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cbginder 's review for:
Dreamland: The True Tale of America's Opiate Epidemic
by Sam Quinones
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.