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title: "Dreamland: The True Tale of America's Opiate Epidemic"
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# Dreamland: The True Tale of America's Opiate Epidemic

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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, desertcart'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.

Review: Best Book I've Read All Year - The United States of America is in the midst of a widespread opiate epidemic that has devastated hundreds of small rural towns and suburbs across the country. The captivating story of exactly how this came to be is expertly told in acclaimed journalist Sam Quinones' fantastic book, "Dreamland: The True Tale of America's Opiate Epidemic", which was published in 2015. In "Dreamland", Quinones magnificently blends together two seemingly-independent narratives: the overly generous prescription of pain medications during the 1990s (including Purdue Pharma's ambitious campaign to aggressively market and sell OxyContin) and the unforeseen—and unprecedented—arrival of cheap, consistent, high quality black tar heroin from one small county in Mexico. According to Quinones, these developments joined forces in a dangerous synergy that ultimately resulted in America's modern-day opiate epidemic. The book opens with a ridiculously thorough timeline that begins with the distillation of morphine in 1804, moves on to the invention of the hypodermic syringe in 1853 (did you know that the inventor's wife was the first to die of injected drug overdose?), glances at the release of OxyContin in 1996, and ends with the FDA's 2014 approval of Targiniq ER, which combined timed-release oxycodone with naloxone. This timeline, which provides plenty of insight into what went on in between those four events, sets the stage for the book's narrative and successfully primes the reader for the information that follows. And the actual book doesn't disappoint, either—as the dust-jacket blurb states, it introduces "a memorable cast of characters—pharma pioneers, young Mexican entrepreneurs, narcotics investigators, survivors, and parents, and Quinones shows how these tales fit together." Sure enough, about midway through "Dreamland", the reader begins to see the sophisticated web that was woven by several groups of people who were simply following the capitalist dream (operating in their own best interest in an attempt to make as much money as possible), and the once-hidden connections between the people and places involved become as clear as crystal. When it comes down to it, "Dreamland" is the best book that I've read so far this year. The story is compelling and unfolds beautifully, in a masterful manner that constantly tempts the reader to read the next chapter. The level of detail that is crammed into each page is truly impressive, but never overwhelming. Simply put—I enjoyed every single word. The topic isn't necessarily the most popular (for the average reader), so I'm not sure that I would recommend this book to someone unless they're already interested in America's opiate epidemic. However, if you are at all intrigued by the topic, then I wholeheartedly recommend this book to you. It will likely take a while to read, because it is packed so densely, but it will be worth your investment of money, time, and energy. And I will keep an eye out for any future books and articles by Quinones, as his writing is an absolute joy to read.
Review: A Toxic Confluence - "Dreamland" is a critical book that charts the epidemic of opiate addiction that has run rampant across the United States over the last 20 years. Quinones does a commendable job of weaving several converging narratives together that collectively gave rise to the scourge that resulted. Quinones focuses a great deal of the story on Portsmouth, Ohio, an epicenter of the destructiveness when these forces collide and a microcosm for what played out across so many places across America. Multiple factors came together to create this epidemic. One key factor was the changing view of pain management in the medical profession. Many medical professionals began viewing and talking about pain as a "fifth vital sign" that required treatment and management like other vital signs such as blood pressure. While there had been more holistic approaches to pain management used given the concern around opiate addiction, a small study was about have a dramatic impact. Since the advent of opioids, pharmacologists and drug companies were looking for ways for a "miracle" formula that took advantage of the pain "numbing" nature of opioids while diminishing or eliminating their addictive nature. Then a study was published in a pain journal (ultimately highly distorted and taken out of context) that provided doctors, drug companies and others the impetus to expand prescribing the drugs as treatment because they could now fall back and cite research that stated these drugs were not addictive. Suddenly, a new drug, Oxycontin, in highly concentrated dosages, combined with aggressive marketing by the drug maker directly to doctor with the pitch of a miracle "cure" --- pain relief without addiction --- created an explosion in the dispensing of pills to treat any and all forms of pain. On the distribution side, Quinones charts the rise of a network of heroin dealers from a small city of Mexico, Xalisco, in the state of Nayarit. They began producing a highly pure form of heroin, black tar, and running drug operations that were completely different from anything police or others had seen previously, especially in major American cities like NY and LA. They essentially built a retail operation selling small, very cheap, but potent heroin, to white suburban kids in second tier suburbs of cities like Columbus, Portland, Salt Lake City and Denver. Unlike the cartels who sold impure drugs on street corners and relied on the stereotypical junkies as their "customers", the "Xalisco Boys" focused on hand delivering highly cheap and pure drugs to suburban kids who had started out using pills and now finding dealers bringing them even cheaper drugs that provided them an ever quicker and more powerful high to feed their habit. Finally, there are the pill mills, unscrupulous doctors many unfit to practice medicine now opening sham clinics to dispense prescriptions for Oxy and other opiates for cash. These pill mills had customers lining up, "zombies" as Quinones calls them, to get their vast quantities to both use and sell to feed their growing addiction costs and could operate unfettered given lax databases within and across states All of this creates an incredibly frightening and depressing story engulfing the country. However, there were a couple of aspects that prevented "Dreamland" from being even more powerful. First, there was a lot of repetition throughout the book. At times, Quinones repeated the same phrases or conclusions multiple times in the same chapter. These points were accurate, but they were already clear from the narrative and began to feel belabored. He probably could have saved 30-40 pages through judicious editing to remove redundancy. Second, this would have provided him more opportunity to focus on the changing nature of the traditionally "tough on crime/drug" crowd that was beginning to rethink crime and punishment for drug use. While Quinones does note changing perspectives among many who focused on mandatory sentencing and get tough policies against mostly minorities, there was plenty of further exploration about attitudes of leniency and treatment for drug offenders now that white America was at the center of opiate addiction epidemic. Even with those critiques, "Dreamland" is an important work about the power and destructiveness of opiates and the recovery much of our country is undergoing as a result.

