A Review of “Dreamland” by Sam Quinones

dreamlandI remember the very first time that someone I knew died from an opiate overdose. I didn’t know the man well, more of an acquaintance than a friend, but still it left an impression upon me. It left an impression upon me particularly because his mothered asked me to pray with her. She was devastated. It was the last in a series of events that led me to that pressing question: how did this happen? That is a massively important and yet complex question. In Dreamland, journalist Sam Quinones helps readers to understand the complex history and progression of America’s opiate epidemic. Like most things, this significant problem has been brought to us by many layers of influence.

Quinones is a fantastic journalist. His writing is compelling and his history is thorough. He tells the story of America’s opiate epidemic by taking us through the individual stories of various people: drug traffickers, addicts, physicians, and law enforcement personnel. The story of our drug problem is really the story of us as a people, as a nation, as individuals with pain, ambition, and mixed motivations. The story is complex, in some sense, because we are complex, and because addiction itself is complex.

The story of America’s opiate epidemic takes readers from the rural Mexican hillsides, through Los Angeles and the rise of a drug corporation unlike anything before, into the halls of ad agency, pharmaceutical companies, and family practice offices. It moves us into major U.S. cities and from there into small towns all across the Midwest. Small towns like the one I used to live and work in, Portsmouth, OH. In fact this book is, in many ways, a short history of Portsmouth. The book’s title is a direct reference to the city pool, which saw its own devolution overtime.

Quinones does an excellent job of showing how we came, rather subtly, to the present. The story is not simple, and Quinones avoids the reductionist explanations for drug use, abuse, addiction, and national crisis. He doesn’t simplify the issues to one singular cause, but rather shows the various contributions made from across seemingly unrelated fields: sugarcane farming, drug-trafficking, pain management, pharmaceutical advertising and sales, and the corruption of one primary care physician. He demonstrates how all the various contributions made for a perfect storm in the 1990s leading to a national crisis that wouldn’t even be realized until it was too late.

I would never have imagined that Portsmouth would become the subject of a nationally award-winning book, but in Dreamland it is at the heart and center of our nation’s drug problem. It was eye-opening to see just how impacted this small rural Southern Ohio town was by the national, indeed international, landscape. Some of us have this tendency to think that small towns are isolated from the rest of the world, that they live in their own little bubble. Quinones proves to the contrary. There is no isolation, and no escape from the national influences. The impact, however, is more devastatingly experienced in our country’s small towns. That reality is what makes Dreamland such a significant book. Whether you are from Portsmouth, or have never heard of it, this book will expose readers to the massive shaping influences that transform our small towns all across the country. Nick Reding does the same thing in Methland, as he talks about the “life and death of an American small town,” but with opiate addiction at the level of national crisis, Dreamland is a more pressing book.

Quinones is a master story-teller. He can weave research and narrative together seamlessly, and impress the “moral” of the story upon readers at every turn, but without ever being preachy. He certainly leads readers to conclusions at times, especially as he writes about companies like Purdue Pharma, but elsewhere he substantiates his reasons for such conclusions. The book is impressive scope, captivating in style, and powerful in intent. This is an expose, of sorts, and one that every American should read. This is our story as a nation.

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