Seven years clean, Oleksandr believed he had left addiction behind. Then, a year into fighting [Russia](https://www.theguardian.com/world/russia), the Ukrainian soldier was prescribed painkillers for a shoulder injury. Under the strain of war, he relapsed and quickly began using stronger illicit opioids. “From that moment, I was fighting two wars – one inside myself and one with Russia,” he said, speaking at a rehabilitation facility in Kyiv. Oleksandr continued to serve for another two years, rising to the rank of officer even as his addiction deepened. “I was hiding my use from the others. It’s the kind of thing you’re ashamed of,” he said. Last winter, he reached a breaking point. Unable to perform his duties, he came clean to his superiors. “Luckily, they were understanding and I was sent to rehabilitation.” [](https://www.theguardian.com/world/2026/apr/19/ukraine-soldiers-confront-addiction-struggles#img-2) * Oleksandr relapsed into addiction after treatment for a shoulder injury sustained during fighting. Drug and alcohol abuse have shadowed every modern conflict. In Ukraine’s war, now in its fifth year, the psychological toll on soldiers has been immense – and for some, addiction has followed. “Drug use among troops is a grey area,” said Oleh Olishevskiy, who runs a specialised rehabilitation clinic at Kyiv City Clinical hospital No 10, treating addiction alongside psychological trauma since the start of Russia’s full-scale invasion. “Everyone knows it exists, but few want to talk about it.” The scale of the problem is hard to measure. Ukraine’s military does not disclose how many soldiers are dealing with mental health problems, let alone addiction. “I don’t think we’ll ever know the real numbers. No one is keeping track,” Olishevskiy said. He cited a 2024 study by the Ukrainian charity 100% Life of 1,000 soldiers that found more than a third had used amphetamines at least once a month, while one in five reported using prescription drugs such as pregabalin. About 15% reported using cheap synthetic cathinones, known as “salt”, and opioids. At the Kyiv clinic, a drab three-storey building in a leafy part of Kyiv, Olishevskiy and his team treat about 25 patients at a time, with stays of up to four months. The aim, ultimately, is for the soldiers to return to the army. But those working in the mental health field say the need for addiction-related care among Ukraine’s troops far exceeds available treatment and will persist long after the fighting ends. As in many other countries, substance abuse also remains difficult to discuss openly – particularly for men, and even more so for soldiers. “The war’s scale is unmatched in modern history. And it is not even over; the worst still lies ahead when soldiers return,” Olishevskiy said. Widespread drug use in the Russian army has been well documented [in media reports](https://www.nbcsandiego.com/news/national-international/russian-troops-punished-for-drink-and-drugs-frontline-attacks-on-ukraine-rising-zelenskyy-says/3355602/), at the front and in the rear, where soldiers can be punished by deployment to high-risk assault units or forced to sit in pits and cellars for days**.** In Ukraine, there are efforts to take a different approach. While stigma around drugs remains, attitudes among commanders are shifting, medics say, with more soldiers being sent for treatment. “There is more understanding now, but much still depends on your superiors,” said Petro, one of the clinic’s counsellors, who asked for his last name to be withheld. “It’s getting better,” he added. Some of the rehab staff, including Petro, are former addicts and servicemen themselves. At the core of the clinic’s work is the belief that addiction and war trauma are inseparable. Counsellors say drug use can only be understood alongside the untreated PTSD and psychological wounds that often precede it. [](https://www.theguardian.com/world/2026/apr/19/ukraine-soldiers-confront-addiction-struggles#img-5) * Petro, a war veteran, who has been treated at the rehab centre and now works there. Stimulants are sometimes used to stay awake during long stretches of duty. But most patients say their addiction worsened away from the front, when they returned to base after weeks of fighting and struggled to unwind, turning to drugs or alcohol to blunt intrusive memories, manage anxiety or simply get through the night. “I never used it on a mission – you’d get killed quickly. You’re already running on adrenaline anyway,” said Dmytro, a Ukrainian soldier, speaking in the rehab’s cafeteria over a bowl of soup. “When you’re back, you just want to switch off. Forget everything you’ve seen – all the death and other shit.” Dmytro, who was undergoing rehabilitation for an addiction to synthetic stimulants, asked for his name to be changed, fearing Russia could use his addiction against him if he were taken prisoner. Like others, Dmytro said drugs were relatively easy to obtain – ordered through the Ukrainian post service or collected from hidden stashes shared through messaging apps. The drugs left him paranoid. He described strapping grenades to the door of his bedroom in Kramatorsk, an eastern Ukrainian city near the front where troops come to rest, convinced he was about to be ambushed by Russian forces. “I started to lose track of what was real,” Dmytro recalled. [](https://www.theguardian.com/world/2026/apr/19/ukraine-soldiers-confront-addiction-struggles#img-8) * The canteen is a place where the soldiers, veterans and civilians being treated can all share a meal. Inside the facility, the daily routine for Dmytro and others is structured, much like in any other rehab centre. Mornings begin with group therapy, followed by individual sessions and physical activity – yoga, light exercise, table tennis. But the war is never far away: drawings by patients on the walls show guns and other scenes of combat. Olishevskiy said he stays in close contact with specialists in western countries, drawing on their latest medical research. This summer, he has planned a retreat for his patients at a farm with horses in Kharkiv. His eyes lit up when talking about promising results for a trial using ketamine to treat PTSD. “If trauma isn’t processed and someone copes through drugs or alcohol, within months you can have severe PTSD that becomes much harder to treat,” said Olishevskiy. “Punishing a soldier at the front by docking his pay will not help treat the underlying issue behind drug use,” he added. But [Ukraine’s acute manpower shortages](https://www.theguardian.com/world/2025/jan/31/tired-mood-changed-ukrainian-army-desertion-crisis) create difficult trade-offs for Olishevskiy and his staff. Pressure to fill gaps has led to some patients being sent back to service before fully recovering. Complete recovery is the “ideal scenario”, said Olishevskiy. In practice, however, even reducing drug use to a level where they can function may be considered good enough, he added. Patients and medics also said mobilisation officers often allow prospective soldiers with existing drug use to serve in the army. “It was obvious to everyone, including the doctors, that I was addicted during my enlistment medical,” said Anton, who had been using synthetic drugs for six months before joining the army. He later developed a severe addiction and was sent to hospital after suffering a heart attack. Still, Anton said he wants to get better and return to the frontlines. “This clinic gave me another chance at life. I want to give something back.”

