Last year I read Nicholas and Alexandra and discovered a whole new, extremely specific genre that I love: nonfiction books about some point in time where everything came together in a very particular way that changed the entire course of history. I’m very pleased to say that Dreamland is now the second book I can add to that category (which really needs a snappier name).
Dreamland is actually two stories which fit together perfectly to create something really terrible: it’s the story of Purdue Pharma’s development and aggressive marketing of Oxycontin, and the story of how a small Mexican state (Nayarit) became the number one supplier of heroin in the United States. It also touches a bit on the role of opium and morphine throughout human history, but it’s mainly about how those two stories collided to create the U.S.’s current “opioid overdose crisis,” as the NIH puts it.
Basically, people from this small part of Mexico figured out a way to sell heroin in a way that the book often compares to pizza delivery: you call your dealer, he tells you where to meet him, and he delivers your order. The dealers spend the day driving around, dropping off dope. They never carry weapons or large amounts of drugs, so if they’re stopped or arrested they’re often deported rather than imprisoned. If they’re deported, a new dealer comes up from Mexico to take their place. Dealers find out where the heroin addicts hang out in a particular city (usually by locating the methadone clinics) and set up shop nearby. They offer deals and price breaks like actual stores. If they notice a customer hasn’t bought in awhile or they think someone is trying to get clean, they’ll give them free heroin or call them repeatedly with deals. In addition to that, the heroin they sell is a lot stronger than what had typically been seen in the U.S. before.
Meanwhile, as dealers are spreading out from California and the Southwest to other parts of the country, Oxycontin was developed and Purdue Pharma started marketing it aggressively as a less-addictive pain medicine. This, of course, turned out to be far from the truth. As the heroin dealers spread east, Oxy spread west and the two met in the middle. And here we are today, in the middle of a public health crisis which has continued to get worse even in the few years since Dreamland was published.
Like I said, I thoroughly enjoyed the way this book walked me through the particulars of how, exactly, this epidemic came about. The story itself is absolutely fascinating. The author interviewed doctors, scientists, law enforcement, politicians, people who had overcome heroin addictions, people who were still using, parents who had lost children to drug overdoses, and even a few drug dealers from Mexico. It’s a great story, and an important one. He also makes some interesting comparisons between this story and the crack epidemic of the 80s. Crack resulted in a “tough on crime” approach, while heroin has resulted in a more understanding approach to addiction (the difference, of course, is in what the typical addict from each epidemic looked like).
The one thing I didn’t like about this book was the way it jumped around. As I read a chapter and would start to get really into that part of the story, the chapter would end and suddenly I’d be somewhere–and maybe even sometime–else. We jumped from Seattle to Mexico to Ohio to Utah and so on and so on, without much rhyme or reason. I know Sam Quinones had a lot to cover, but I think the book could have been better organized. That’s my only complaint, though–I really liked this book.
Well that’s going on the list.