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Dreamland: The True Tale of America's Opiate Epidemic Hardcover – April 21, 2015
| Sam Quinones (Author) Find all the books, read about the author, and more. See search results for this author |
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Winner of the NBCC Award for General Nonfiction
Named on Slate's 50 Best Nonfiction Books of the Past 25 Years, Amazon's Best Books of the Year 2015--Michael Botticelli, U.S. Drug Czar (Politico) Favorite Book of the Year--Angus Deaton, Nobel Prize Economics (Bloomberg/WSJ) Best Books of 2015--Matt Bevin, Governor of Kentucky (WSJ) Books of the Year--Slate.com’s 10 Best Books of 2015--Entertainment Weekly’s 10 Best Books of 2015 --Buzzfeed’s 19 Best Nonfiction Books of 2015--The Daily Beast’s Best Big Idea Books of 2015--Seattle Times’ Best Books of 2015--Boston Globe’s Best Books of 2015--St. Louis Post-Dispatch’s Best Books of 2015--The Guardian’s The Best Book We Read All Year--Audible’s Best Books of 2015--Texas Observer’s Five Books We Loved in 2015--Chicago Public Library’s Best Nonfiction Books of 2015
From a small town in Mexico to the boardrooms of Big Pharma to main streets nationwide, an explosive and shocking account of addiction in the heartland of America.
In 1929, in the blue-collar city of Portsmouth, Ohio, a company built a swimming pool the size of a football field; named Dreamland, it became the vital center of the community. Now, addiction has devastated Portsmouth, as it has hundreds of small rural towns and suburbs across America--addiction like no other the country has ever faced. How that happened is the riveting story of Dreamland.
With a great reporter’s narrative skill and the storytelling ability of a novelist, acclaimed journalist Sam Quinones weaves together two classic tales of capitalism run amok whose unintentional collision has been catastrophic. The unfettered prescribing of pain medications during the 1990s reached its peak in Purdue Pharma’s campaign to market OxyContin, its new, expensive--extremely addictive--miracle painkiller. Meanwhile, a massive influx of black tar heroin--cheap, potent, and originating from one small county on Mexico’s west coast, independent of any drug cartel--assaulted small town and mid-sized cities across the country, driven by a brilliant, almost unbeatable marketing and distribution system. Together these phenomena continue to lay waste to communities from Tennessee to Oregon, Indiana to New Mexico.
Introducing a memorable cast of characters--pharma pioneers, young Mexican entrepreneurs, narcotics investigators, survivors, and parents--Quinones shows how these tales fit together. Dreamland is a revelatory account of the corrosive threat facing America and its heartland.
- Print length384 pages
- LanguageEnglish
- PublisherBloomsbury Press
- Publication dateApril 21, 2015
- Dimensions6.33 x 1.32 x 9.48 inches
- ISBN-101620402505
- ISBN-13978-1620402504
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Editorial Reviews
Amazon.com Review
An Amazon Best Book of April 2015: The rise of OxyContin addiction and subsequent heroin use has been much in the news lately as we try to make sense of what is happening in suburban and small town America. Sam Quinones’ Dreamland takes a multifaceted approach to the subject, profiling people from all walks of life, ranging from citizens of impoverished Mexican ranchos to young affluent white athletes, all cogs in the wheel of the latest drug epidemic. Unlike the crack cocaine phenomenon of the 1980s, today’s widespread opiate addiction has roots in the prescription pads of certified physicians and the marketing machine of Big Pharma. When the addict, forced by availability and economics, transitions to heroin he is met by a new breed of entrepreneurial drug dealers who are only too happy to take calls and make deliveries. The changing landscape of small town America, along with science, opportunity, shame, and of course greed, all play a role here and to see the puzzle come together, one comprehensible piece at a time, is as fascinating as it is unsettling.-- Seira Wilson
Review
About the Author
Product details
- Publisher : Bloomsbury Press; First Edition (April 21, 2015)
- Language : English
- Hardcover : 384 pages
- ISBN-10 : 1620402505
- ISBN-13 : 978-1620402504
- Item Weight : 1.55 pounds
- Dimensions : 6.33 x 1.32 x 9.48 inches
- Best Sellers Rank: #397,453 in Books (See Top 100 in Books)
- #271 in Sociological Study of Medicine
- #780 in Organized Crime True Accounts
- #1,344 in Criminology (Books)
- Customer Reviews:
About the author

Sam Quinones is a journalist, former LA Times reporter, author and storyteller.
His new book of narrative nonfiction - DREAMLAND: The True Tale of America's Opiate Epidemic - was published in 2015 by Bloomsbury Press. It has received rave reviews from Salon.com, Christian Science Monitor, Kirkus Reviews, and a bunch of Amazon.com readers.