May 15, 2026 1:31 PM The LA mayoral candidate and former reality TV star is fueling his campaign with fears about an ultra-potent meth. Experts say it’s drug war propaganda.  Photograph: Roy Rochlin/Getty Images Spencer Pratt, once the [villain](https://www.wired.com/story/netflix-love-is-blind-brandon-riegg-on-why-so-many-men-on-dating-shows-are-terrible/?utm_brand=wired&utm_campaign=aud-dev&utm_medium=social&utm_social-type=owned&utm_source=facebook) of the 2000s MTV [reality show](https://www.wired.com/story/reality-tv-saved-me/) _The Hills_ and now an insurgent candidate in this year’s [Los Angeles](https://www.wired.com/tag/los-angeles/) mayoral race, had a breakthrough moment in his first debate performance last Wednesday. Turning to his signature issue of public safety, Pratt berated his opponents—Mayor Karen Bass and city councilmember Nithya Raman—for not doing enough about [unhoused people](https://www.wired.com/2017/05/new-york-citys-businesslike-tech-fighting-homelessness/) dealing with [drug addiction](https://www.wired.com/story/addiction-rehab-is-broken-can-technology-fix-it/). “The reality is, no matter how many beds you give these people, they are on super meth,” Pratt [said](https://x.com/amyforsandiego/status/2052185293701386733), criticizing Raman’s [plan](https://x.com/nithyavraman/status/2043765281609372056?s=20) to expand addiction treatment. “I will go below the Harbor Freeway tomorrow with her, and we can find some of the people she’s gonna offer treatment for. She’s gonna get stabbed in the neck. These people do not want a bed. They want fentanyl or super meth.” The viral attack on Bass and Raman was not some anomaly: On the campaign trail, Pratt, a registered Republican running as an independent, has routinely conjured [dystopian visions](https://x.com/jayplemons/status/2054011982978978084) of LA’s urban sprawl, nearly always [punctuated by the watchword](https://x.com/TheNewsBuffetX/status/2052090079041224961) “[super meth](https://www.instagram.com/reels/DX-MR6sEV8n/).” It’s a term that suggests a drug crisis beyond anything the average voter had imagined, a terrifying new tide of ultra-potent methamphetamines flooding the streets. There’s just one small detail that undercuts Pratt’s message: “Super meth” isn’t a thing. “Thankfully, super meth isn't real,” says Claire Zagorski, a paramedic, harm reductionist, and PhD candidate at the University of Texas at Austin College of Pharmacy. “If there really was a new type of meth, it'd have its own chemical name and we'd be hearing about it from much more reputable sources than Mr. Pratt.” Zagorski explains that while some have used the phrase “super meth” to differentiate phenyl-2-propanone (or P2P) methamphetamine from meth made with pseudoephedrine, “it's all still meth at the end.” (You may recall that _Breaking Bad_’s Walter White preferred the P2P process for cooking meth because it allowed him to scale up his operation.) P2P meth is the molecular mirror-image of the meth that was once more common in the US, but that doesn’t make it a distinct drug. P2P-produced meth, as Zagorski wrote in a [2022 article](https://filtermag.org/new-meth-p2p/) for _Filter_ magazine, actually emerged [in the 1970s](https://pmc.ncbi.nlm.nih.gov/articles/PMC3243901/), with suppliers shifting to the pseudoephedrine found in the decongestant Sudafed when P2P was [federally scheduled in 1980](https://www.deadiversion.usdoj.gov/drug_chem_info/meth.pdf). Then, after the government [cracked down](https://www.cga.ct.gov/2006/rpt/2006-R-0637.htm) on pseudoephedrine in 2006—restricting and tracking pharmacy sales—meth manufacturers went back to P2P. Which, as Zagorski noted in her piece, shows no signs of being “any more or less neurotoxic” than the alternative. Notions that this wave of meth was particularly harmful may [trace](https://reason.com/2023/11/13/the-new-york-times-credulously-embraces-the-super-meth-theory/) in part to journalist Sam Quinones’ 2021 book _The Least of Us_ and accompanying [article](https://www.theatlantic.com/magazine/archive/2021/11/the-new-meth/620174/) in _The Atlantic_, each mentioning a “new meth” that supposedly had far more extreme and debilitating side effects than the pseudoephedrine version. (Quinones did not immediately respond to a request for comment. Following the LA mayoral debate, he penned a Los Angeles Times [op-ed](https://www.latimes.com/opinion/story/2026-05-13/super-meth-los-angeles-homelessness-mayoral-campaign) acknowledging that super meth “isn’t exactly real.”) Pratt’s campaign did not immediately return a request for comment on their definition of “super meth” or where the candidate picked up the term. “What has changed in the past several years is purity and