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4.11 AVERAGE
4.11 AVERAGE
emotional
informative
sad
slow-paced
Although this book was very info-heavy, and very repetitive, I think it’s an important read. I live in southern Ohio and the opioid epidemic (which has now turned into the meth epidemic) has wrecked our part of the planet, as it has many other places. It was interesting to see how it all started.
The opiate epidemic was caused by an extremely complicated web of independent factors that created a perfect storm, and in “Dreamland,” Quinones delves deep and creates a compelling case for each one of those factors, and for how they worked in concert. From changing attitudes about pain management in the medical community, to new methods of marketing by drug companies, the innovative modes of heroin distribution arising in the 1980s, and the unexpected incentives created by SSI and Medicaid, Quinones pieces together how each group acted with rational intent — whether to help patients or help themselves — in a way that didn’t need to anticipate how those factors would work in concert. It’s a fascinating read that focuses on first-person stories and does a great job of unraveling the complicated threads of causation.
Dreamland is the exploration of the opioid and heroine addiction crises in the U.S. that began in the mid-90s. The book describes how changes in the approach to treating and managing pain combined with aggressive pharmaceutical marketing led to an increase in the use of opioids. Dealers from a small town in Mexico were able to take advantage of this changing culture by bring black tar heroine into the U.S. and selling it to addicts who could no longer afford the opioids' high street price.
I tried my best to give a simple description, but there is so much more to this book. I purchased this through a two-for-one deal on Audible and I’m glad I did. I don’t think this book would have been on my radar without this promotion. It was fascinating, albeit a bit repetitive at times. If you’re a fan of documentaries, it’s definitely worth a listen (or read).
I tried my best to give a simple description, but there is so much more to this book. I purchased this through a two-for-one deal on Audible and I’m glad I did. I don’t think this book would have been on my radar without this promotion. It was fascinating, albeit a bit repetitive at times. If you’re a fan of documentaries, it’s definitely worth a listen (or read).
I liked the story of this book, but felt the narrative was bogged down by repetition. The spread of the Xalisco Boys was described in a number of chapters, with each one beginning with the same (long) description of how their heroin trafficking/dealing worked. I'm not sure if the author did it on purpose or not, but I think it made the book longer than it should have been and slowed the pace of the narrative. Despite that, I would still recommend the book because the story contained within is heartbreaking.
learned a lot through this book and i’m glad i read it. some really interesting thoughts towards the end about community as the only real solution for addiction, and i’d read a book exploring the connection between the american psyche/capitalism with the opioid crisis alone.
that being said, the author being an old white guy is pretty apparent through the language he used, some of which is a little
that being said, the author being an old white guy is pretty apparent through the language he used, some of which is a little
Essential reading, even if overly repetitive at times, Dreamland ties together the revolution in pain treatment leading to Oxycontin and other pill addictions and the spread of heroin trafficking across the United States, focusing on a network he calls the Xalisco Boys. The narrative does an effective job jumping back and forth between small towns in America, some bigger cities like Los Angeles, Mexico, and little snippets of history, biology and medicine. It portrays doctors--both good and bad--pharmaceutical executives, dealers, addicts, parents of addicts, coroners, public officials, in a kaleidoscopic and almost epic narrative. And at the epicenter of the book is Portsmouth, a small city in Ohio that faced a combination of a declining economy, the spread of prescription opioids many of them dispensed by pill mills, and also the expansion of heroin dealing into smaller cities across the country.
The human stories in Dreamland are often painful, but you are left with the greatest anger that for so long so few people really paid attention and shined a spotlight on the set of issues around opioids, both prescription and in the form of illegal heroin. The book tries to end with a hopeful note as people in Portsmouth can admit their addiction problem, begin to treat it, and their city's economy and government starts to repair itself. But it is more of an open question of whether this somewhat hopeful ending accurately reflects that national trends so the most important lesson is to keep focused on the issue.
The human stories in Dreamland are often painful, but you are left with the greatest anger that for so long so few people really paid attention and shined a spotlight on the set of issues around opioids, both prescription and in the form of illegal heroin. The book tries to end with a hopeful note as people in Portsmouth can admit their addiction problem, begin to treat it, and their city's economy and government starts to repair itself. But it is more of an open question of whether this somewhat hopeful ending accurately reflects that national trends so the most important lesson is to keep focused on the issue.
Dreamland is the story of how America's opiate epidemic was born of a perfect storm of events - from the rise of Xalisco Mexican black tar heroin cells moving from west to east and how pharmaceutical marketing and OxyContin began moving east to west and both collided in the Midwest - specifically, Southwestern Ohio.
