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muhly22 's review for:
Dreamland: The True Tale of America's Opiate Epidemic
by Sam Quinones
As an assistant prosecutor in a rural Ohio county that has been hit very hard by the opiate epidemic, I found this book very interesting, although the history of the Xalisco Boys doesn't really apply to my jurisdiction, as we rarely see black tar heroin (having prosecuted several hundred heroin cases, I can think of only one time that black tar heroin was present...we more typically see brown or white powder heroin).
While the part of me that yearns for a bigger sandbox found the discussions of the Xalisco Boys very interesting but ultimately irrelevant to my community's situation, the discussion about painkillers as the origination point of the current heroin crisis was fascinating. I have seen many (though not all) heroin addicts who started with painkillers...some due to chronic pain, but others because it was a drug that they could take and got addicted to. I've long recognized the role that OxyContin and other prescription opiates played in leading people to heroin, but I've never before read a history of how those drugs came to be so easy to get. If nothing else, Quinones' pulling back of that curtain is valuable in revealing how little doctors are able to know about all the different complaints we come to them with, and how much they depend on other specialists to inform them.
One thing that does tend to get lost in discussions about the heroin epidemic, though, is that many addicts are not simply addicts, they are criminals. They lie, cheat, and steal, and don't care who is hurt by that, or whether the pain they leave behind is physical, economic, or psychological. That comes from a mixture of inherent personality traits and constantly poisoning one's own body, which also poisons the mind; the exact mixture varies from person to person. I have seen addicts who have stolen from their parents, from their friends, from the last family members to give them a chance and a place to stay. That leaves a devastation behind that no amount of treatment can fix, without major reforms by the addict.
While the part of me that yearns for a bigger sandbox found the discussions of the Xalisco Boys very interesting but ultimately irrelevant to my community's situation, the discussion about painkillers as the origination point of the current heroin crisis was fascinating. I have seen many (though not all) heroin addicts who started with painkillers...some due to chronic pain, but others because it was a drug that they could take and got addicted to. I've long recognized the role that OxyContin and other prescription opiates played in leading people to heroin, but I've never before read a history of how those drugs came to be so easy to get. If nothing else, Quinones' pulling back of that curtain is valuable in revealing how little doctors are able to know about all the different complaints we come to them with, and how much they depend on other specialists to inform them.
One thing that does tend to get lost in discussions about the heroin epidemic, though, is that many addicts are not simply addicts, they are criminals. They lie, cheat, and steal, and don't care who is hurt by that, or whether the pain they leave behind is physical, economic, or psychological. That comes from a mixture of inherent personality traits and constantly poisoning one's own body, which also poisons the mind; the exact mixture varies from person to person. I have seen addicts who have stolen from their parents, from their friends, from the last family members to give them a chance and a place to stay. That leaves a devastation behind that no amount of treatment can fix, without major reforms by the addict.