price,” Zagorski says. That’s because a [new refining process](https://www.euda.europa.eu/publications/eu-drug-markets/methamphetamine/main-production-methods-europe_en#h3_recycling) developed in Europe in 2020 and exported to Mexico has “allowed drug manufacturers to lower prices and ensure a more pure product.” The method separates and recycles the less desirable molecular form of meth included in product yield—typically about half the total—into the kind users want. Zagorski says this is likely contributing to an uptick in meth use, but that it’s a “relatively minor” factor overall, with economic precarity and housing instability doing far more to drive the crisis. Nicky Mehtani, an assistant professor in the UCSF Division of General Internal Medicine at San Francisco General Hospital who specializes in addiction medicine and does clinical work with homeless people, tells WIRED that P2P meth is nothing new. “It's been the dominant form in the US supply for the better part of a decade,” she says. “I've never heard it called ‘super meth’ in any clinical or scientific context, probably because it's just the meth we've all been seeing for years now. There's nothing novel or uniquely ‘super’ about it at this point.” Mehtani notes that meth use disorder is notoriously difficult to treat, in part due to the lack of any FDA-approved pharmacotherapies, and that “recovery is genuinely difficult.” But she says that Pratt’s narrative misses the root causes of meth use among people experiencing homelessness. “The most common reason I hear is functional,” Mehtani says. “People are using stimulants to stay awake, to maintain vigilance, to survive on the streets at a time of increasing criminalization of poverty and homelessness.” “Calling it ‘super meth’ obscures all of that and reduces a complex public health problem to a moral panic, which tends to push us toward punitive responses and away from the evidence-based interventions that actually help,” Mehtani warns. She considers the phrase to be “classic War on Drugs language,” describing it as “vague, alarming, and not grounded in how clinicians or researchers actually talk about methamphetamine.” Ryan Marino, an associate professor in the Departments of Emergency Medicine and Psychiatry at Case Western Reserve University School of Medicine who specializes in addiction and toxicology, says the “super meth” claims are part of a broader propaganda push. (Pratt has also [referred](https://x.com/SeanSemanko/status/2054356939010932773?s=20) to homeless people as “zombies.”) “Pratt seems to be trying to use the same right-wing drug lies as we have seen other politicians use in recent years in areas like San Francisco and Portland, which were lies at the time and which have actually led to worse outcomes for those places,” Marino says. In Oregon, the [recriminalization](https://www.pbs.org/newshour/politics/oregon-law-rolling-back-drug-decriminalization-takes-effect-making-possession-a-crime-again) of possession of small amounts of drugs has not reduced homelessness within the city of Portland, where [more people are unhoused than ever,](https://www.oregonlive.com/politics/2026/04/more-people-homeless-in-portland-than-ever-despite-mayors-assurances.html?outputType=amp) while research from multiple cities has shown [a strong link](https://pubmed.ncbi.nlm.nih.gov/38211403/) between police drug busts of opioids and [increased overdose deaths](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831697). “Los Angeles is not suffering particularly worse from drug problems than places governed by Republicans or with stricter drug criminalization,” Marino says. Pratt’s line about homeless people wanting drugs rather than a bed and shelter “contradicts all available evidence,” he adds, observing that drug use “isn’t the reason for LA’s large unhoused population.” If Pratt is truly concerned about illicit drug use and homelessness, he should advocate for “evidence-based solutions like public education, drug checking facilities and supervised consumption centers, and regulation of the drug supply,” Marino says, as well as for “drug treatment, access to mental health care, and housing.” The candidate, however, probably won’t go that route. Pratt is currently [polling in second place](https://ktla.com/news/local-news/la-mayor-poll-karen-bass-leads/) behind Bass after months of demonizing the unhoused and mocking initiatives to help them recover from addiction. The repeated “super meth” soundbite, spurious as it is, makes it sound as if they’re in the grips of something too powerful to counteract by civic or medical means. And maybe that’s exactly the point: to convince Los Angeles voters that the city’s most vulnerable residents are a hopeless cause.

