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Dreamland: The True Tale of America's Opiate Epidemic

4.24  ·  Rating details ·  22,820 ratings  ·  3,006 reviews
Named on 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's 10 Best Books of 2015--Entertainment Weekly's 10 Best Books of 2015 --Buzzfeed's 19 Best Nonfiction Books of 2015 ...more
Kindle Edition, 385 pages
Published April 21st 2015 by Bloomsbury Press (first published April 15th 2015)
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Carmen Blankenship
There are not enough stars in the rating system to accurately explain how important this book is. There isn't a home that should not have a copy. Dreamland by Sam Quinones is the single most well researched, well written, and heartbreaking account on the plague of opiate addiction. I can tell you this confidently because I am an oppiate addict, who has been clean for five years. Dreamland will take you not only through the history of opiates but to living rooms of white suburban American who has ...more
The Spirit of Capitalism: A Case Study

Adam Smith said it first: ‘Greed is good.’ According to him and his intellectual and political descendants, the desires of individuals form a self-regulating economic system which is advantageous to everyone. The rich do get richer, but so do the poor. It’s called capitalism: having and meeting needs through honest competition without interference from bureaucrats, politicians, or government agencies.

And capitalism works. It does exactly what it says on the
Ellen Gail
It only took me a month, but I'm finally done! Whew.

But it was the United States...that now consumed 83 percent of the world's oxycodone and fully 99 percent of the world's hydrocodone...people in the United States consume more narcotic medication than any other nation worldwide.

Dreamland is the story of the surge of opiate addiction in the mid 90s / early 2000s in the United States. Facilitated by the massive prescribing of new "miracle dug" Oxycontin, new changes in the attitudes around m
The spectacular public service reporting Sam Quinones does in this nonfiction is so detailed and many-faceted that it left me feeling a little voyeuristic, not having been visited by the scourge of opioid addiction myself. Good lord, I kept thinking, so this is what we are dealing with. I knew something was different, I just didn’t have any conception of the size, scope, method, and means of this problem.

Quinones starts his story in the early 1980s when the first rancho Xalisco marketers came up
Denny Bales
May 02, 2015 rated it it was amazing
Extraordinary Investigative Journalism

I have been an American cardiologist for many years. I've had little awareness of the many thousands of deaths caused by the narcotic epidemic described so well in this book. The strangling web of causes, you will learn, includes misinterpreted medical research leading to deadly malpractice, shady doctors, the rusty economic meltdown, the easy penetration of Mexican heroin into the U.S., the economic desperation of Mexican small town culture, highly effectiv
Mar 02, 2018 rated it it was amazing  ·  review of another edition
Shelves: current-events
Quinones weaves together two themes to help explain today’s opiate and opioid epidemic. He uses the term opiate throughout to refer to both so I will too. Theme one is the story of the dramatic spike in the use of painkillers, particularly oxycodone. This culminated in pill mills that devastated many communities. Theme two is the spread of black tar heroin taking advantage of those already addicted to prescription painkillers. The heroin comes from a Mexican sourcing and distribution network dub ...more
May 18, 2015 rated it really liked it  ·  review of another edition
Frightful Look at the Catch-22 'twixt Controlled Opioids & Outlawed Black Tar Heroine

This is an ominous, but illuminating, exploration of the scourge in the U.S. of controlled opioids (overprescribed or sold on the streets) and the outlaw opioid heroine, and what has led us here, i.e., the interplay between controlled opioids (lortab, norco, oxycontin, etc.) and the cheaper outlaw substitute that opioid addicts turn to when they cannot afford the opioids' high street price: black tar heroine, wh
Really important to get this information out, and the book is very well researched. From a writing perspective, though, I agree with the reviewer who said the structure doesn't build a narrative and feels very repetitive. The piece Quinones published in the NY Times a few weeks back covered most of the key points quite well in a more compact format.

The last 20% or so brings in some of the solutions to the problem and covers more topics.

In the acknowledgements section the author seemed to say th
Jun 18, 2015 rated it it was amazing  ·  review of another edition
Shelves: social-sciences
Read this book. I'm going to say that again: READ. THIS. BOOK. If you live anywhere in middle America, but especially if you live in Southern Ohio, you have to read this book to see where the scourge of narcotics has come from. The origins of the opiate epidemic are laid out as clearly as possible for all to see. One of the most significant problems in our society over the last 20 years, and the perfect storm that led to it called out in black and white. But probably most significant is how clea ...more
Nancy Oakes
May 27, 2015 rated it really liked it  ·  review of another edition
there's more at my online journal nonfiction page, so feel free to click here to go there if you'd like.

If you are someone who pays attention, it is no secret that there is a massive heroin epidemic in this country. Dreamland takes its readers into examining the burgeoning heroin problem. Mr. Quinones charts how the "realities of American medicine and medical marketing of the 1980s and 1990s" came to be "connected to why, years later, men from a small town in Mexico could sell so much heroin
Sarah Jaffe
Apr 26, 2017 rated it it was amazing  ·  review of another edition
This book was incredible. I had only vaguely heard about it and needed something new to audiobook, and wound up having my mind blown.