## Technical Specifications

| Specification | Value |
|---------------|-------|
| Best Sellers Rank | #43,029 in Books ( See Top 100 in Books ) #21 in Sociological Study of Medicine #23 in Government Social Policy #27 in Organized Crime True Accounts |
| Customer Reviews | 4.5 out of 5 stars 9,198 Reviews |

## Images

![Dreamland: The True Tale of America's Opiate Epidemic - Image 1](https://m.media-amazon.com/images/I/91lodyiEc+L.jpg)

## Customer Reviews

### ⭐⭐⭐⭐⭐ Best Book I've Read All Year
*by D***R on June 6, 2018*

The United States of America is in the midst of a widespread opiate epidemic that has devastated hundreds of small rural towns and suburbs across the country. The captivating story of exactly how this came to be is expertly told in acclaimed journalist Sam Quinones' fantastic book, "Dreamland: The True Tale of America's Opiate Epidemic", which was published in 2015. In "Dreamland", Quinones magnificently blends together two seemingly-independent narratives: the overly generous prescription of pain medications during the 1990s (including Purdue Pharma's ambitious campaign to aggressively market and sell OxyContin) and the unforeseen—and unprecedented—arrival of cheap, consistent, high quality black tar heroin from one small county in Mexico. According to Quinones, these developments joined forces in a dangerous synergy that ultimately resulted in America's modern-day opiate epidemic. The book opens with a ridiculously thorough timeline that begins with the distillation of morphine in 1804, moves on to the invention of the hypodermic syringe in 1853 (did you know that the inventor's wife was the first to die of injected drug overdose?), glances at the release of OxyContin in 1996, and ends with the FDA's 2014 approval of Targiniq ER, which combined timed-release oxycodone with naloxone. This timeline, which provides plenty of insight into what went on in between those four events, sets the stage for the book's narrative and successfully primes the reader for the information that follows. And the actual book doesn't disappoint, either—as the dust-jacket blurb states, it introduces "a memorable cast of characters—pharma pioneers, young Mexican entrepreneurs, narcotics investigators, survivors, and parents, and Quinones shows how these tales fit together." Sure enough, about midway through "Dreamland", the reader begins to see the sophisticated web that was woven by several groups of people who were simply following the capitalist dream (operating in their own best interest in an attempt to make as much money as possible), and the once-hidden connections between the people and places involved become as clear as crystal. When it comes down to it, "Dreamland" is the best book that I've read so far this year. The story is compelling and unfolds beautifully, in a masterful manner that constantly tempts the reader to read the next chapter. The level of detail that is crammed into each page is truly impressive, but never overwhelming. Simply put—I enjoyed every single word. The topic isn't necessarily the most popular (for the average reader), so I'm not sure that I would recommend this book to someone unless they're already interested in America's opiate epidemic. However, if you are at all intrigued by the topic, then I wholeheartedly recommend this book to you. It will likely take a while to read, because it is packed so densely, but it will be worth your investment of money, time, and energy. And I will keep an eye out for any future books and articles by Quinones, as his writing is an absolute joy to read.

