評論
打印
Standing in the bitter cold outside the DeCoach Recovery Centre, a drug treatment clinic on the edge of an ocean of car parking in Hamilton, Ohio, Scott Weaver explains where his life went off track.
斯科特·韋弗（Scott Weaver）冒著寒風站在德科奇康復中心外面，這是俄亥俄州漢密爾頓市停車場邊緣的一家戒毒診所。他解釋了自己的生活是如何偏離軌道的。
First, he says, about ten years ago he was in a car wreck. "I started taking pills", he explains—they were prescribed. "But I wasn't hooked on them at that time."
首先，他說，大約十年前他遭遇了一場車禍。“我開始吃藥”，他解釋道——這些都是醫(yī)生開的處方藥。“但那時我還沒有上癮。”
Then his mother got cancer and, in his depression, he began taking her pain pills. After she died he turned to heroin. Then came fentanyl.
后來他的母親得了癌癥，抑郁的他開始吃她的止痛藥。母親去世后，他開始吸食海洛因。然后是芬太尼。
He lost a girlfriend to an overdose. "It messed me up pretty bad," he says. Now Mr Weaver is clean and he is taking Suboxone, a drug that is meant to reduce cravings.
他因吸毒過量而失去了女友。“這讓我很傷心，”他說。現(xiàn)在韋弗已經(jīng)戒毒了，他正在服用丁丙諾啡，這是一種旨在抑制吸毒渴望的藥物。
"It works," he says. "People will tell you it don't because they don't want to take it, ‘cause they ain't done yet." Mr Weaver's story reflects America's opioid crisis.
“它很有效，”他說。“人們會告訴你它沒用，因為他們不想吃，因為他們還沒有戒掉。”韋弗的經(jīng)歷反映了美國的阿片類藥物危機。
Having begun in earnest two decades ago with the overprescription of pain pills, it escalated through heroin and now to fentanyl, a synthetic opioid so potent that 0.2% of a gram can kill.
二十年前，止痛藥濫用開始猖獗，后來逐漸升級為海洛因，現(xiàn)在又升級為芬太尼，一種合成阿片類藥物，其藥效強大，0.2%的劑量就能致人死亡。
Over a million Americans have died from overdoses since the turn of the century; 108,000 of those deaths were in 2022 alone. And yet there is reason to think that the tide may be turning.
自本世紀初以來，已有超過一百萬美國人因服藥過量而死亡；其中10.8萬人死于2022年。然而，我們有理由認為形勢可能正在好轉(zhuǎn)。
Data published by the Centers for Disease Control and Prevention, a government agency, suggest that nationally, deaths peaked around August last year.
政府機構疾病控制與預防中心發(fā)布的數(shù)據(jù)顯示，全國死亡人數(shù)在去年8月左右達到頂峰。
In the 12 months to July this year, there were 90,000 deaths—still an appalling total, but a reduction of around a sixth.
截至今年7月的12個月內(nèi)，死亡人數(shù)為9萬人——仍然是一個令人震驚的總數(shù)，但減少了約六分之一。
Could America be nearing the point where it is, as Mr Weaver might put it, "done" with opioids? No one is exactly sure why deaths might have started falling.
美國是否即將達到韋弗所說的“停止”使用阿片類藥物的程度？沒有人確切知道死亡人數(shù)為何開始下降。
"We're all speculating at this point," says Daniel Ciccarone, a professor in addiction medicine at the University of California in San Francisco.
“目前我們都在猜測，”加州大學舊金山分校成癮醫(yī)學教授丹尼爾·西卡羅內(nèi)(Daniel Ciccarone)表示。
Data on the number of fentanyl users are scarce, as are data on prices and purity. Addiction treatment has been expanding for years.
關于芬太尼使用者數(shù)量的數(shù)據(jù)很少，價格和純度的數(shù)據(jù)也很少。成癮治療多年來一直在擴大。
But the drop in deaths is too sudden and too widespread (almost all states have experienced it) to be primarily down to this.
但死亡人數(shù)的下降太突然、太普遍（幾乎所有州都經(jīng)歷過這種情況），因此不能主要歸因于此。
There has been no dramatic increase in prescriptions of anti-addiction drugs, either.
抗成癮藥物的處方也沒有大幅增加。
More naloxone kits (an injection which can reverse an overdose, first approved under the brand name Narcan) are being distributed.
正在分發(fā)更多的納洛酮套件（一種可以逆轉(zhuǎn)過量服用的注射劑，最初以Narcan的品牌名稱獲批）。
That must be helping, but also cannot fully explain the drop. One possibility is a supply shock.
這肯定有幫助，但也不能完全解釋下降的原因。一種可能性是供應沖擊。
According to the Drug Enforcement Administration, which polices drug smuggling, the amount of fentanyl in pills they intercept has fallen.
據(jù)負責監(jiān)管毒品走私的緝毒局稱，他們攔截的藥丸中芬太尼的含量已經(jīng)下降。
Some reports suggest the Sinaloa cartel, a huge Mexican organised-crime group, has stepped back from smuggling fentanyl because of American pressure.
一些報道稱，由于美國施壓，墨西哥龐大的有組織犯罪集團錫那羅亞販毒集團已停止走私芬太尼。
In July two high-ranking members, including the son of El Chapo, one of Sinaloa's founders, were arrested. Experts however say it is far too early to be sure.
7月，兩名高級成員被捕，其中包括錫那羅亞販毒集團創(chuàng)始人之一El Chapo的兒子。然而，專家表示，現(xiàn)在下結論還為時過早。
Another possibility is that the decline represents a return to pre-pandemic norms. When covid-19 hit, opioid overdoses soared.
另一種可能性是，這種下降代表著恢復到疫情前的常態(tài)。當新冠疫情來襲時，阿片類藥物過量用藥激增。
It is hard to say why, but feels intuitive: hospitals were full of covid patients, many treatment centres had shut, and more people were experiencing the sort of traumatic losses that can make them turn to drugs.
很難說清楚原因，但感覺很直觀：醫(yī)院里擠滿了新冠患者，許多治療中心已經(jīng)關閉，越來越多的人正在經(jīng)歷那種可能讓他們轉(zhuǎn)向毒品的創(chuàng)傷性損失。
If this is the primary reason, the current decline will level off, and seems unlikely to keep falling. If this is instead a sustained drop, look to a third explanation.
如果這是主要原因，那么目前的下降將趨于平穩(wěn)，而且似乎不太可能繼續(xù)下降。如果這是一種持續(xù)的下降，那就看看第三種解釋吧。
Though deaths have fallen in most of the country, the steepest improvements have been in places that were hit especially early, particularly in Appalachia and the Midwest.
雖然全國大部分地區(qū)的死亡人數(shù)有所下降，但最顯著的改善出現(xiàn)在那些早期受到?jīng)_擊的地方，尤其是阿巴拉契亞和中西部地區(qū)。