DREAMLAND recounts twin tales of drug marketing:
A pharmaceutical corporation flogs its legal new opiate painkiller as nonaddictive; immigrants from a small town in Nayarit, Mexico devise a method for retailing black-tar heroin like pizza and take that system nationwide riding a wave of pill addiction.
The result is our current scourge of opiate - pain pills and heroin - addiction.
A reporter for almost 30 years, Quinones lived and worked as a freelance writer in Mexico from 1994 to 2004. He spent time with gang members and governors, taco vendors and Los Tigres del Norte. He wrote about soap operas, and he lived briefly in a drug-rehabilitation clinic in Zamora, while hanging out with a street gang. He did the same with a colony of transvestites in Mazatlan, with the merchants in the Mexico City neighborhood of Tepito, and with the relegated PRI congressmen known as the Bronx. He hung out with the promoters of Tijuana's opera scene and with the makers of plaster statues of Mickey Mouse and Spiderman in that city's Colonia Libertad.
His previous two acclaimed books of narrative nonfiction about Mexico and Mexican immigration made him, according to the SF Chronicle Book Review, "the most original writer on Mexico and the border."
His first book -- True Tales From Another Mexico: The Lynch Mob, the Popsicle Kings, Chalino and the Bronx (Univ. of New Mexico Press, 2001) -- is a collection of nonfiction stories about contemporary Mexico.
His second -- Antonio's Gun and Delfino's Dream: True Tales of Mexican Migration (UNM Press, 2007) -- was called "genuinely original work, what great fiction and nonfiction aspire to be, these are the stories that stop time and remind us how great reading is." (S.F. Chronicle).
In 1998, he received a Alicia Patterson Fellowship, and Columbia University's Maria Moors Cabot Prize in 2008, for a career of excellence in reporting about Latin America.
He returned to the United States in 2004 to take a job with the LA Times, where for 10 years he wrote stories about immigrants, street gangs, drug trafficking, and marijuana growers in Northern California.
Contact him at www.samquinones.com
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I’ve read two other serious works on the human and social devastation that have been wrought by the outsourcing of jobs overseas and the “comfort” that the humans who have been placed on the discard pile have sought through the use of drugs, often opioids. “Dopesick” was written by Beth Macy, a reporter with the “Roanoke Times,” who had covered, for two decades “marginalized families,” as the expression has it, and focused on the trial of Purdue Pharma, and its corporate leadership. The “Ghosts of Tom Joad – A Story of the 99%” was written by Peter Van Buren. In my idiosyncratic rating system, I rated both books 6-stars. Van Buren also mentioned Springsteen; in fact, both Quinnones and Van Buren reference the same line from Springsteen’s lament, “The River,”: “They bring you up to do like your daddy done.”
Quinnones starts in the Ohio River valley, in the town of Portsmouth, Ohio. In his preface he provides a profoundly moving elegy for “the way things were,” when in 1929, the town opened a massive swimming pool that would be the community center for decades, where first loves were consummated. It was called “Dreamland.” Again, Springsteen’s lines would resonate: “Her body tan and wet down at the reservoir.” Portsmouth would become the epicenter for the “pill mill” revolution. Imagine obtaining your medical care from a doctor who dressed like Liberace! The author describes (Dr.) David Proctor in this manner. No physical exam, no diagnosis. “You ache, here, take this pill, all will be resolved. Two-fifty, please.” Proctor would be the godfather of the “pill mill,” and would do serious prison time, before being deported to Canada.
A true strength of Quinnones’ reportage is that he moved far beyond the Ohio River Valley and Appalachia, the locales of the other two books. He speaks Spanish, lived in Mexico for a decade and understands the rural areas as well as any “gringo” can. All the black tar heroin sold in the United States comes from Xalisco, in the sixth smallest state of Mexico: Nayarit. They control it all, using basic free market principles, emphasizing customer satisfaction, with interchangeable drivers that deliver the goods. An internet for drug distribution. Poor farm boys, escaping the sugar cane fields, so they can buy Levi 501’s, and be the “big man” when they return to Xalisco… at least for a week or two. Quinnones nails the motivation perfectly. A quiet subtext of his account is how easily these farm boys turned heroin merchants, as well as their merchandise, transit the border between the United States and Mexico, after a very simple phone call. They and their merchandise arrive faster than an Amazon Prime two-day package.