The Trump administration has a surprising new agenda item: It’s all-in on legalizing a psychedelic drug called ibogaine. Ibogaine is classified as a Schedule I drug, which means it’s illegal on the federal level. But some studies show it may be able to treat opioid addiction, and researchers are also hopeful that it can help with PTSD. It’s that second use that has caught the White House’s ear. Veterans and veterans’ groups have been lobbying hard for ibogaine as a way to treat PTSD and traumatic brain injuries. Last month, they made some headway on that project when President Donald Trump signed an [executive order to fast-track](https://www.whitehouse.gov/fact-sheets/2026/04/fact-sheet-president-donald-j-trump-is-accelerating-medical-treatments-for-serious-mental-illness/) the Food and Drug Administration review process. Mattha Busby, a freelance journalist writing about drug policy and other topics, told _Today, Explained_ guest host Jonquilyn Hill that, naturally, podcaster Joe Rogan was also involved. Busby spoke with Hill about what ibogaine does, how the right got into psychedelics, and whether the FDA could soon approve some of them for use. Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full episode, so listen to [_Today, Explained_](https://www.vox.com/today-explained-podcast) wherever you get podcasts, including [Apple Podcasts](https://podcasts.apple.com/us/podcast/today-explained/id1346207297), [Pandora](https://pandora.com/podcast/today-explained/PC:140), and [Spotify](https://open.spotify.com/show/3pXx5SXzXwJxnf4A5pWN2A). **When did Trump become interested in psychedelics?** Well, he’s famously never smoked a cigarette, had a drink, certainly not had a trip. So in the Oval Office the other week, he’s kind of joking about taking ibogaine. There’s a lot of bravado there, but ibogaine is an incredibly potent psychedelic. It famously gives people sort of recalls of every traumatic moment in their life. It’s an extracted molecule from a West African — Gabonese, specifically — root bark from a shrub, and basically became known as being able to rid opioid addicts, heroin addicts, of withdrawal symptoms in one trip. **Ibogaine and psychedelics have now entered the mainstream conversation with the Trump administration talking about legalizing certain psychedelics. How did we get here?** Psychedelics have obviously long belonged to the cultural left, the counterculture, but it seems now there’s almost like a counter-counterculture with these right-wing, mostly Christian former special forces fighters, soldiers in the US Army, that are suffering from really debilitating conditions — from PTSD and \[traumatic brain injuries\] — and they’ve basically figured out that ibogaine and other psychedelics provide them the relief that conventional medicines don’t. **How is Joe Rogan involved in the policymaking here?** He’s had figures talking about psychedelics on his podcast since it began. The original sort of bro-cast dude, Aubrey Marcus, he’s had the former Texas governor and Trump’s first energy secretary, Rick Perry, on his podcast twice, along with a Kentucky lawyer and ibogaine advocate named Bryan Hubbard, who sounds like a Christian Southern revivalist and always quotes his favorite passage out of Isaiah. Joe Rogan had this unlikely duo — who have both done ibogaine and are waxing lyrical about the benefits — on his podcast like three weeks before the executive order and they basically said, “Look, Joe, we need to make this happen.” So Joe texts Donald Trump, and apparently Donald Trump responds almost instantaneously saying, “Sounds good. Do you want FDA approval?” **This culminates with Joe Rogan actually going to the White House to attend the signing of an executive order about psychedelics. What’s in that executive order?** “But we shouldn’t be under any illusions. This is a seriously potent and dangerous psychedelic when used improperly.” The thing about the executive order is it is sort of shouting into the wind a bit, but there is this money to go into the research side. It has five or six prongs. One of the main ones is that now under \[the Right to Try Act\] that Trump \[signed\] in his first term to allow end-of-life patients to try experimental drugs. That will be extended to psychedelics, so long as the DEA doesn’t try and obstruct that process. There’s $50 million for psychedelic research, most of which it seems is going to support state-led initiatives to investigate ibogaine and allow a US-first human trial. It’s also accelerating the path to a potential approval for psychedelic drugs. Three candidates that just submitted their data got fast-tracked for potential approval, so their applications will be considered more quickly. This would open the floodgates more widely to research. **Do you expect the FDA to say, “This is great, go ahead, use psychedelic drugs, they will help you.”** It’s quite likely really, within this presidency, to see several psychedelic drugs approved now. There was talk about \[Joe Biden\] setting up a federal task force and helping stuff along, and he didn’t seem to put any political will behind it. Trump has really seized the mantle here and he’s surfing the zeitgeist, as he weirdly seems to be able to on certain topics, all the while outraging and provoking us along the way. **There does seem to be some dissonance here, though. The GOP traditionally was all about the war on drugs.** There’s a lot of dissonance. I think that broadly, we’re seeing the war on drugs coming to an end little by little, despite the rhetoric, and I think this is a significant threshold moment. Trump’s always been kind of outside the Republican Party establishment compared to some previous presidents. It is not like it’s been some sort of topsy-turvy issue. The Democrats, when they’ve come in, there have been piecemeal changes. Joe Biden himself introduced the law when he was a senator to make the punishments for crack cocaine, which is more likely used by people of color, is like 30 times more stringent than for powder cocaine, which is used more often by white people. I think that there’s been a bipartisan war on drugs. **Do we know who’s using psychedelics?** I think the interesting thing with psychedelics now, as opposed to maybe 10 or 15 years ago, is that they’ve crossed the political divide. A lot of people from unexpected segments of society are getting turned on because they are seeing, broadly, the benefits, even while there are serious risks, especially with ibogaine. **There was only one drug named in that executive order: ibogaine. Why?** The veterans. These stories from veterans about the transformative effects of ibogaine have been really difficult to refute politically. Twenty-two veterans, on average, are committing suicide in the US every day. And Trump in the Oval Office, when he signed the order, said that “Since 9/11, we’ve we’ve lost over 21 times more veteran lives to suicide than on the battlefield.” There are so many \[representatives\] and senators who are veterans themselves. There was a study from Stanford a couple of years ago that looked at 30 ex-special forces \[soldiers\] and found that a dose of ibogaine reduced all of their traumatic brain injury significantly. But we shouldn’t be under any illusions. This is a seriously potent and dangerous psychedelic when used improperly, and there’s been a whole spate of deaths. Indeed, the deaths are probably underreported because the drug disrupts the QT interval in the heart and can lead in some cases to fatal cardiac arrest.

