Area residents who have been reading “Dreamland: The True Tale of America’s Opiate Epidemic” soon learn it isn’t a checklist for communities to fix their problem with heroin addiction.
Instead, it was written for families affected by heroin overdoses who wanted to know why their loved one died, author Sam Quinones said.
“I wanted them to understand the nature of the beast,” Quinones said in a telephone interview.
Quinones will be the featured speaker at the “Moving the Needle: Community Forum,” 6:30 p.m. April 19 at The Commons, where he will talk about his journey in writing the book and how his research about heroin addiction is affecting communities across the nation — including Columbus.
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“Dreamland” didn’t start out as a book — but instead as a newspaper story assignment that Quinones took on for the Los Angeles Times in 2004.
Quinones said the book was written primarily from interviews he did over a five-year period as a reporter. Some of the cities he traveled to included the Ohio cities of Columbus and Portsmouth; Indianapolis; Portland, Oregon; Denver, Colorado; and towns in Kentucky, West Virginia and New Mexico.
Prior to that, Quinones had spent 10 years working and writing in Mexico, using that background and experience to learn how drugs were entering the United States from Mexico, and how the drugs were dispersed throughout the U.S.
How it worked
Quinones discovered a pattern of Mexican men he named the Xalisco boys, in Nayarit, Mexico, smuggling in heroin to select cities and territories in the United States and selling it retail much like a pizza delivery service.Heroin sellers would hang out around methadone clinics in the U.S. to distribute it to heroin addicts trying to recover, the book states.
Quinones’ book describes how the young Mexican men selling heroin were told to avoid violence or carrying guns to make interactions with their customers easier, and to fly under the radar of local law enforcement. Some were asked to view the clothing on mannequins at local department stores and dress similarly to fit in, the book states.
The book chronicles how heroin use ramped up at the same time a crackdown began in the United States on prescription pain medication, which caused millions of Americans to search for a replacement for their prescription refills. Many substituted opiates and heroin from Mexico.
“I discovered it was a much much larger story than what we originally started with,” Quinones said.
Starting with the drug epidemic’s roots in Mexico, it tells individual stories about people — from the leaders of the drug cartels and the Mexican heroin traffickers, to their recruits from Mexico who arrived in the United States illegally to sell it on the street, to others who were buying the drugs and to their families who were losing loved ones to overdoses.
He also worked the U.S. side of the border, starting with the pill mills of the past decade, when pain became a symptom that needed to be controlled and pharmaceutical companies made billions of dollars in prescription medication designed to ease pain.
The book describes how one of the most lethal forms of the drug, black tar heroin, made its way east of the Mississippi, something that had never happened before, Quinones said.
“I wanted to tell a complicated story,” he said.
The book as a resource
One local reader who is sold on “Dreamland” and its potential to educate is Columbus Police Department Sgt. Jay Frederick, who uses statistics and research from the book to educate area residents about how the national heroin epidemic is affecting Columbus and Bartholomew County.
Frederick said he first read the book in late 2015, after a friend recommended it.
It wasn’t the “Dreamland” part of the title that led him to read the book, he said. It was the subtitle, “The True Tale of America’s Opiate Epidemic.”
“I kept finding myself saying ‘Yes, yes, yes,’ “ Frederick said of reaching the book’s narrative describing how overprescribed pain-relief drugs led people to find other methods for their eventual addiction, including heroin.
In Frederick’s presentations about prescription drug abuse and the heroin epidemic, which he gives throughout the Columbus community, the city police sergeant uses Quinones’ book as a resource to point out that America makes up 4.6 percent of the world’s global population, but consumes two-thirds of the world’s illegal drugs.
The book also notes that Americans use 80 percent of the world’s opioid analgesics and 99 percent of the worlds’ hydrocodone, which Frederick defines as a gateway drug to heroin.
Quinones’ book provides that explanation of how America’s heroin epidemic had its beginning in prescription drugs and why it’s getting worse now, he said.
“Most people don’t understand addiction and how it works,” Frederick said.
“I think the book captures the forces at play here,” Frederick said. “If people had a better understanding of the problem, we might get to some lessons learned about what we can do differently.”
Local readers embraced the book in advance of Quinones appearance.
All rental copies, including e-copies, are either on hold or checked out at the Bartholomew County Public Library and the Hope Library, said Mary Clare Speckner, adult programming services coordinator and reference librarian.
