Book Review: Dreamland

https://goo.gl/AEunKC

The true tale of America's opiate epidemic.

The Sunday San Diego Union-Tribune on Dec. 18, 2016, carried two stories related to opioid overdoses.

One was from the Associated Press, headlined "DRUG OVERDOSE DEATHS UP 33% NATIONWIDE." According to the CDC, 30 states saw heroin and opioid overdose deaths increase and four had death rates jump more than 100%.

The second story was reprinted from The Washington Post with the title "STOCKING UP ON OVERDOSE KITS." The fentanyl crisis was so bad in Canada, according to the Post, that funeral homes were now keeping kits on hand. Apparently there was some risk of absorption by embalmers or police officers so the kits would be there for them. They might also come in handy "in case a grieving funeral attendee overdoses during services."

These articles brought to mind Sam Quinones' detailed and terrifying non-fiction book published in 2015, Dreamland, The True Tale of America's Opiate Epidemic.

Quinones lives in Southern California and started his investigation of drug abuse over five years ending in 2014 as a reporter for the Los Angeles Times. He points out that "abuse of prescription painkillers was behind 488,000 emergency room visits in 2011, almost triple the number of seven years before. Overdose deaths involving opiates rose from ten a day in 1999 to one every half hour by 2012."

The story of the black tar heroin epidemic across the United States that began in the 1980s parallels the sweeping prescription opiate epidemic in America because the lined-up clientele was the same group. And the product, whether natural like heroin or manufactured like Purdue opiate pill, is the very same companion to all those Americans who wanted Better Living Through Chemistry. But heroin was cheaper, Quinones observed, and the opiate prescriptions had already "tenderized" those who would want heroin.

It's a long, frightening story, moving backwards and forwards from how a small group of heroin growers in the villages of Xalisco on the west coast of Nayarit in Mexico started their business with family members and became successful in America by selling and delivering heroin like pizza to how Big Pharm discovered erroneous data to suggest that addicting narcotics were not really addicting whereupon manufacturer Purdue manipulated the data further.

The book is painstakingly, carefully, and accurately written. It is fascinating. And it is horrifying. It also requires some understanding because Quinones wrote two books at the same time: how easily the poppy grew in the high altitudes of coastal Nayarit, where rural Mexicans chose low-key family members to develop a heroin supply service for Americans, and how this all tied in with what some physicians thought should become a more generous and kindly professional pain relief package, even one that finally showed it was a mistake.