[](https://www.theguardian.com/lifeandstyle/2026/may/24/dining-across-the-divide-joe-eddie-decriminalising-cannabis-war-on-drugs#img-2) **Occupation** Geography student **Voting record** Green in the last general and local elections. Describes himself as a “democratic socialist” **Amuse bouche** The restaurant where Joe and Eddie met is a retrofitted old church where Joe’s great-grandparents got married [](https://www.theguardian.com/lifeandstyle/2026/may/24/dining-across-the-divide-joe-eddie-decriminalising-cannabis-war-on-drugs#img-3) ### Eddie, 63, Romsey **Occupation** Sales in the cleaning industry **Voting record** Labour, and sees himself as left of centre, but his Conservative MP, Caroline Nokes, is great, he says **Amuse bouche** Eddie referees youth football after qualifying as a ref two years ago. “I’m on the lowest rung of the referee ladder, but I love what I do_”_ ### For starters **Eddie** I’d left my car at the station so I just had a non-alcoholic gin and tonic. I looked at Joe and thought, nice lad. Football came up, inevitably. We’re both big Saints fans. **Joe** Eddie’s very cool – he had a suit on and a matching cap. I think he could tell I was a bit nervous and was, like, don’t worry, it’ll be fine. **Eddie** Joe thinks the Labour government should do more to look after vulnerable members of society. We’ve got to do that, up to a point, but Rachel Reeves also has to look after the public purse. **Joe** All the starters looked mahoosive, so we shared some olives. Then we both had a steak. I had mine medium rare; his was well done. [](https://www.theguardian.com/lifeandstyle/2026/may/24/dining-across-the-divide-joe-eddie-decriminalising-cannabis-war-on-drugs#img-4) ### The big beef **Eddie** Decriminalising drugs would be the thin end of the wedge. If you legalised cannabis, people would get fed up with that and want to go to the next step, like that line from Prince’s Sign o’ the Times: “In September, my cousin tried reefer for the very first time / Now, he’s doing horse – it’s June.” **Joe** People who traffic drugs should go to jail. But possession of a substance you’re only intending to use yourself should not be a criminal offence. Criminalising those people – affecting their employability – just exacerbates the problem. It’s a healthcare issue and there should be a healthcare response. When Portugal decriminalised drugs, they saw a drop in overdose deaths. In Switzerland, addicts can get their heroin at a clinic. **Eddie** Is that dealing with the drug problem or are you just feeding the addiction? Drugs change people physically, but most of all mentally, and that’s not a good thing. I like to be in control of my body, although I do drink alcohol. If we go down the decriminalisation route, I’m scared which way the population will go. **Joe** Fifteen-year-olds are going to smoke weed, which is getting stronger, with more links to psychosis. It would be better if it came from a regulated shop, like the ones in California. The “war on drugs” has failed. [](https://www.theguardian.com/lifeandstyle/2026/may/24/dining-across-the-divide-joe-eddie-decriminalising-cannabis-war-on-drugs#img-5) ### Sharing plate **Eddie** If there’s one individual I blame for the destruction of society, it’s Boris Johnson. I detest the man. **Joe** We agreed on Brexit; both hate Reform. Eddie lived in Bristol and I’m at uni there. We spoke about the Edward Colston statue, which got pulled down and is now [on display in a museum, covered in graffiti](https://www.theguardian.com/uk-news/2024/mar/14/edward-colston-statue-placed-quiet-corner-bristol-museum), which we agreed was a cool solution. [](https://www.theguardian.com/lifeandstyle/2026/may/24/dining-across-the-divide-joe-eddie-decriminalising-cannabis-war-on-drugs#img-6) ### For afters **Eddie** We disagreed on the [HS2](https://www.theguardian.com/uk/hs2) train route. It was going to be London to Manchester; now it’s only going to Birmingham. Cutting a few minutes off that stretch is a complete waste of public money. We could have spent half that and made rail links within the north better, instead. **Joe** Historically, the north has been forgotten. Obviously, Manchester is doing amazingly now, and Liverpool and Birmingham are coming back, but it would be good to link them up to London. If we were a serious country, we’d invest in infrastructure to connect our two biggest economic hubs in a fast and green way. [](https://www.theguardian.com/lifeandstyle/2026/may/24/dining-across-the-divide-joe-eddie-decriminalising-cannabis-war-on-drugs#img-7) ### Takeaways **Eddie** Joe is a very intelligent young man who knows what’s going on in the world today. I’m in sales, so I speak to everyone. As long as you’re respectful – which Joe is – I’ve got time for you. **Joe** As a young person trying to engage in politics, you often face: “You’ve only been on this planet 20 years, so you don’t know what you’re talking about.” Eddie didn’t dismiss me. He didn’t always agree, but was empathetic, listened in a respectful way, and I really appreciated that. I said I’d see him at the football: he’s only 10 or 15 seats behind. [](https://www.theguardian.com/lifeandstyle/2026/may/24/dining-across-the-divide-joe-eddie-decriminalising-cannabis-war-on-drugs#img-8) _Additional reporting: Kitty Drake_ Eddie and Joe ate at [Papillon](https://papillon-southampton.co.uk/) in Southampton Want to meet someone from across the divide? [Find out how to take part](https://www.theguardian.com/lifeandstyle/2026/mar/18/would-you-like-to-take-part-in-dining-across-the-divide)