The library initially had two copies of the book at its main Columbus location and one in Hope, but received an additional 10 copies from Healthy Communities, along with two e-copies, she said.
One of the original copies of the book has been checked out 19 times, she said.
It’s also been the top seller in adult non-fiction at the local Viewpoint Books every week but one since March, according to the store’s sales figures.
“Dreamland” has been the talk of the town since author Quinones was announced in mid-February as the April 19 program speaker in Columbus. His book was the topic for a March 28 discussion at the library, Speckner said.
Not a self-help book
In next Wednesday’s presentation, Quinones said the audience shouldn’t expect some sort of self-help, five-things-you-need-to-do outline to eliminate your community’s heroin problem.
Instead, he will take listeners back to the root of the problem, which Quinones said is isolation.
“Heroin, this drug, thrives on our isolation from one another,” Quinones said. “It’s the poster drug of our time — of the isolation that is America right now.”
Describing the United States as a country that has been invaded by cheap junk and has a strong thirst for things to make people happy, Quinones said it’s that type of environment that leads to heroin addictions.
“We actually believe we can buy a substance, and it can make you happy,” he said.
Many people who become addicts are looking for something far more than a high, but instead find themselves going after the cheap junk of opiates, he said.
“To counteract that, we need to band together — to find some sort of community,” he said. “You can’t buy happiness, and the heroin epidemic is an expression of that.”
Heroin is affecting communities of all sizes and all ranges of economic success, Quinones said.
He has spoken to poor communities in Appalachia and upscale suburbs of Portland, Oregon.
There are a couple of traits that are unique to this epidemic, Quinones said. One is that the demographic for heroin addicts is almost entirely white, and it’s unique in that sense.
“There’s never been a drug scourge before that’s primarily uni-racial,” he said.
Its all-encompassing reach into all kinds of communities shows that a healthy local economy is no defense against this epidemic.
“These drugs are being used to numb pain,” he said. “But many of the people who are getting addicted don’t seem to be suffering economic pain.”
A problem with relapse
Although Quinones says he won’t be bringing a solution to Columbus with his talk, he can offer his perspective on how difficult it is for heroin addicts to recover, and how difficult it can be not to relapse after receiving treatment.
“I do believe it takes awhile,” he said of the recovery process. “If you get them to treatment, when they get out is the most dangerous time of all. They can die very easily,” he said.
When parents don’t want to talk about the problem, when churches turn away addicts rather than offer acceptance and when law enforcement doesn’t rethink its process, finding solutions takes longer, he said.
Talking about heroin addiction needs to become a normal conversation — something that might get brought up in a budget hearing or a parent-teacher organization gathering, he said.
“Prevention is a major thing,” Quinones said.
“This will not change until doctors change they way they are prescribing pills to patients. There are a lot of people dying from those decisions,” he said.
There’s a difference between other types of addictive behaviors — Quinones admits to working on a nicotine addiction — and being addicted to heroin, he said.
“People relapse all the time. But the difference here is, when people relapse, they can die.”
What: “Moving the Needle: Community Forum”
Featuring: Sam Quinones, author and journalist, talking about his book “Dreamland: The True Tale of America’s Opiate Epidemic,” and Dr. Kendall Stewart, a psychiatrist from Portsmouth, Ohio
When: 6:30 to 8:30 p.m. April 19
Where: The Commons
How much: Free and open to the public
“Dreamland: The True Tale of America’s Opiate Epidemic”
Published: April 21, 2015 by Bloomsbury Press, New York and London
Honors: Winner of the National Book Critics Circle Award and finalist for the Los Angeles Times Book Prize
Behind the name: The book “Dreamland” chronicles the struggles of Portsmouth, a southern Ohio blue-collar city of about 20,000 that struggled with the effects of opioid addiction in the aftermath of unregulated prescription drug availability in the 1990s during Purdue Pharma’s campaign to sell OxyContin. The book’s title refers to Portsmouth’s project to build a swimming pool the size of a football field, which the city named Dreamland. It describes how the opioid crisis affected Portsmouth and how the community dug its way out of the epidemic of overdoses and addiction.
“Most people don’t understand addiction and how it works. I think the book captures the forces at play here.”
— Sgt. Jay Frederick, Columbus Police Department
“You can’t buy happiness, and the heroin epidemic is an expression of that.”
— Author Sam Quinones, “Dreamland: The True Tale of America’s Opiate Epidemic”