, and broken families. We have politicians on both sides grandstanding about “cracking down on crime” while ignoring the real crime happening in boardrooms and healthcare systems, profiting off misery while offering no real solutions.

We don’t need more punishment.

We don’t need more profit.

We need healing.

Until we deal with the mental health epidemic, the trauma epidemic, and the hopelessness epidemic, America will continue to bury its people while congratulating itself for fighting a ‘war on drugs.’

And it’s time for people on both sides to demand better.

Other countries have solved this, so why won’t America listen?

While America keeps doubling down on criminalization and corporate rehab schemes, other countries have quietly built systems that actually save lives. They aren’t perfect, but they’ve figured out something we refuse to: if you treat people like human beings instead of criminals, they live. And the data proves it.

Portugal: Decriminalize, don’t demonize

In 2001, Portugal was drowning in one of the worst drug crises in Europe. They had the highest rate of drug-related AIDS in the European Union, the second highest rate of HIV among people who inject drugs, and overdose deaths were surging.

Instead of throwing more people in jail, Portugal did something radical: they decriminalized all personal drug use and redirected their resources toward treatment, mental health care, and social reintegration. And the results were historic.

Overdose deaths fell by more than 85%.
HIV infections among drug users dropped by over 90%.
Heroin use plummeted from 100,000 to just 25,000 people.
More people voluntarily sought treatment than ever before.

But maybe the most revolutionary shift wasn’t in numbers, it was in mindset. Portugal adopted a national philosophy that “people use drugs for many reasons,” that “a drug-free society is impossible,” and that punishment doesn’t heal trauma; it deepens it.

Switzerland: Safe use saves lives

Switzerland went in another direction, one that the U.S. won’t even dare to consider. They legalized safe consumption sites, created heroin-assisted treatment programs, and established a “four-pillar model” built around prevention, treatment, harm reduction, and law enforcement working together, not against each other. The result?

Overdose deaths were cut in half between 1991 and 2010.
HIV infections among IV drug users dropped by 65%.
Public nuisance complaints about drug use fell dramatically, while crime associated with drug use also dropped.
Safe injection sites recorded "zero" overdose deaths on site.

People who were once overdosing in public bathrooms are now alive, stabilized, and when they’re ready, they’re supported into recovery on their own terms.

Iceland: Stop it before it starts

Iceland didn’t wait for people to become addicted – they went upstream.

In the 1990s, Iceland had sky-high rates of teenage substance use. Instead of punitive crackdowns, they invested in community programs, after-school activities, parental engagement, and mental health support; basically, the exact opposite of what we do in the U.S.

And the transformation was dramatic:

Teen binge drinking dropped from 42% to just 5%.
Teen daily smoking dropped from 23% to 3%.
Teen cannabis use shrank from 17% to 5%.

They didn’t “just say no”; they built support systems so kids didn’t need to say yes in the first place.

We can choose a better way, but we have to want it

Every country I’ve mentioned made a choice: they chose to see people, not criminals. They chose to invest in healing, not punishment. And because of that, they have fewer funerals, fewer broken families, and fewer wasted lives.

America could make that same choice, but we haven’t. Not yet.

I walked away from my career in the emergency room because I couldn’t stand to watch another preventable death. I couldn’t stomach the revolving door of patients who needed help but were labeled as “lost causes.” I’ve seen the system from the inside, and now, I’m fighting it from the outside, because somebody has to.

We don’t need more excuses. We don’t need more criminal charges. We need real solutions: mental health support, trauma-informed care, harm reduction, and treatment that actually works for everyone, not just the people who can afford it.

But I can’t fight this alone, we need to demand better together

If you’ve ever lost someone to addiction…

If you’ve ever been dismissed by a healthcare system more focused on profits than people…

If you believe that every life is worth saving…

Then I’m asking you: help me fight for the change we all deserve.

Share this message. Start the conversation in your own circles. Challenge your local leaders. Visit my social media to learn how you can help. Support harm reduction programs in your community. Because when we stop treating addiction like a crime, we stop filling graveyards and start saving lives.

Follow me on Instagram, and visit my website for more info!

Read more from Amber Soiland

Amber Soiland, Nurse Educator & Public Advocate

Amber is a nurse educator, public advocate, and entrepreneur dedicated to saving lives through education and harm reduction. With a background in emergency nursing, she specializes in critical care training, simulation-based learning, and Narcan distribution. As the owner of The RTI, she provides hands-on instruction in mock codes, trauma response, and national certifications. Amber also leverages social media to make complex medical topics accessible to a wider audience. Follow her for expert insights on emergency care, patient safety, and healthcare innovation.

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