Westerners seem to have built up some resistance and tolerance to drugs and alcohol now. I know many high functioning people who have quit, or atleast can hold their booze and drugs. Many people I know have "been there done that" yet pull themselves together and look after their kids or job etc...

Maybe something in our culture acts as a failsafe of sorts? Our work ethic combined with a sense of atleast some responsibility. I knew many alcoholics that would scrape their shit together enough to show up at work and function for their family.