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4.11 AVERAGE
4.11 AVERAGE
This book was really eye opening into how the current heroin epidemic evolved from pain pills. I had forgotten the messaging when opiates were becoming a common pain killer that people in real pain would not get addicted because the would not find much euphoria. The book talked about the messaging and how it has been proven to be wrong.
I found it interesting that some addiction specialists said that these people getting hooked on opiates would have likely gotten hooked on some other drug, such as alcohol, later on in life. According to them, alcohol takes a longer time to grab ahold of a person and become an addicting substance versus the opiates. So it's almost a pull ahead of addictions.
I hope we don't swing back to the time when opiates were hardly ever prescribed. Hopefully we land somewhere back in the middle and take a holistic approach versus the quick pill "fix".
I found it interesting that some addiction specialists said that these people getting hooked on opiates would have likely gotten hooked on some other drug, such as alcohol, later on in life. According to them, alcohol takes a longer time to grab ahold of a person and become an addicting substance versus the opiates. So it's almost a pull ahead of addictions.
I hope we don't swing back to the time when opiates were hardly ever prescribed. Hopefully we land somewhere back in the middle and take a holistic approach versus the quick pill "fix".
Fascinating but ultimately a frustrating read. Quinones seems to have deeply delved into what the back cover touts as a "weav[ing] together two tales of capitalism catastrophically run amok." Indeed, the strongest part of the book to me was the afterword, in which he boldly opines, "Perhaps heroin is the most important force for positive change in our country today." In reading his expose of how a letter to the editor became cited as research that influenced policy that was leveraged by pharma whilst a new breed of heroin dealers with "farms-to tables" access to high potency, pure grade heroin used the on demand delivery service model to foster their (North) American dreams, one can understand how Quinones comes to such a brazen conclusion.
However, while I initially appreciated the chapter by chapter back and forth between the two strands, I began wearying of the ever-redundant observations. Repeatedly we learn that the Xalisco Boys hail from the same small town in tiny region of Mexico with little in the way of opportunity for the locals, and that they mostly wanted to make money in order to live large back home, and that the drivers were quickly and easily replaceable when caught, and they placed special emphasis on customer service and spread to places where coincidentally opiod addiction had taken root, fostered by physicians' mandate to quell the newly dubbed fifth vital sign by prescribing opiates they'd been (mis)led to believe were non-addictive. Also oft repeated, the Medicaid angle, the pill mill scenario, the pitfalls of "the molecule" as Quinones likes to call it, etc.
These are the bones of the story, but in all honesty it could all have been revealed in what is nowadays referred to as longform journalism or as a series of articles, rather than 345 pages of the same thing over and over. Because, when I finally got to the end, I got to the part where Quinones' voice is strongest, his thoughts full of epiphany, and his words directed towards a unique point of view. There he writes, "For this book is only on one level about dope. It occurred to me, as I researched Dreamland, that talking about heroin -- opiates in general -- was really a way of talking about America. Where we stand as a country has a lot to do with the nature of drugs...." That's the part that's truly revelatory. The other parts of the book are obviously necessary, and none of it was anything I had known before, but having laid that groundwork, I would like to know more about what this says about the state of the nation. It'd be one man's opinion, but an informed man. What say ye, Sam? 3.5 stars
However, while I initially appreciated the chapter by chapter back and forth between the two strands, I began wearying of the ever-redundant observations. Repeatedly we learn that the Xalisco Boys hail from the same small town in tiny region of Mexico with little in the way of opportunity for the locals, and that they mostly wanted to make money in order to live large back home, and that the drivers were quickly and easily replaceable when caught, and they placed special emphasis on customer service and spread to places where coincidentally opiod addiction had taken root, fostered by physicians' mandate to quell the newly dubbed fifth vital sign by prescribing opiates they'd been (mis)led to believe were non-addictive. Also oft repeated, the Medicaid angle, the pill mill scenario, the pitfalls of "the molecule" as Quinones likes to call it, etc.
These are the bones of the story, but in all honesty it could all have been revealed in what is nowadays referred to as longform journalism or as a series of articles, rather than 345 pages of the same thing over and over. Because, when I finally got to the end, I got to the part where Quinones' voice is strongest, his thoughts full of epiphany, and his words directed towards a unique point of view. There he writes, "For this book is only on one level about dope. It occurred to me, as I researched Dreamland, that talking about heroin -- opiates in general -- was really a way of talking about America. Where we stand as a country has a lot to do with the nature of drugs...." That's the part that's truly revelatory. The other parts of the book are obviously necessary, and none of it was anything I had known before, but having laid that groundwork, I would like to know more about what this says about the state of the nation. It'd be one man's opinion, but an informed man. What say ye, Sam? 3.5 stars
An interesting look at the rise of pain pill and heroin abuse in rural America. Unfortunately, Quinones fractured narrative structure makes it hard to follow the various threads he tries to weave together, and he repeats himself as individuals and places are reintroduced throughout the book. Overall 2.5 out of 5
challenging
informative
slow-paced
dark
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reflective
medium-paced
informative
challenging
dark
informative
slow-paced
Very very repetitive and boring. The three stars is for the fact that it was still very interesting and unique.
Very important information well told. For someone unaffected (knowingly, anyway) by this problem, a bit more background information would have been helpful about the actual use of opioids: what is the euphoria, exactly; the mechanics of addiction, the delivery of it to the body...I confess ignorance. The casual mention of mu receptors and scabby, pitted addicts assumes readers know this personally. Likewise I expected more coordination with methamphetamine abuse and there was none, only a single mention; meth at least I have heard about, and figured more of an overlap, demographically.
This book is one you could read as a companion to Hillbilly Elegy. It is about the opioid crisis in America and tells the tale of pharmaceutical marketing of painkillers, a change in the medical world to treating pain, a small Mexican town’s marketing of black tar heroin in America’s suburbs, and the search for happiness of Americans suburbs and depressed post-industrial areas. Some of these topics could be boring but Quinones masterfully weaves the story together with stories of individual families, junkies, cops, dealers, and doctors.