 On a cold December night in 2023, the staff at Providence Milwaukie Hospital in Milwaukie, Ore., called local police. They wanted help getting one of their patients, a 26-year-old man named Jean Descamps, out of the emergency room. "He's been evaluated medically. There's no medical problems for him," a member of the hospital team, who NPR has not been able to identify, told police. The moment was captured on an officer's body camera. Records show the hospital's medical staff believed Descamps — emaciated, covered in feces, and often unresponsive — was experiencing symptoms of chronic street drug use, a leading cause of death for young Americans. After Descamps arrived in an ambulance earlier that day, hospital staff cleaned him up and administered naloxone, a medication that reverses opioid overdoses. But now they wanted him gone. "He's not thriving chronically, but there's no medical reason for him to be here anymore," one hospital staffer can be heard saying. Video [released by the Milwaukie Police Department](https://www.milwaukieoregon.gov/business_detail_T13_R232.php) shows Descamps sprawled in a hospital bed, his body limp, moaning and drooling, while medical staff stood nearby. After determining Descamps was too unwell to spend the night in jail, police officers challenged the hospital's decision to discharge him. "He can't be on his own," one officer said. "Why is he being released? We have no place to take him." "A bus station is fine," a hospital worker replied. Another member of the hospital staff told police Descamps was faking the severity of his illness: "It's not really a medical problem, it's malingering." Officers eventually complied, rolling Descamps' limp body in a wheelchair into the dark parking lot, where they covered him with a blanket against the winter cold. Police who gathered around Descamps can be heard voicing fear for his safety.  "Do you feel at all comfortable with anything that's going on right now?" one police officer asked. Another officer answered, "No." Their fears proved justified. A short time after being discharged, Descamps would be dead of an overdose from street drugs already in his system. A spokesman for Providence Milwaukie Hospital declined NPR's repeated requests for an interview about Descamps' case and didn't respond to detailed questions about his treatment. In a statement issued to the media after Descamps' death, the hospital expressed regret and acknowledged the care he received was inadequate. "In this case, we fell short of our goal of providing safe, reliable, compassionate care to our patient," it said. But in interviews with more than a dozen doctors, scientists, federal officials and addiction activists, along with a review of research and government data, NPR found that what happened that night in Oregon is part of a troubling national pattern. People with serious alcohol or drug addiction in the U.S. regularly go to doctor's offices, clinics and hospitals, [only to leave after receiving insufficient or no treatment](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821497?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=071724), often with devastating consequences. "I think we should be outraged every single time someone dies from any condition that has treatment available that someone isn't getting," said Dr. Judy Chertok, who treats addiction patients and teaches medicine at the University of Pennsylvania. "We would not allow, as a society, people with heart attacks to come to a hospital and not get appropriate treatment. This is as serious as that." ### Most addiction patients get little or no treatment Chertok is among the growing number of critics who say efforts to bring addiction treatment into the mainstream of American medicine have fallen short. Addiction is widespread in the U.S., affecting more than 40 million people, according to the [latest federal data released last month](https://www.samhsa.gov/newsroom/press-announcements/20260727/samhsa-releases-annual-national-survey-on-drug-use-and-health). While drug overdose deaths have dropped in recent years, [alcohol- and drug-related](https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics-z/alcohol-facts-and-statistics/alcohol-related-emergencies-and-deaths-united-states) disorders still kill more than 250,000 people every year. Meanwhile, research shows alcohol-related deaths [have doubled over the last 20 years](https://www.amjmed.com/article/S0002-9343(24)00704-6/fulltext), while [nonfatal overdoses from fentanyl](https://www.cdc.gov/mmwr/volumes/74/wr/mm7416a2.htm#:~:text=Overall%20Trends%20in%20Fentanyl%2DInvolved%20Nonfatal%20Overdoses&text=The%20rate%20of%20ED%20visits,10%2C000%20ED%20visits%20(Figure).) are rising. Despite that toll, [the federal data](https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/national-releases/2025) released last month shows that in 2025 more than 80% of people who need help get no medical treatment of any kind for their addiction. "Much of what I do is scream back at that," Chertok told NPR. "Many who ultimately die from their \[addiction-related\] illness have had significant contacts with healthcare and social services agencies in the few months leading up to their deaths." In the case of Jean Descamps on that winter night in Oregon, death came much faster, after Milwaukie police decided to transport him to an emergency behavioral health center in nearby Portland. On the body camera recording, officers can be heard growing increasingly alarmed by his condition as he sat in the back of a police cruiser. "Hey Jean, hey Jean!" one officer shouted, after searching for signs Descamps was breathing. "Boy, I don't know. Look at his eyes, I don't know."  