“You can run, but you can’t hide.” I grew up at the commencement of the Ohio River, but serendipity lead me NOT to do what my daddy done, which was work in a steel mill. Quinnones repeatedly visits many places in California, as well as Portland Oregon and Boise Idaho. He devotes two entire chapters to two towns in my late-in-life new home in the Land of Enchantment, specifically the village of Chimayo, with its 4000 somewhat tarnished souls, a place dubbed the “Lourdes of America,” as well as Santa Fe. Nary a mention of the Opera House in the chapter on the latter; rather, he notes that when the drug bust came that nailed the director of the funeral home, who also had a habit, who used his name to register all the cars and apartments for the drug delivery boys, that the supply of heroin in the town was disrupted for ONE DAY.
The 24th richest family in America, per Forbes, the Sacklers, became obscenely rich by pushing heroin, labeled as Oxycontin. Poor farm boys from Xalisco did not grow as rich, but did obtain designer clothes, nice homes with running water, and pick-ups. Quite a few would do prison time, as they managed to replace the higher priced Oxycontin with black-tar heroin, where a user could get his daily fix for about the price of a 6-pack of beer.
Much of this social devastation has occurred because, as a nation, which certainly includes US attorney’s offices, follow the path blazed by the fictional Mary Tyrone, of over a century ago: “Now I have to lie, especially to myself.” Quinnone has provided an excellent account of how this all occurred, with many pithy observations and phrases, like “the vinegar for a crucified region.”
Who amongst us has not been affected? Two weeks ago my wife and I toasted, remotely, a “celebration of life” for one of our daughter’s friends, who “slipped in the shower” at the age of 32, in San Francisco. Meanwhile, three days ago, the local newspaper announced the death of the University of New Mexico defensive lineman, Nahje Flowers, age 21. UNM refused to disclose the cause of death. Indeed, we have to lie, especially to ourselves. 6-stars for Quinnone’s seminal work.
The Xalisco Boys started in the San Fernando Valley area of Los Angeles; but selling on the street corners was dangerous as the Mexican cartels tried to "tax" the new sellers or run them off by force. Technology was on the side of the Xalisco Boys. They simply went inside; a user would call a number to order his dope and the call center would page a young man driving around with a mouth full of heroin filled balloons would meet the buyer. This heroin was strong - 80% pure. "These street dealers were selling tenth-of-a-gram heroin doses that when tested by the FBI came up 80 percent pure. Street dealers don't ever consistently sell addict-ready doses that pure. The traditional heroin trade made it impossible. In the typical heroin supply chain, the drug moves from wholesalers through middlemen down to street dealers. Every trafficker who handles the dope steps on it - expands the volume by diluting it - before selling it. Usually by the time heroin makes it from the poppy to the addicts' arm, it's been sold a half-dozen times, stepped on each time, and is about 12 percent pure." [p120] Why could the Xalisco boys sell stronger dope at a cheaper price? Simple, "'It's because they're salaried,' ... 'The runners are up here, nephews of the regional sales manager, and just coming to do a job, paid five hundred dollars a week. They didn't care what the potency was; they made the salary no matter how much they sold.' Salaried employees were unheard-of in the drug business." [p 121] However safe to buy, heroin is still a killer. "heroin overdoses had become Multnomah County [Portland, OR area] second cause of accidental death among men twenty to fifty-four years old - after car crashes." [p 119]
As young men from the small town in Mexico prospered; the clan stayed away from big cities where the cartels dominated the trade and instead moved into towns like Fresno, Portland, Boise and even as far east as Portsmouth Ohio.
The Xalisco Boys' success also built on the burgeoning legal opiate business as the medical business started to take pain management more seriously. In 1980, Dr. Hershel Jick wrote a short letter entitled "Addiction Rare in Patients Treated with Narcotics" to the New England Journal of Medicine. "That 'less than 1 percent' stuck. But a crucial point was lost: Jick's database consisted of [i]hospitalized[/i] patients from years when opiates were strictly controlled in hospitals and given in tiny doses to those suffering the most acute pain, all overseen by doctors. These were not chronic-pian patients going home with a bottles of pain pills. It was a bizarre misinterpretation, for Jick's letter really supported a contrary claim: that when used in hospitals for acute pain, and then when mightily controlled, opiates rarely produce addiction. Nevertheless, its message was transformed into into that broad headline 'Addiction Rare in Patients Treated with Narcotics.'" [p 107]. This short letter was held up as full research and the opiate business was on its way.
