Brazil's Pill-Popping Problem

While much of the West has seen the danger in abusing psychoactive drugs such as Valium, sales of these drugs in Brazil are skyrocketing, and doctors warn that it's out of control.

Cláudia Collucci and Monique Oliveira

SAO PAULO — In many European countries, sales of sedatives in the benzodiazepine family such as Rivotril, Valium and Lexotan have fallen by as much as 30% over the past decade. But in Brazil, sales of the pyschoactive drugs have been consistently on the rise, new data shows.

Between 2009 and 2013, in fact, sales of these drugs jumped from 12 million boxes to 17 million boxes, a surge of 42%, according to figures obtained from the consulting firm IMS Health.

These drugs are prescribed for anxiety and panic, and tend to work faster for such symptoms than anti-depressants. But patients often become dependent and suffer severe side effects such as memory lapses and drowsiness. While British physicians are being trained to “wean” dependent patients off them by gradually reducing doses, psychiatrists in Brazil say that most patients use the drugs without supervision, often exceeding both recommended doses and duration of use.

“They should be used temporarily, over two or three months,” warns Antônio Geraldo da Silva, president of the Brazilian Association of Psychiatry. “But some people have been taking them for years. The situation is a lot worse than what people think.”

He says the boom in consumption can be explained by the absence of adequate control of their sales and by the fact that many non-psychiatrists prescribe these psychoactive drugs. “Psychiatrists prescribe these drugs a lot less than other health professionals,” Silva explains. “There’s also a lot of self-medication. Anybody can make a fake prescription. There’s no control whatsoever.”

Ronaldo Laranjeira, psychiatrist and professor at the Federal University of São Paulo, says that doctors in developed countries are careful to prescribe fewer and fewer of these drugs because there is actually no evidence that patients benefit from using them over a long period of time. “The recommended period of time is always the shortest possible. It’s the exact opposite to what happens in Brazil.”

Among those who use these drugs inappropriately are people who have trouble sleeping, Laranjeira explains. “They stay awake 20 hours a day and prefer turning to pharmacology instead of changing their lifestyles.”

Maria Inês Vasconcelos, a labor attorney and author of the book Panic Syndrome and Work, says that the use of the drugs is “widespread” among executives. “I’ve had more that 30 cases that were extremely severe and in which people were incapacitated,” she says.

Their use is also common in the art world. According to V.M., a 35-year-old artistic director who prefers to remain anonymous, people in her line of work use Rivotril a lot. “It’s a way of dealing with stress. Sometimes I’m so agitated that I can’t sleep. That’s when I started taking medications. It makes you switch off instantly,” she explains. “I even reached the point when I had to take one in the middle of the day. But now I’ve managed to control my consumption.”

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Debt Trap: Why South Korean Economics Explains Squid Game

Crunching the numbers of South Korea's personal and household debt offers a glimpse into what drives the win-or-die plot of the Netflix hit produced in the Asian country.

In the Netflix series, losers of the game face death

Yip Wing Sum


SEOUL — The South Korean series Squid Game has become the most viewed series on Netflix, watched by over 111 million viewers and counting. It has also generated a wave of debate online and off about its provocative message about contemporary life.

The plot follows the story of a desperate man in debt, who receives a mysterious invitation to play a game in which the contestants gamble their lives on six childhood games, with the winner awarded a prize of 45.6 billion won ($38 million)... while the losers face death.

It's a plot that many have noted is not quite as surreal as it sounds, a reflection of the reality of Korean society today mired in personal debt.

Seoul housing prices top London and New York

In the polished streets of downtown Seoul, one sees endless cards and coupons advertising loans scattered on the ground. Since the outbreak of the pandemic, as the demand for loans in South Korea has exploded, lax lending policies have led to a rapid increase in personal debt.

According to the South Korean Central Bank's "Monetary Credit Policy Report," household debt reached 105% of GDP in the first quarter of this year, equivalent to approximately $1.5 trillion at the end of March, with a major share tied up in home mortgages.

Average home loans are equivalent to 270% of annual income.

One reason behind the debts is the soaring housing prices. In Seoul, home to nearly half of the country's population, housing prices are now among the highest in the world. The price to income ratio (PIR), which weighs the average price of a home to the average annual household income, is 12.04 in Seoul, compared to 8.4 in San Francisco, 8.2 in London and 5.4 in New York.

According to the Korea Real Estate Commission, 42.1% of all home purchases in January 2021 were by young Koreans in their 20s and 30s. For those in their 30s, the average amount borrowed is equivalent to 270% of their annual income.

Playing the stock market

At the same time, the South Korean stock market is booming. The increased demand to buy stocks has led to an increase in other loans such as credit. The ratio for Korean shareholders conducting credit financing, i.e. borrowing from securities companies to secure stock holdings, had reached 21.4 trillion won ($17.7 billion), further increasing the indebtedness of households.

A 30-year-old Seoul office worker who bought stocks through various forms of borrowing was interviewed by Reuters this year, and said he was "very foolish not to take advantage of the rebound."

In addition to his 100 million won ($84,000) overdraft account, he also took out a 100 million won loan against his house in Seoul, and a 50 million won stock pledge. All of these demands on the stock market have further exacerbated the problem of household debt.

42.1% of all home purchases in January 2021 were by young Koreans in their 20s and 30s

Simon Shin/SOPA Images/ZUMA

Game of survival

In response to the accumulating financial risks, the Bank of Korea has restricted the release of loans and has announced its first interest rate hike in three years at the end of August.

But experts believe that even if banks cut loans or raise interest rates, those who need money will look for other ways to borrow, often turning to more costly institutions and mechanisms.

This all risks leading to what one can call a "debt trap," one loan piling on top of another. That brings us back to the plot of Squid Game, "Either you live or I do." South Korean society has turned into a game of survival.

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