### ⭐⭐⭐⭐ A Toxic Confluence
*by W***O on May 22, 2015*

"Dreamland" is a critical book that charts the epidemic of opiate addiction that has run rampant across the United States over the last 20 years. Quinones does a commendable job of weaving several converging narratives together that collectively gave rise to the scourge that resulted. Quinones focuses a great deal of the story on Portsmouth, Ohio, an epicenter of the destructiveness when these forces collide and a microcosm for what played out across so many places across America. Multiple factors came together to create this epidemic. One key factor was the changing view of pain management in the medical profession. Many medical professionals began viewing and talking about pain as a "fifth vital sign" that required treatment and management like other vital signs such as blood pressure. While there had been more holistic approaches to pain management used given the concern around opiate addiction, a small study was about have a dramatic impact. Since the advent of opioids, pharmacologists and drug companies were looking for ways for a "miracle" formula that took advantage of the pain "numbing" nature of opioids while diminishing or eliminating their addictive nature. Then a study was published in a pain journal (ultimately highly distorted and taken out of context) that provided doctors, drug companies and others the impetus to expand prescribing the drugs as treatment because they could now fall back and cite research that stated these drugs were not addictive. Suddenly, a new drug, Oxycontin, in highly concentrated dosages, combined with aggressive marketing by the drug maker directly to doctor with the pitch of a miracle "cure" --- pain relief without addiction --- created an explosion in the dispensing of pills to treat any and all forms of pain. On the distribution side, Quinones charts the rise of a network of heroin dealers from a small city of Mexico, Xalisco, in the state of Nayarit. They began producing a highly pure form of heroin, black tar, and running drug operations that were completely different from anything police or others had seen previously, especially in major American cities like NY and LA. They essentially built a retail operation selling small, very cheap, but potent heroin, to white suburban kids in second tier suburbs of cities like Columbus, Portland, Salt Lake City and Denver. Unlike the cartels who sold impure drugs on street corners and relied on the stereotypical junkies as their "customers", the "Xalisco Boys" focused on hand delivering highly cheap and pure drugs to suburban kids who had started out using pills and now finding dealers bringing them even cheaper drugs that provided them an ever quicker and more powerful high to feed their habit. Finally, there are the pill mills, unscrupulous doctors many unfit to practice medicine now opening sham clinics to dispense prescriptions for Oxy and other opiates for cash. These pill mills had customers lining up, "zombies" as Quinones calls them, to get their vast quantities to both use and sell to feed their growing addiction costs and could operate unfettered given lax databases within and across states All of this creates an incredibly frightening and depressing story engulfing the country. However, there were a couple of aspects that prevented "Dreamland" from being even more powerful. First, there was a lot of repetition throughout the book. At times, Quinones repeated the same phrases or conclusions multiple times in the same chapter. These points were accurate, but they were already clear from the narrative and began to feel belabored. He probably could have saved 30-40 pages through judicious editing to remove redundancy. Second, this would have provided him more opportunity to focus on the changing nature of the traditionally "tough on crime/drug" crowd that was beginning to rethink crime and punishment for drug use. While Quinones does note changing perspectives among many who focused on mandatory sentencing and get tough policies against mostly minorities, there was plenty of further exploration about attitudes of leniency and treatment for drug offenders now that white America was at the center of opiate addiction epidemic. Even with those critiques, "Dreamland" is an important work about the power and destructiveness of opiates and the recovery much of our country is undergoing as a result.

### ⭐⭐⭐⭐⭐ Addictive… Another Long Day’s Journey into the Night…
*by J***I on November 8, 2019*

Eugene O’Neill won the Nobel Prize for literature in 1936. His most famous play, “Long Day’s Journey into the Night,” is set on just one day in August 1912. Mary Tyrone, 54, is a central character, stricken by rheumatism, stricken by grief after the death of her second son. The helpful family doctor, back when they carried little black leather bags and made house calls, prescribes morphine to comfort. Mary would become hooked, and would later say: “It hides you from the world and the world from you. You feel that everything has changed, and nothing is what it seemed to be. No one can find or touch you anymore.” Denial is the addict’s crutch, as Mary proclaims: “Now I have to lie, especially to myself.” Just over a century after the setting of this play, on New Year’s Day, 2013, Sam Quinnones, a former reporter for the Los Angeles Times, sat in a café in Covington, Kentucky, as he commenced full-time work on this remarkable book. He never mentions O’Neill in his work, but he does mention Bruce Springsteen. 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.

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