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For plot reasons, I'd like to introduce a (legal; prescribed or OTC) drug that ends up primarily used by a certain segment of society, to wit, lower to middle income folks, with only occasional use outside that segment.

I'd also like this to be world-wide, or at least, multinational. (It's okay if it's primarily "developed" countries, for example.)

What the drug does is completely open at this point. What sorts of reasons would people in that segment rely on a drug like this instead of some other?

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closed as too broad by sphennings, Mołot, Azuaron, Vylix, JBH Nov 22 '17 at 5:38

Please edit the question to limit it to a specific problem with enough detail to identify an adequate answer. Avoid asking multiple distinct questions at once. See the How to Ask page for help clarifying this question. If this question can be reworded to fit the rules in the help center, please edit the question.

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    $\begingroup$ You're asking two different questions. "Why would only one segment of the population rely on mystery drug x?" is a very different question than "Who would profit from the distribution of mystery drug x?" Please limit yourself to one question per post. $\endgroup$ – sphennings Nov 21 '17 at 19:06
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    $\begingroup$ Perhaps you might like to lok at the demographics of beer drinkers vs wine drinkers. $\endgroup$ – Justin Thyme Nov 21 '17 at 19:09
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    $\begingroup$ Without knowing the specifics of the drug it's going to be impossible to answer either question. $\endgroup$ – sphennings Nov 21 '17 at 19:10
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    $\begingroup$ I agree with @sphennings : we need to know the effects of the drug in order to know why people would rely on "a drug like this". For example, people who do cocaine may not like ecstasy. Marijuana smokers may not drink alcohol. Etc. $\endgroup$ – BrettFromLA Nov 21 '17 at 19:15
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    $\begingroup$ In many countries, the same pharmaceutical, for example acetylsalicilic acid or ibuprofen, is available under many different brand names at very different prices. Poor people get the locally produced dirt cheap brand, very rich people get the German-made Bayer or the British-made Nurofen, middle income people something in between... $\endgroup$ – AlexP Nov 21 '17 at 19:44
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Know your place

If you have a well defined class structure this product can be a signal of it. Class A uses X, class B uses Y, class C uses Z. If you have limited or formal mobility between classes there will be little or no outside use, as people either don't want to be mistaken for a different class or be accused pretending to it.

Similarly if there is a religious or ethnic divide between classes it is easy for the cultures to be quite distinct.

Follow the leader

There is a class hero who uses it. The interested classes take the example while the opposition classes find it distasteful.

Shaken not stirred

The privileged people have a slightly better version, or a convoluted replacement that is non-viable for even the most enthusiastic common person. "...And then you filter the resulting gas through a stack of at least 4 inches of clean $100 bills..."

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Speaking as a European with nationally funded healthcare, nope, not happening here. Everyone gets the same.

You'd have to look to countries with private insurance funded healthcare only.

At this point it becomes relatively simple, most drugs come in branded and generic versions. Consider Nurofen or supermarket own brand ibuprofen, Betnovate or Betamethasone Valerate 1%, there are many equivalents. People with the cheap insurance get the cheap generic unbranded stuff, people who can afford the top insurance get the best of everything.

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    $\begingroup$ How do such systems handle drugs that are not medically necessary, but may improve health? $\endgroup$ – Uueerdo Nov 21 '17 at 20:51
  • $\begingroup$ @Uueerdo, The upper band would let you have anything you could get a doctor to prescribe. The lower band would play a cost effectiveness game, "to what extent does it prevent a higher cost later". $\endgroup$ – Separatrix Nov 21 '17 at 21:52
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Two obvious possibilities:

  1. The drug has a better but more expensive alternative. The better alternative may be newer and so temporarily more expensive while it is protected by patents or it may be intrinsically more expensive to make or rely on some scarce natural ingredient. The better alternative may also not be a drug; it could be an expensive surgery or other treatment.
  2. The drug is used to treat a condition which is more common in lower-income patients. For example, if nicotine addiction is more common in poorer people then drugs to treat it will be used more by poorer people.
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Crack fits the bill: https://en.wikipedia.org/wiki/Crack_cocaine

Used mostly by the poor, due to low prices.

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  • $\begingroup$ but neither legal nor OTC, otherwise yes, crack and meth $\endgroup$ – Separatrix Nov 21 '17 at 20:25
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Between the lines, you've pretty much answered yourself:

What sorts of reasons would people in that segment rely on a drug like this instead of some other

What is the difference between "that segment" and the others? It's mainly monetary. Therefore, the reasons they have must be economic, either directly or indirectly. Related to some of the differences between rich people and poorer people; the most obvious is the spending power.

They use that drug and not another because either they need it more than richer people do, or because albeit needing the active ingredient the same, that particular drug is cheaper (why then don't rich people use the cheaper drug? That must be because it's worse in some way - more side effects real or perceived, lower potency again either real or perceived).

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The Russian Sci-Fi novel guy strikes back! I think it's relative hard to find a class difference in getting a treatment (as a Euro guy). But emerging side effects might be your thing.


There was an old story about an (illegal) drug (called slegh, a fictional word) that was an unfortunate combination of perfectly legal components. In the original text it was like:

  • if you plug a module for your aroma generator into your radio
  • while lying in a bathtube
  • and best if you chew on an anti mosquito aroma pill while doing so,

you'd get hallucinations that are so powerful, they are addictive. Folks keep lying in baths, at some point they stress their body too much and die. And no one tells outsiders what's happening, because, like, everyone does it.

(By the way, the story features some unconditional basic income, the philosophy of hedonism and consumerism, "let's destory this" demonstrations – hello red hot press from youtube, some kind of harsh immigration laws, gambling machines and what not. And it was written in the 60s!)


What can we learn from this? Mix your (legal) drug in, but make the undesirable side-effect of it a combination of several factors. Some of these factors would need to filter the target group.

Examples:

  • you need a radio to enjoy the genuine recipe of slegh, but also that fictional smell adaption thingy (which I would guess was originally a radio lamp or a heterogyne);
  • mixing antibiotics with alcohol, or, as mentioned in another answer, smoking;
  • the plastic fumes of cheaper cars emits some smell ("of the car"), but also some more dangerous molecules, where the danger was not found earlier, as it persists only in combination with something else;
  • one thing that might segregate the classes well is the availability and habbit of more exotic foods. Your drug might help to accumulate the fugu fish toxine, harmless elsewise;
  • exposure to faster and more expensive ways of travel might be also a good separator. Let your drug induce the accumulation of radioactivity from full body scanners and flying;
  • somewhat similar to bourgeois foods: Burgundy wine (for example) carries some endemic danger, that is exposed in combination with whatever (again, your drug, Rolls Royce leather seats, you name it), endangered are people who can afford such wines and locals. But most locals don't drive luxury cars.

I think you get the idea by now.

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