When we awaken in the nightmarish city of Bowie's Outside, we find that it is merely a place where today's trends have continued and become a little worse. It is a landscape where murder is considered by psychopaths an art form, a place where drug addiction is rampant. In this world, vapid performers are known not for their art, but for their bizarre habits.
At the beginning of Outside, a detective is investigating the murder of a little girl. He is investigating an "art crime" because, horribly, this has become such a widespread type of homocide. The girl's eviscerated corpse is elaborately displayed in a public place. This type of crime exists today; men like Mark David Chapman become somebodies by murdering the most public figures they can target and they bask in their creativity. Men like the BTK enjoy the attention their "oeuvre" brings them and speak of their crimes with the meticulous detail of a painter disecting a portrait in the Louvre.
Along with these horrific murders, there is the use of amphetamine, called "interest drugs." Bowie's Outside is full of drug users and drug dealers. The suspects are all well known addicts. This is not surprising. The police know that a criminal on a speed binge can be the most dangerous of all; the delusions associated with amphetamine psychosis have caused fathers to behead their children. Whenever coke and speed use rises, so does the level of violent murder.
The emptiness of the society that exists in the Outside album is reflected in the artists. They are "performance" artists: known for what they do, rather than what they create. These performers hack off their body parts and bleed themselves for attention and recognition, much like today's performers who simply bare a breast to make the headlines. Many of today's musicians are famous for simply absorbing bullets and gunning down their adversaries.
Like all great sci-fi writers, Bowie has created a dark world in the future to comment on the problems that exist today.