2015 National Book Critics Circle Award Winner, General Nonfiction
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By IYER on 08-03-18
Drug gang as consumer focussed enterprise
There is a certain image of a drug dealer in most people’s minds. It is likely that of a scruffy African-American, selling crack on a shady side street of a large city. But while that is the popular image, there is another world, perhaps more insidious and yet lesser known – where the dealers carry no weapons, keep balloons of “stuff: in their mouth, and carry only as much heroin as they can without running the risk of being tried for drug dealing if caught. Oh, and they also offer bonus hits to long standing clients, free samples if you have suddenly stopped ordering your dope, and follow up with “sales calls” to check on the quality of stuff offered – customer servicing of a standard to make any consumer marketer proud.
It is this world of new wave dealers, unscrupulous pharma marketers and addiction that Sam Quinones explores in his well-researched “Dreamland”.
The Dreamland in the title was the name of a company built swimming pool in Portsmouth, Ohio, a typical company town in the industrial heartland of America. Until the Seventies and Eighties, this was the social center of the town. But as deindustrialization enveloped and turned the erstwhile industrial belt into a Rust Belt, the town now lies almost deserted with no jobs – a story seen in many towns across the region. “Dreamland” visits such towns and is the story of the drug epidemic that has swept in there as people battled joblessness, the loss of careers and indeed their futures.
The decline of America’s industrial heartland and rise of blue collar unemployment coincided unfortunately with the discovery of a time release opioid painkiller, OxyContin, by Purdue Pharma, which promised pain relief with just one tablet every 12 hours. The active ingredient, Oxycodone, is almost identical in its chemistry to heroin, with the same euphoric effect, the same brain damage and the same withdrawal symptoms. This combined with the growing belief among some physicians that every patient had the right to seek pain relief, something aggressively promoted behind the scenes by Purdue, which then had just the drug that was needed.
Since 1999, 200 thousand Americans have died from overdose related to OxyContin or other prescription opioids; 145 now die every day; by the time you have read this review another person would have died of opioid overdose. And 4 out of 5 addicts today are those who started with painkillers.
Of course, as demand for these drugs burgeoned, along with Purdue Pharma’s sales so did cheaper substitutes, in the form of cheap “black tar” heroin, supplied by Mexican groups based mainly out of the states of Xalisco and Nayarit. This forms a particularly intriguing sub plot, of the afore-mentioned dealers who behaved like small-franchise business owners rather than a dreaded gang criminals. The book follows and juxtaposes the parallel paths of legal and illegal drugs, both prescription opiates and black tar heroin.
The two have combined to create a silent crisis which, owing to its location away from the spotlights of the coastal metropolises, has long hidden under the collective consciousness – an epidemic affecting the unemployed, the disabled, and particularly the young (some of the saddest stories are those of young men, usually white and middle class, who were prescribed the drug as a result of college sport injuries, and who then were hooked – until they suddenly died, even as their parents hid from society the truth of their children’s’ addiction, saying they dies of heart attack or some other disease)
As Quinones investigates, other sad but fascinating vignettes emerge – pill mills where doctors run practices almost entirely based on prescriptions of OxyContin; a sub-economy among addicts based on OxyContin pills as barter or a substitute for money; and stories of Mexicans doing 2 to 3 month stints in the drug pushing business until they were caught and deported, their close knit lives in their home towns, and their fascination with the Levi’s 501.
“Dreamland” is both an enlightening and a deeply disturbing study of the health and social crisis caused by deindustrialization, unscrupulous corporate marketing, unethical medical practices, and dismayingly efficient supply chain management and customer servicing by criminals.
The only grouse with the author would be that while he is rightly appalled and castigates the prescription opioid trade, he is far less trenchant and almost sympathetic to the Mexicans supplying the alternative heroin and their methods.
