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4.11 AVERAGE
4.11 AVERAGE
Accidentally grabbed the abridged opps
Liked it but felt so repetitive I stopped reading halfway. Great knowledge and insight along with background information. A good book, I just lost interest.
challenging
informative
reflective
medium-paced
I can't imagine what it took for Sam Quinones to write this book. It is an extraordinary piece of investigative journalism, and he doesn't shy away from the seemingly all-encompassing breadth of his topic, opiate addiction in America, which is what makes this book truly impressive. There is no Pablo Escobar or El Chapo to vilify for the heroin epidemic that hit our country. Rather, if Quinones is to be believed (and I think he is), it's a perfect storm made up of economic depression, a new emphasis on pain management in medicine, some Mexican guys who just want to impress their friends and family without causing much trouble, and the loss of places like the Dreamland Pool in Portsmouth, Ohio, that gave people a sense of community. Even Walmart gets an apportionment of blame. A summary of this book that does it justice would be cumbersome, but it is an important book about a subject that impacts our lives in ways we may not have considered, and the author truly leaves no stone unturned. My main quibble was that many of the points were repeated ad nauseum towards the end; there were times listening to the audio that I thought I must have accidentally hit rewind because I was sure I had heard that part before. It's a big story so I forgive him the need to repeat himself, but it did feel like a bit much. This book didn't arouse intensely strong feelings in me like, say, The Big Short or Making a Murderer, but it definitely weighed on me in a good way and is a book I won't soon forget.
Well that was one hefty book!
I can't say I agree with everything the author said (like how he ridiculed trigger warnings as signs of a weak psyche and talked about how running outside can prevent kids from reaching out for drugs in his ending speech. That felt very old man, "back in my times...").
But anyway, it's clear there was a lot of research that went into gathering all this information. I can't really think of any complaints right now because it's literally 3 am and I should be asleep.
I actually had to do two takes at this book - at first I read around 20% and returned around now - in May, to finish it up. It's hard to say why I had a problem with at first - I remember I was confused by the authors direction and why he spoke mostly of heroin, even though it was supposed to be about opioids. I also didn't like the chapters about Enrique, which I felt like were too novel like. I didn't like how he spoke of that man's actions and emotions like he knew them.
But anyway, I think I learned a lot
I can't say I agree with everything the author said (like how he ridiculed trigger warnings as signs of a weak psyche and talked about how running outside can prevent kids from reaching out for drugs in his ending speech. That felt very old man, "back in my times...").
But anyway, it's clear there was a lot of research that went into gathering all this information. I can't really think of any complaints right now because it's literally 3 am and I should be asleep.
I actually had to do two takes at this book - at first I read around 20% and returned around now - in May, to finish it up. It's hard to say why I had a problem with at first - I remember I was confused by the authors direction and why he spoke mostly of heroin, even though it was supposed to be about opioids. I also didn't like the chapters about Enrique, which I felt like were too novel like. I didn't like how he spoke of that man's actions and emotions like he knew them.
But anyway, I think I learned a lot
The opiate epidemic in America that Sam Quinones chronicles in his revelatory 2015 book, “Dreamland,” continues unabated. Just this past week in Columbus Ohio, 27 heroin overdoses were reported in one 24-hour period (9/27/16) and another 21 were reported the next day. Quinones’ book traces the epidemic back to the 1980’s and shows how two phenomena: corporate greed and liberal prescribing of opiates such as OxyContin for pain relief and a decentralized trafficking and distribution system for heroin devised by enterprising migrants from Xalisco in the Mexican state of Nayarit converged to create a devastating epidemic that has spread throughout the United States.
In 1980, a one-paragraph letter to the editor in the New England Journal of Medicine made the unsubstantiated assertion that addiction occurred in <1% of patients prescribed opiates for pain relief. A “revolution” in pain management began, and physicians were encouraged to treat it liberally with opiates. In 1986, Purdue Pharma released OxyContin and aggressively promoted it to physicians for the treatment of chronic pain. Unscrupulous sales promotions were followed by establishment of pain clinics, many of which were nothing more than “pill mills” where unethical doctors prescribed opiates to patients willing to pay cash for their visit and walk away with a prescription. Some of these people had Medicare cards that allowed them to obtain opiates with a co-pay of a few dollars, and then they turned around and sold the drugs on the street for hundreds of dollars. Thus, American taxpayers unwittingly subsidized the spread of these drugs. Addicts who could not afford the street price of the drugs turned to shoplifting to obtain merchandise that could be traded for drugs and a barter economy was established. One of the original doctors who ran a pill mill in South Shore, Kentucky ultimately pled guilty to drug trafficking and served 11 years in prison. By 2007, Purdue Pharma pled guilty to misdemeanor charges of false branding and was fined $634 million.
