I read on the plane a fascinating article in The Economist about the improvement in many inner city areas of the UK, and deterioration of places further out, including rural areas. That is happening in New York, as the poor dependent on transfer payments move out of NYC to cheaper locales, where their transfer payment stipends buy more good and services. Vermont now has a massive heroin epidemic. Troy, New York, I am told, has become a real "pit," as it becomes a pit stop as it were for this kind of population moving in.
Do you think Vermont's problems are linked to poorer people moving in to the state? The dominant narrative for drug issues here and other places (like Cape Cod) is that people moving in have money, and it's the local population which struggles with boredom and limited opportunities. Troy has also been in bad straits for decades because of deindustrialization, and it's always been a temptation of upstaters to ascribe problems to the "others" from downstate, whether or not the data backs it up.
If VT's heroin problem is like suburban Chicagoland then it is due to people who get hooked on prescription pain killers. This tends to happen where the population has good health care that can readily prescribe the drugs, and that includes areas like suburbs and higher income rural areas like VT.
The next step occurs when the addiction kicks in and the addict looks to the black market for prescription opiates, like the ones that were previously available legally. It turns out that heroin is cheaper than illegal prescription opiates. Hence the huge uptick in suburban heroin use.
