23 February 2020 DREAMLAND: THE TRUE TALE OF AMERICA’S OPIATE EPIDEMIC, A YOUNG ADULT ADAPTATION by Sam Quinones, Bloomsbury, July 2019, 224p., ISBN: 978-1-5476-0131-8
“I’ve seen the needle and the damage done
A little part of it in everyone
But every junkie’s like a setting sun”
-- Neil Young (1971)
“SAN FRANCISCO -- Downstairs at the medical examiner's office, the bodies lay side by side on stainless steel tables and shelves, shrouded and anonymized in white bags, each person identifiable only by a protruding foot that had been toe-tagged.
Upstairs, Luke Rodda, the chief forensic toxicologist, looked over his morning docket and the terse reports from first responders.
Male, 33, ‘prior history of fentanyl overdose,’ found at bus stop.
Male, 27, white powder in baggie.
Male, 51, found by construction worker, syringe next to him.
There had been at least nine apparent drug-related deaths over the previous three days in late January, Rodda said.
‘This is our new norm now,’ he said.”
-- front page of the Washington Post, “Drug overdose deaths rise in the West while they drop in the East” (2/21/20)
“On Super Bowl Sunday 2014, America awoke to the news that one of its finest actors was dead.
Philip Seymour Hoffman, forty-six, was found that morning in his New York apartment, a syringe in his arm and powder heroin in packets branded with the Ace of Spades near his corpse. Blood tests showed he had heroin in his system, combined with cocaine, amphetamine, and benzodiazepine.
The Oscar-winning actor--a father of three-- had checked into rehab the previous May for ten days, and then, pronouncing himself sober again, left to resume a hectic film schedule. Just as the death of Rock Hudson thirty years ago forced the country to recognize AIDS, Hoffman’s death awoke it to the opiate epidemic.
Within days, media outlets from coast to coast discovered that thousands of people were dying. Heroin abuse, the news reports insisted, was surging. Almost all the recent heroin addicts were first hooked on prescription painkillers, they reported.”
That last sentence bears repeating: “Almost all the recent heroin addicts were first hooked on prescription painkillers...” This is the crux of the story told here by journalist Sam Quinones.
Humans have ingested opiates for thousands of years. As the author notes, “Mesopotamians grew the poppy at the Tigris and Euphrates. The Assyrians figured out how to slice open the plant’s golf-ball-sized bulb and drain the goo inside that contains opium.”
Readers learn a number of facts about the history of opiates. But DREAMLAND primarily focuses on the use and abuse of these substances in the US over a two-decade period, between the mid-1990s and 2015, when the original version of DREAMLAND was published for adults.
Throughout DREAMLAND, the author shares jaw-dropping true stories of people central to the crisis: those who have worked at different points along the supply chains; former users; parents of dead users; law enforcement officials. The author brings together these narratives, illuminating how a confluence of circumstances led to a horrific national crisis. Things got so bad that, for the first time, in certain parts of the country, the number of deaths from car crashes was surpassed by opiate-related deaths.
How did this happen?
What we learn is that the drug manufacturer Purdue employed a big lie. They claimed that their OxyContin pills, a time-release version of the opiate-based drug Oxycodone, was not addictive. Then they employed armies of sales representatives to sell doctors on prescribing the drug to anyone with some pain to be “managed.”
Recreational drug users discovered that by crushing OxyContin pills, they could circumvent the time-release mechanism and get a powerful effect--twelve hours’ worth of time-release medication at once. “Pain clinics” arose, featuring doctors with dollar signs in their eyes. These immoral physicians prescribed the pills to anyone with the money for an appointment. People drove from one clinic to another to obtain hundreds of pills to use or sell. All these people, whose common motivation was to make a quick buck, greased the wheels for widespread abuse and addiction.
Meanwhile, a small town in Mexico led the way to a resurgence of heroin use in the US. A sophisticated marketing and delivery scheme was employed to make Mexican black tar heroin readily available, at low cost, in scores of medium-to-large American cities. Addicts were given phone numbers to call, and drivers would promptly deliver the goods--just like a pizza delivery service. The managers of these heroin supplier “cells” were in constant contact with their Mexican employers ensuring that a steady stream of supply was always on hand.
Thus, millions of Americans first became addicted to the opiate-based pills and then discovered lower-cost and high quality Mexican heroin available 24/7. This is how we got here. The gripping stories of real people involved in the various aspects of the crisis make DREAMLAND an addictive read. So many of us know friends, family members, and neighbors, who have been affected. And we’ve read the stories of famous people who have died with a needle in their arm.
Today, fentanyl, a synthetic version of heroin, is becoming the latest chapter in the story.
If you read the comments in reaction to Friday night’s Washington Post article, you encounter the same arguments heard decades ago about the futility of the war on drugs. But if we don’t do something significant about the sale and use of recreational drugs that are both addictive and deadly, what is the solution? Do we just accept that opiate use and abuse will continue to kill more people than car crashes? How do we dissuade today’s teens from becoming part of the gruesome statistics?
DREAMLAND shows how the pain clinics were put out of business and how Purdue was forced to concede that their product was addictive. Heroin sales forces were infiltrated and numerous headline-grabbing arrests were made. But plenty of addicts remain and now--subsequent to the book’s publication--we have the rise of fentanyl which is addicting and killing more people. Is this just the nature of the human beast?
Knowledge is power. Get this one into the hands of teenagers and their parents.
Richie Partington, MLIS
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