Efforts to revive Descamps failed. [An investigation by a local prosecutor in Oregon](https://www.scribd.com/document/698129208/Multnomah-County-prosecutor-s-memo-on-Jean-Descamps-death) found hospital staff failed to give him a toxicology test to evaluate drugs in his body before discharging him. While this kind of catastrophic outcome is rarely caught on camera, federal data suggests similar moments may be common. [One study by the Centers for Disease Control and Prevention](https://www.cdc.gov/overdose-prevention/data-research/facts-stats/sudors-dashboard-fatal-overdose-data-accessible.html) found more than two-thirds of Americans who died from fatal overdoses in 2024 had "at least one potential opportunity for intervention" but didn't receive help. "When it comes to substance use disorder, we have not decided as a country this is an illness we actually can treat," said Beth Meyerson, an expert on addiction care at the University of Arizona's College of Nursing. ### Addiction treatments are safe, effective — and rarely offered According to Meyerson, the problem isn't just in hospital emergency rooms. It's still the norm for doctors and nurses across U.S. healthcare settings to avoid treating patients with alcohol- and drug-related disorders. "If I'm at my own general practitioner and it's suddenly clear I'm addicted to an opioid, my doctor will likely send me somewhere else," Meyerson said. "Versus \[saying\], I can treat that here, just like I can treat your diabetes or any other chronic disease you might have." This happens despite the fact that safe and affordable medications for treating the deadliest forms of addiction have been available to U.S. clinicians for decades. "We have good tools. Methadone and buprenorphine are gold standards," Meyerson said. "Access to treatment would reduce opioid overdose by 60%. In some studies, I saw 80%." In 2022, Congress [lowered regulatory barriers](https://www.samhsa.gov/substance-use/treatment/resources/mat-act/training-requirements), making it far easier for nonspecialist clinicians to prescribe buprenorphine, a medication that reduces opioid cravings. [But most doctors still don't](https://pmc.ncbi.nlm.nih.gov/articles/PMC12766698/)**.** It's [even rarer for doctors to offer naltrexone](https://pmc.ncbi.nlm.nih.gov/articles/PMC9127043/), a medication that helps patients by reducing the desire for alcohol. ### Many doctors carry a strong bias against addiction patients The obvious question is why? If addiction is common and deadly but treatments are available, why don't more clinicians help these patients? There's consensus that this is, in part, [a legacy of America's drug war](https://pmc.ncbi.nlm.nih.gov/articles/PMC9302017/). Addictions are now considered treatable disorders, but for decades substance use was seen by many as a criminal or moral issue, with [access to treatment often heavily regulated](https://nam.edu/perspectives/improving-access-to-evidence-based-medical-treatment-for-opioid-use-disorder-strategies-to-address-key-barriers-within-the-treatment-system/). Some forms of addiction still involve illegal drugs. Research suggests this history led to fear and hostility in the general public [and among medical professionals](https://pmc.ncbi.nlm.nih.gov/articles/PMC10656222/) toward people with addiction. Chertok said despite efforts to change attitudes, many of her fellow doctors still view people experiencing these disorders with suspicion. "I have observed or heard people talk about someone with addiction in the healthcare setting in a way that is not tolerated for any other group," Chertok said. "It's so jarring that that is accepted by so many." It may seem inconceivable, 30 years after the first wave of the opioid crisis made addiction a life-or-death issue for many families across the U.S., that the vast majority of clinicians still actively opt out of treating vulnerable patients because of personal bias.  But studies show stigma among healthcare workers remains deep-rooted. One study [published in the _Annals of Internal Medicine_ in 2020](https://publichealth.jhu.edu/2020/nearly-one-third-of-primary-care-providers-do-not-view-medication-treatment-for-opioid-use-disorder-as-effective) found only 1 in 5 American physicians "have interest in treating a patient with opioid use disorder." A report issued earlier this year by the American Medical Association, the nation's leading physician trade group, identified stigma among health workers as a significant hurdle for patients needing treatment. Bias is so widespread that many doctors believe their patients will abuse addiction medications to get high, even though, for instance, studies show [misuse of buprenorphine