challenging dark emotional informative slow-paced

Informative read! Great insight into the complicated history of substance use. A little slow at times.

It’s an interesting topic, but very slow and seemingly disjointed in the beginning. If you are interested in the book, read the last chapter. It summarizes everything. I would not recommend this one. I am sure there are better books on the topic. The afterword is very preachy

Absolutely devastating. Growing up and going to high school during the opiate epidemic has been harrowing. Almost a dozen kids from my graduating class are dead now.

The history of pain in the medical field and how it came to be seen as the fifth vital sign is truly fascinating. I had no idea about this aspect of the epidemic. The points about how Mexican drug dealers came to sell only to whites and not to blacks (because of racism towards darker skinned people) is fascinating. So many contributing factors had to occur for this to happen.

The death to small town America is also something I am very familiar with. Our generation watched it die. How that effected people and left a desolate environment ripe for drug abuse is clear. I did not find this too repetitive but I did listen to it on Audible. I highly recommend this.

jeaneem22's review

2.0

Great content, didn't like the writing.

A very important read for all. Fascinating and scary.

This is a great, important book

This book reads like a season of The Wire. It covers so much ground, from changes in the pharmaceutical and medical fields, to the ins and outs of heroin sales that crippled suburban America and how they all connect. It's a fascinating read.

The fact that I grew up in Southeastern Ohio in the late 90's and early 00's made this book very close to home for, both literally and figuratively. My family, like basically every family in my community, has been rocked by the effects of the opiate epidemic. My county has been a victim of the same decline as Quinones details so vividly about Portsmouth (In fact, I remember traveling through Portsmouth in middle school and, even at the age of 12, sensing there was something horribly wrong there. I discovered I wasn't wrong when I read the chapters in this book detailing the full-fledged painkiller economy taking place in the town at that time.) So, I guess this is all to say that there is no way for me to be completely objective about this work due to its proximity, and I appreciate the effort that Quinones made to convey the reality of the epidemic on these hard-hit areas.

I also loved that this book allowed me to see beyond my own scope of the opiate epidemic to the much larger picture of how it culminated into a national crisis. Reading about the pain revolution and the marketing strategies employed by pharmaceutical companies was infuriating, but so helpful in understanding the perfect storm they created. Reading about the Xalisco Boys, I often found myself surprisingly invested in their stories and almost pulling for them in a way, which is a credit again to Quinones' ability to keep a massively complex story ultimately focused on its humanity.

I agree with many other readers in that the book sometimes seems as if it could have used some more editing and is curiously repetitive in a way that doesn't seem intentional. And there are a lot of moving parts, which can get a little convoluted, but none of this disrupted the incredible learning experience of reading this book, which gave me so much insight into a crisis through which I've lived.

Lastly, I appreciated his optimism at the end of the book. Though the devastation of this epidemic is far from over, I've seen welcome glimmers of revitalization in my own community. In finishing the book—even though I'd spent so many of its pages haunted by my ability to put faces and names to those who have lost parents, children, and partners to this cruel epidemic—instead of shame, I unexpectedly felt myself overcome with compassion and pride for the resiliency and heart of my home. Having recently graduated from college, I feel compelled to continue learning as much as I can about this issue and lending all the resources I can to its recovery.

I'm very grateful to Sam Quinones for this work of comprehensive journalism that allowed me to both think and feel so deeply about this issue.

An enlightening, and infuriating, look at the opioid crises here in the US and the greed driving it, from Purdue Pharma to the Xalisco boys drug distribution system. The book is very well researched and investigated and one of the best investigative books on this subject that I’ve read.

Fascinating look at the roots of America's opiate epidemic, using first-person accounts, historical documents and much more, all wound together in a surprisingly easy to read page-turner.