Dreamland is based on Quinones' interviews as a reporter investigating the opiate epidemic, from speaking with leaders of the Xalisco Boys heroin cells to law enforcement officials across the country to parents of children who overdosed to addicts themselves. It's nonfiction, but it reads like a novel and I had a hard time putting it down. It was fascinating how resistant the Xalisco heroin cells were (and likely, still are) because of the franchise / corporate way they were run - a leader, a dispatcher, and drivers crisscrossing cities to deliver black tar heroin in balloons. The cells started out west, but began moving east when the cell leaders realized that the midwest - particularly Columbus, Ohio - were virtually untapped by the nearly-pure black tar heroin they were selling.
At the same time, on the east coast, Purdue Pharma was developing OxyContin - time-released oxycodone that they heavily marketed as virtually non-addictive. This coincides with the rise of "pain as the fifth vital sign" and changes in how chronic pain is treated in the US. As doctors prescribed more and more opiates to treat chronic pain patients, more and more Americans became addicted to OxyContin. Pill Mills began to spring up, and a pill economy began booming in the midwest. Many Americans - a lot of them white and upper-middle-class - moved from pills to heroin, specifically, the black tar heroin sold by Xalisco heroin cells.
I also found it fascinating that the epidemic went unnoticed for a long time - one of the stats is that people began to take notice when overdoses overtook car accidents as the number one accidental cause of death in Ohio. By that point, the opiate epidemic was in full swing: millions of Americans were addicted to opiates, either because they started on OxyContin and switched to heroin, started on heroin, or became part of the pill economy in the midwest.
There is no one root cause of the opiate epidemic, and it went unnoticed for far too long for Americans to have an easy time overcoming it. Stigma surrounding addiction must go down - many parents of children who died of overdoses or other drug-related causes refused to actually admit how their child died - and the concept of recovery must change as well. Many parents that Quinones interviewed explained how they thought their child was okay after being released from rehab, only to have that child overdose within a week of their release.
Dreamland was gripping, fascinating, and I had trouble putting it down - I enjoyed the way that Quinones showed how each part of the epidemic (rise of black tar heroin, the release of OxyContin as a "virtually nonaddictive" pain medication, the decline of manufacturing and decent jobs in the Midwest) all began to gather steam around the same time, leading to the epidemic the country faces now. I highly recommend it.
Dreamland is based on Quinones' interviews as a reporter investigating the opiate epidemic, from speaking with leaders of the Xalisco Boys heroin cells to law enforcement officials across the country to parents of children who overdosed to addicts themselves. It's nonfiction, but it reads like a novel and I had a hard time putting it down. It was fascinating how resistant the Xalisco heroin cells were (and likely, still are) because of the franchise / corporate way they were run - a leader, a dispatcher, and drivers crisscrossing cities to deliver black tar heroin in balloons. The cells started out west, but began moving east when the cell leaders realized that the midwest - particularly Columbus, Ohio - were virtually untapped by the nearly-pure black tar heroin they were selling.
At the same time, on the east coast, Purdue Pharma was developing OxyContin - time-released oxycodone that they heavily marketed as virtually non-addictive. This coincides with the rise of "pain as the fifth vital sign" and changes in how chronic pain is treated in the US. As doctors prescribed more and more opiates to treat chronic pain patients, more and more Americans became addicted to OxyContin. Pill Mills began to spring up, and a pill economy began booming in the midwest. Many Americans - a lot of them white and upper-middle-class - moved from pills to heroin, specifically, the black tar heroin sold by Xalisco heroin cells.
I also found it fascinating that the epidemic went unnoticed for a long time - one of the stats is that people began to take notice when overdoses overtook car accidents as the number one accidental cause of death in Ohio. By that point, the opiate epidemic was in full swing: millions of Americans were addicted to opiates, either because they started on OxyContin and switched to heroin, started on heroin, or became part of the pill economy in the midwest.
There is no one root cause of the opiate epidemic, and it went unnoticed for far too long for Americans to have an easy time overcoming it. Stigma surrounding addiction must go down - many parents of children who died of overdoses or other drug-related causes refused to actually admit how their child died - and the concept of recovery must change as well. Many parents that Quinones interviewed explained how they thought their child was okay after being released from rehab, only to have that child overdose within a week of their release.
Dreamland was gripping, fascinating, and I had trouble putting it down - I enjoyed the way that Quinones showed how each part of the epidemic (rise of black tar heroin, the release of OxyContin as a "virtually nonaddictive" pain medication, the decline of manufacturing and decent jobs in the Midwest) all began to gather steam around the same time, leading to the epidemic the country faces now. I highly recommend it.
dark
emotional
informative
slow-paced
This book is so, so good. I'll probably read it again.
"Dreamland" was a deeply interesting read. I work with many people who suffer from addiction and it honestly never occurred to me to ask where it all came from. This book should be required reading for healthcare professionals and law enforcement officials. It's like a detective novel where you know who the culprit is, but you need to find out how he got away with it.