is](https://oig.hhs.gov/reports/all/2023/the-risk-of-misuse-and-diversion-of-buprenorphine-for-opioid-use-disorder-in-medicare-part-d-continues-to-appear-low-2022/) [rare](https://oig.hhs.gov/reports/all/2023/the-risk-of-misuse-and-diversion-of-buprenorphine-for-opioid-use-disorder-in-medicare-part-d-continues-to-appear-low-2022/). "Forty-three percent of healthcare professionals believe medications for opioid use disorder substitute one drug for another," said Robert DeForde, with a group called Shatterproof that conducted a survey of clinician attitudes in 2024. DeForde's organization works to convince doctors and nurses to treat people with addiction, conducting online training and in-person seminars. That work left DeForde convinced that bias in the medical community against this group of patients remains intense. "They don't want these people around them. They don't think that the drugs that we have that are FDA-approved medications are really going to actually help the patient. That is what I would say is a fatal flaw in our system," he said. ### Will the next generation of doctors do better? Maybe not While the AMA [acknowledges](https://www.end-overdose-epidemic.org/sites/end_overdose/files/2026-01/2025-AMA-Report-on-Substance-Use-and-Treatment-Progress-Policy-and-Future-Directions.pdf) that stigma affects clinician behavior and prescribing, the organization has long urged patience with the pace of reform and resisted efforts to mandate more rapid change. "I think it's going in the right direction," said Dr. Bobby Mukkamala, who served as AMA president until June 2026 and currently leads the organization's substance use task force. "Could it be going faster? Should it be going faster? Absolutely." In an interview with NPR, Mukkamala said he believes primary care doctors contributed to the decline in drug overdose deaths since 2023. But he also said many physicians are wary of treating addiction because they lack proper training and already feel overwhelmed by other duties.  "We know that we need to do this new thing that we are just gaining comfort with. But facing the headwinds of all the other things that we face as physicians, I think that's a pretty understandable hurdle that we have to get over," he said. According to Mukkamala, those professional challenges heighten the personal unease some clinicians feel treating addiction patients. "There's the emotional response from within that basically makes us say, 'Yeah, but you know, it's not something I'm comfortable with.' That's the stigma." Most experts interviewed for this story agree that some progress has been made. But not a single doctor, researcher, activist or federal official described the current level of addiction care as acceptable. "What models can be developed to actually change the culture?" said Dr. Nora Volkow, who heads the U.S. government's National Institute on Drug Addiction. "How do you embed the education and the training and the support systems in healthcare that will make clinicians feel more comfortable treating patients with substance use disorder?" But despite the urgency of America's addiction crisis — President Trump declared the opioid crisis [a national public health emergency](https://www.npr.org/2017/10/26/560083795/president-trump-may-declare-opioid-epidemic-national-emergency) nearly a decade ago — most medical and nursing schools in the U.S. still [don't teach students how to care for patients](https://pmc.ncbi.nlm.nih.gov/articles/PMC9731765/) with substance use disorders as a core part of their medical practice. Meyerson at the University of Arizona College of Nursing thinks that has to change. "We will have to have very clear laws, policies, and frankly training practices and curriculum in medical school and nursing schools to really combat this," she said. ### "That guy does not need to be dead right now" For now, experts say the results of poor addiction care are widespread, with few legal or professional consequences, even when patients with substance use disorders die. After Jean Descamps' fatal overdose in December 2023, Providence Milwaukie Hospital promised to make immediate changes, including more careful evaluation of patients before discharge. But a [follow-up investigation by the Oregon Health Authority](https://embed.documentcloud.org/documents/28534377-2024-0534-record-survey-report-or46820-or43003-redacted/?embed=1), made public in February 2024, found the facility was still discharging vulnerable patients, including those with severe addiction, without proper safeguards. The OHA warned of the "possibility that a similar event could occur." There's no record that the hospital or its staff faced any kind of disciplinary action or sanction. Oregon officials say the facility is no longer under scrutiny. In a statement sent to NPR, Providence officials said they have enhanced staffing and "strengthened" procedures for caring for vulnerable patients. The statement also said hospitals shouldn't be held responsible for what happens to patients after they leave. "We do not have the capabilities nor the resources to manage the community needs once patients are discharged from our facilities," it said. Not everyone sees it that way. On the body camera recording, police officers who tried to save Descamps' life can be heard voicing sorrow and anger at his lack of treatment. "That guy does not need to be dead right now," one officer said. "Their mindset there \[at the hospital\] is 'Oh, it's just another tweaker.'"