During the time that Americans were becoming addicted to prescription opiates, migrants from Xalisco were establishing a heroin trafficking business in California’s San Fernando Valley, using “black tar” heroin processed from poppies grown in the hills of Nayarit. A system was developed that ultimately spread to cities all over the United States such as Portland OR, Reno and Las Vegas NV, Salt Lake City UT, Phoenix AZ, Santa Fe NM, Denver CO, Nashville and Memphis TN, Lexington KY, Charlotte NC, and Columbus, Cincinnati, and Dayton OH. These “cells” intentionally followed the pattern of Mexican immigration across the United States, so the traffickers could blend in seamlessly. They specifically avoided cities without substantial Mexican immigrant populations. The Xalisco boys delivered heroin to young affluent white kids as if it were pizza. The user placed a call to a dispatcher who would send the driver to a specific location based on coded messages. The “black tar” heroin was very pure (80%) and could be sold cheaply as a result of the large sales volume. The drivers were courteous, carried no weapons and were dedicated to customer service. The rolled-up balls of “black tar” were carried in their mouths in uninflated balloons that could be swallowed if they were pulled over by the police. These delivery boys were smart enough to never use the product themselves – they understood the consequences of addiction. Instead, they sent their profits back to Mexico where they built houses and spent lavishly on friends and family. Despite Operation Tar Pit in 2000 and Operation Black Gold Rush in 2006, “cells” kept springing back up as soon as one was shut down. It was like the arcade game where you smash a little pop-up monster with a hammer only to have another one pop up nearby – there was an inexhaustible supply of young Mexicans willing to take the risk involved for money and fame back home. The switch from prescription painkillers to heroin was logical in retrospect because the efficient marketing and delivery system of the Xalisco boys made it cheaper and more convenient than prescription opiates.
The insight provided by Quinones’ book is as mind boggling as the epidemic is devastating for American society. This book should be required reading for every student entering high school (maybe even for middle school students).
In 1980, a one-paragraph letter to the editor in the New England Journal of Medicine made the unsubstantiated assertion that addiction occurred in <1% of patients prescribed opiates for pain relief. A “revolution” in pain management began, and physicians were encouraged to treat it liberally with opiates. In 1986, Purdue Pharma released OxyContin and aggressively promoted it to physicians for the treatment of chronic pain. Unscrupulous sales promotions were followed by establishment of pain clinics, many of which were nothing more than “pill mills” where unethical doctors prescribed opiates to patients willing to pay cash for their visit and walk away with a prescription. Some of these people had Medicare cards that allowed them to obtain opiates with a co-pay of a few dollars, and then they turned around and sold the drugs on the street for hundreds of dollars. Thus, American taxpayers unwittingly subsidized the spread of these drugs. Addicts who could not afford the street price of the drugs turned to shoplifting to obtain merchandise that could be traded for drugs and a barter economy was established. One of the original doctors who ran a pill mill in South Shore, Kentucky ultimately pled guilty to drug trafficking and served 11 years in prison. By 2007, Purdue Pharma pled guilty to misdemeanor charges of false branding and was fined $634 million.
During the time that Americans were becoming addicted to prescription opiates, migrants from Xalisco were establishing a heroin trafficking business in California’s San Fernando Valley, using “black tar” heroin processed from poppies grown in the hills of Nayarit. A system was developed that ultimately spread to cities all over the United States such as Portland OR, Reno and Las Vegas NV, Salt Lake City UT, Phoenix AZ, Santa Fe NM, Denver CO, Nashville and Memphis TN, Lexington KY, Charlotte NC, and Columbus, Cincinnati, and Dayton OH. These “cells” intentionally followed the pattern of Mexican immigration across the United States, so the traffickers could blend in seamlessly. They specifically avoided cities without substantial Mexican immigrant populations. The Xalisco boys delivered heroin to young affluent white kids as if it were pizza. The user placed a call to a dispatcher who would send the driver to a specific location based on coded messages. The “black tar” heroin was very pure (80%) and could be sold cheaply as a result of the large sales volume. The drivers were courteous, carried no weapons and were dedicated to customer service. The rolled-up balls of “black tar” were carried in their mouths in uninflated balloons that could be swallowed if they were pulled over by the police. These delivery boys were smart enough to never use the product themselves – they understood the consequences of addiction. Instead, they sent their profits back to Mexico where they built houses and spent lavishly on friends and family. Despite Operation Tar Pit in 2000 and Operation Black Gold Rush in 2006, “cells” kept springing back up as soon as one was shut down. It was like the arcade game where you smash a little pop-up monster with a hammer only to have another one pop up nearby – there was an inexhaustible supply of young Mexicans willing to take the risk involved for money and fame back home. The switch from prescription painkillers to heroin was logical in retrospect because the efficient marketing and delivery system of the Xalisco boys made it cheaper and more convenient than prescription opiates.
The insight provided by Quinones’ book is as mind boggling as the epidemic is devastating for American society. This book should be required reading for every student entering high school (maybe even for middle school students).
challenging
dark
informative
reflective
sad
medium-paced
challenging
hopeful
informative
slow-paced