Big Business knew a big seller when they saw it. the drug company Purdue Pharma pulled out all the stops: "the company urged salespeople, meanwhile, to 'attach an emotional aspect to non-cancer pain so physicians treat it more seriously and aggressively." [p 127]. "Some Purdue reps - particularly in southern Ohio, eastern Kentucky, and other areas first afflicted with rampant Oxy addiction - were reported to have made as much as a hundred thousand dollars in bonuses in one quarter during these years. Those were unlike any bonuses ever paid in the U.S. pharmaceutical industry." [p 134]
The eased access to narcotics resulted in the opening of pill mills in places such as Portsmouth, Ohio. "If heroin was the perfect drug for drug traffickers, OxyContin was ideal for these pill mill doctors. The drug had several things going for it, as far as they were concerned. First it was a pharmaceutically produced pill with a legal medical use; second it created addicts, ... Every patient who was prescribed the drug stood a chance of soon needing it every day. These people were will to pay cash. They never missed an appointment. ... That meant a monthly-visit fee from every patient - $250 usually. And that kept waiting rooms full and cash rolling in" [p 154]. After manufacturing fled areas such as Portsmouth, an underground market around the OxyContin trade took over.
And the Xalisco Boys moved in. As addicts couldn't afford the black market price for OxyContin, cheap and strong black tar heroin moved in. "So, the contours of the Xalisco heroin nation took shape, based largely on the territory the Man [one of the central characters of the book] carved out by avoiding the biggest cities where heroin markets were already controlled, and by following the OxyContin." [p 167]
The retail selling made it difficult to stop the trade. "They were a new kind of drug trafficking in America. The Xalisco Boys weren't the General Motors of drugs. They succeeded because they were the internet of dope: a network of cells with no one in charge of them all." [p 183]. When a cell was broken up a new group came up from Xalisco to take over the business.
"And so it went. OxContin first, introduced by reps from Purdue Pharma over steak and dessert and in air-conditioned doctors' offices. Within a few years, black tar heroin followed in tiny, uninflated balloons held in the mouths of sugrar cane farm boys from Xalisco driving old Nissan Sentras to meet-ups in McDonald's parking lots.... Phillip Prior [family physician in southern Ohio] was now knee-deep in what was unthinkable a few years before: rural, white heroin junkies. 'I've yet to find one who didn't start with OxyContin,' he said. 'They wouldn't be selling this quantity of heroin on the street right now if they hadn't made these decisions in the boardroom.'" [p 270]
Sam Quinones started as a newspaper reporter and his news style is fast-paced and succinct, written in short chapters. That makes for a quick read. If you want a shorter discussion check out episode 757 of Marc Maron's WTF podcast
One takeaway from this book in more evidence that what is good for business is not necessarily good for the public. The marketing of these powerful drugs helped the ruin of many cities and lives. There are also passages showing how insurance companies would rather pay for quick treatment such as injections or pill prescriptions rather than holistic pain management.
Top reviews from other countries
Mr Quinones is a previous reporter and it shows. His style is bare, sober to a fault and quite effective - in some episodes, the reader feels like he's in the room of what's written. And some parts are almost painful to read: the hopeful parents that bring their son from a several months rehab, only to find the next morning that the son is dead - overdosed by a bit of stuff he had stashed away in his room; whole middle-class neighborhoods in which there are barely a bunch of homes in which there is not an addict; parent consoling other parents after their children have died overdosed and confessing at the same time "I have the same problem at home".
Rather than lineal, the author chose to make the book as a collection of stories, thinly interrelated and diverse, yet all of which, in the end, do lead to the same conclusion: the extended addiction was provoked by two factors, the illicit traffic of heroin from Mexico; and the greed of some huge Pharma companies that profited mercilessly of products that they knew, but concealed, were highly addictive. The cocktail was (still is) explosive and the consequences are still to be fully known.
At points, the reading is hard, due to the many stories and characters going on at the same time, in parallel. But in the end, the book is rewarding, more than it looks and much more than 350 pages seems in principle to allow for.
Unlike other reviewers I liked the narrative style of jumping from perspective to perspective - I felt it was a successful way of knitting together a really complex story. However, like other reviewers I found that it was extremely repetitive. Although a new ‘character’ may have just learnt something about Mexican heroin gangs, as the reader you had already been told this multiple times and really didn’t need to be given the full description of how it worked yet again, down to practically copy and paste wording (‘pizza delivery’ started to drive me mad). It was unfortunate that small things like customer service tactics and paying for bands on return to Mexico were repeated SO often, because it made the last half of the book a slog to get through. Unfortunately I don’t feel like I could recommend this because it just ended up being so boring due to the repetitive writing style.
The reason for 4 stars (and not 5) is that the story keeps jumping around between different times and different people and is often neither chronological nor following a specific person for a long time, making it sometimes confusing to follow. e.g. a character and their backstory could be introduced early on, but their role could become clear only many-many pages later, with the intermittent story addressing someone else or another part of the story entirely.








