There is a lot of stigma associated with it, so people just try to deal with it themselves rather than try to get help, esp if its a place that still has criminal penalties for it.
Like, no one wants to admit they are "committing crime" esp people who are really decent people who just made a mistake, so they just hole up and hide it, which just makes them more depressed and in turn, harder to get away from it, and it becomes cyclic.
Obviously thats not the "this is how it happens in every case" but i have seen it happen that way, esp with people who are otherwise good hard working folk. They dont want to come off as "junkies" or something.
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