You need to sign in or sign up before continuing.


My rating is closer to a 3.5. The book is dense and somewhat repetitive. Quinones thoroughly researched the opioid epidemic and provides a strong history of the ties between Oxycodone and heroin usage across America. A worthwhile read on a timely topic.
challenging informative reflective sad medium-paced

Quinones' exploration of how we've found ourselves in the middle of an opioid epidemic is broad and deeply nuanced. He thoroughly plots the recent rise of the medical world's 'pain revolution' and the subsequent over-prescribing and abuse of opioids, whilst telling the parallel story of how a more potent and cheaper kind of heroin called black tar hit the streets of small town America, and created a perfect storm of opioid addiction that we see today. His writing is historical, devastating and ultimately humanizing.

If you've ever wondered about the frequent and seemingly non-ending deaths due to opioid addiction, this is the book to read.

Fascinating and comprehensive

This book gives a clear-eyed view of the myriad problems in the US and Mexico which led to the perfect breeding ground for a culture of addiction, greed, and secret shame.

Intense, necessary read

A powerful introduction to the twin story of Purdue Pharma's Oxy and Xalisco's heroin ushering in the opioid epidemic in America.

Great informative read

As someone who sort of works in social services and sees heroin and prescription drug abuse I️ was looking for a book that provided some good information about where it all came from. This provided that and more. The writer is excellent and provides a fascinating background for this epidemic all while being non-judgmental and sowing the seeds for hope. This writer has been extremely thorough in investigating this whole ordeal and while he shows this epidemic spreading like a web throughout our country he shows the growth and progression of the epidemic using a town in Ohio which reminded me so much of my own hometown and several other hometowns in states that I️ have visited. Well worth the read

Read this book. I'm going to say that again: READ. THIS. BOOK. If you live anywhere in middle America, but especially if you live in Southern Ohio, you have to read this book to see where the scourge of narcotics has come from. The origins of the opiate epidemic are laid out as clearly as possible for all to see. One of the most significant problems in our society over the last 20 years, and the perfect storm that led to it called out in black and white. But probably most significant is how clearly you can see that the issue is not one of moral failings on the part of drug addicts. It is the result of our society's delusional pursuit of wealth at all costs, and the desire to live some absurd dream life that is not only unrealistic, but isn't even life. Not only in the desire to eliminate pain with a magical pill, but also to make huge amounts of money selling those pills no matter the human cost. How clearly you can see that it's not just the "junkies" pursuing that delusion, it's the heroin pushers, the drug reps, pharmaceutical companies, Walmart, and the unrealistic expectations placed on middle class America.

But not only can you see exactly how we got here, you can also see how we're beginning to wake up and get out. The first step to recovery is admitting you have a problem, and that applies not just to the "junkies" but to all of us as well. This isn't a problem just for criminal lowlifes who are hooked on drugs. This is a problem for all of us. When you look at that "junkie" you have to see a brother or a sister, not some morally corrupt non-being. We have to stand up and say "no more." We have to accept that alleviating pain is hard work, and there is no short cut. We have to recognize that our salvation is not in a pill or a doctor or a corporation or a bigger house or a better car. It's in ourselves and in our connection to other human beings. I swear I got choked up at the end of the book because in Portsmouth's recovery I saw the recovery of Chillicothe and Columbus and so much more of middle America. A recovery that I've witnessed again and again as individuals stand up and say I'm going to make a difference in my community. A recovery that is based in reaching out to each other, speaking the truth to each other, pulling each other up, and saying to anything or anybody who would put us down that we're better than that, and we'll prove it.
informative medium-paced

This book was ok. It provided a lot of information that is very interesting and informative about the opiate epidemic and the rise of Heroin use. Being from Cincinnati I thought the connections to Portsmouth and the area was very interesting. However, the author was very repetitive and some of his claims seem exaggerated. I wish he had a bibliography or end, page notes so that I would be able to fact check some of his claims

I'm amazed - and a bit skeptical - of the work that went into this book. Quinones had interviews not only with prosecutors and doctors, but with several drug users and dealers. All of these interviews helped him paint a very vivid, detailed picture of the opiate crisis in the U.S. Even down to the factors that had a secondary effect on the crisis - like Walmart's influence.
Very informative and definitely worth the read.