Customer ReviewsMost Helpful
By Perkyanne on 09-04-16
The Truth Finally Told
Having known many addicts who have committed suicide or OD'd. I admire the author's research and learned so much about why the abuse is growing at an alarming rate.
I am so happy I read this book. it's a shame that so many people turn a blind eye to this epidemic.
16 of 16 people found this review helpful
By Mel on 09-05-15
American Nightmare that is Necessary Reading
In 1980, Portsmouth Ohio was selected as an All-American city, boasting a community center of parks and recreation facilities that radiated out from a football field-sized swimming pool called Dreamland. Quinones describes the town complex like a Rockwell mural, teenagers would ride the bus to town for a cherry Coke and fries, and spend the day around the pool choked with families. A timeline he includes with the book notes that that same year, across the map in California, the first Mexican immigrants crossed the border and set up heroin trafficking in the San Fernando Valley. Four years later, Purdue-Pharma released MS Contin.
In one of the most comprehensive, and important journalistic pieces on drugs that I've ever read, Quinones gives extensive details of how our country came under siege of a true epidemic, and exactly who made the devastation possible, how and why. Dreamland is unlike what you might expect from a book that chronicles the etiology of a drug epidemic; it is weirdly entertaining on an alarming level, a better word might be fascinating. Quinones writes like a novelist, telling a real-life Grimm's fairy tale, tracing the path of the black tar heroin invasion from the small Mexican farming town of Xalisco, and following the trail as it spread through the veins and arteries across America. The revelations of Big Pharma and the Reps that Quinones follows are beyond repulsive; the greed, duplicity, and disregard for lives is nothing less than murder and treason.
We all have some degree of involvement since addiction has jumped from the lower classes and come home to roost at all levels of the economic stratification -- a fact that makes this book all the more timely and important. "The new addicts are cheerleaders, football players, daughters of preachers, sons of cops and doctors...housewives, bankers, teachers." "Wounded soldiers return from Afghanistan hooked on pain pills and [die] in America." Quinones declares, "It''s a great day to be a heroin dealer in America." We are losing the war on drugs with an addiction rate that has skyrocketed over 1000% percent in less than 10 yrs.
Today, Dreamland no longer exists. By the early 90's, OxyContin (time released Oxycodone) was prescribed routinely for pain; the Xalisco "pizza-delivery-style" heroin market spread east, across the Mississippi. As of 2008, drug-overdose primarily from opiates, surpassed auto accidents as the leading cause of accidental death. With a phone call, a dose of black tar heroin from one of the Mexican Xalisco drug families can be delivered to your front door. Young Mexicans are eager to come to America and earn money with the dream of escaping poverty. Quinones talked with a few, and even followed some. They hope to return back across the border, impress a wife, buy a farm, a new jacked-up truck, some American style jeans... Customers die, but there is always a fresh new supply. A few quit the heroin, but none ever really make it out. Heroin becomes a part of the user, it's with them forever like they say, a sleeping monster -- as any parent, or loved one of an addict knows. You live with the addict, then you live with the fear of the return. Philip Seymour Hoffman had used heroin in his younger life. At the age of 46, he'd been sober 23 years -- before the day he was found dead from an apparent heroin overdose.
Structurally, there are some spots where information is repeated, almost like cut and paste sections, and that could be a spot for nit-picking for some. But, Quinones does a job that is praiseworthy. The format goes back and forth between a few of the Xalisco big dealers, the pharmaceutical companies and doctors wrongly prescribing opiates, addicts, and the efforts of the DEA and the FBI. I highly recommend the book. It's an alarm that will enrage you, scare you, and possible break your heart. ALSO: For a great quick look that will have you hooked (npi), go to a site (Goodreads) where you can click on a preview of the book. The preview contains: Maps of Mexico and the Xalisco farms; Maps of the Xalisco drug cells in the US; a Timeline of the development of heroin in America; a Preface about Portsmouth, Ohio and Dreamland; and a fascinating Introduction.
109 of 116 people found this review helpful