It's a story of the opioid epidemic told through fascinating characters and a history of capitalism over the past few decades--everything from the disappearance of factory jobs to the retailing of heroin sales to the birth of pharma advertising to the role of Walmart in small towns and so much more.

It occasionally slides into some sort of weird bootstrappy ish wh
Mikey B.
This is a remarkable book explaining the forever changing and evolving drug trade in the United States (which also influences Canada). There are two aspects that the author analyzes in detail and how they became tied to each other.

He reveals how the drug companies have always searched for an elusive elixir that could remove pain. The trouble was that in many people in caused addiction. But with production of OxyContin this was advertised as being non-addictive, but based on very little research.
Mar 03, 2019 rated it really liked it  ·  review of another edition
This is an intense, chilling account of how the parallel forces of Purdue Pharma (with the support and ignorance of the medical community) and entrepreneurs in the town of Xalisco, Mexico pushed millions of Americans into becoming addicts of oxycontin and black tar heroin. I was familiar with the outlines of the "opioid crisis" but there was so much I didn't know until reading this book. I really appreciate how Quinones laid out his research in an engaging and riveting manner. Like many non-fict ...more
DREAMLAND: The True Tale of America's Opiate Epidemic by Sam Quinones, 2015 @bloomsburypublishing

Even after reading many articles and another book on the opioid crisis in the US, this book provided the most expansive view of HOW things occurred - the scale, the interconnectedness - more of the macro approach. Beyond Purdue Pharma and the Sacklers, beyond pill mills and hack doctors...

Quinones' investigative work shows the rise of 'black tar heroin' from the small rural area of Xalisco, Nayarit,
Jan 18, 2016 rated it liked it  ·  review of another edition
My first job as a nurse was on a surgical floor. I routinely gave people narcotics, both intravenously and as pills. I had patients who had undergone radical surgeries that required high doses of course, but as any healthcare provider can attest, there were also plenty of patients demanding narcotics for even minor procedures. I remember one patient, in her early twenties, who refused to be discharged unless her doctor gave her a prescription for fifty percocets! He did, of course, so she would ...more
Darcia Helle
This book is a fascinating and disturbing look at the connection between the use of prescription opiates and heroin addiction. The author blends facts with real life stories, pulling us into this world where pharmaceutical companies and pill mill doctors are knowingly creating addicts.

Much of the story centers around Portsmouth, Ohio, a blue-collar town where families once thrived. We follow its history, through an economic collapse, the burgeoning pain clinics and Oxycontin push, and the subse
Cindy Leighton
As the mother of both a medical student and of a recovering (? Part of the pain - you can never be completely sure) addict, I found this impeccably researched book on the creation of opiate addiction (in large part by doctors who were fed and believed lies by the pharmaceutical companies pimping their wares) in the US compelling, fascinating, terrifying, heartbreaking, and scary af.

The book itself could stand a bit of editing; at times it feels like Quiñones spent so much time investigating he
Judith E
Aug 08, 2018 rated it it was amazing
Shelves: non-fiction
A powerful exposé. Mr. Quinones has written an intensive work piecing together the progression of oxycodone and black tar heroin use in America. He unearthed the perfect storm when his research showed the medical community interpreted false opiate addiction data and ignored the resulting addictions and deaths. The scene was ripe for the black tar heroin producers of Narayit, Mexico to step in and fill addiction gaps with cheaper and better opioids. A deadly epidemic was created.

Mr. Quinones dis
Mar 16, 2015 rated it it was amazing  ·  review of another edition
Fascinating and infuriating account of the work of the Xalisco Boys (a network of Mexican drug dealers selling cheap heroin) and Purdue Pharmaceuticals selling the pain medication oxycontin (which Purdue insisted was non-addictive even though it's essentially heroin) converged to create an opiate-addiction epidemic across the country, but particularly in the Ohio River Valley. Some people genuinely needed pain medication; others were people leading hopeless lives in the Rust Belt and were lookin ...more
May 11, 2017 rated it it was amazing  ·  review of another edition
A brilliant, fascinating account of the rise of opiate addiction in America. This is a masterwork of research and writing that traces the factors — from pharmaceutical marketing to the invasion of black tar heroin — that created a perfect storm and ruined the lives of millions. More frightening than anything I could ever write.
Feb 03, 2016 rated it it was ok  ·  review of another edition
***** for reporting
* for organization/structure

A fascinating and incredible work of journalism undermined by poor organization and excessive repetition.

The ideas behind the book itself are incredible. Essentially, small cities/towns across the Midwest have been devastated by two simultaneous trends: 1) the aggressive over prescribing of opiates for pain and 2) the importation of black tar heroin from essentially a small village in Mexico. The former essentially primed a lot of young people for
Diane Yannick
Oct 19, 2016 rated it really liked it  ·  review of another edition
I read this book to learn more about the history of the opiate epidemic and believe me, I learned a lot. That said, it took me awhile to plow through the many redundancies. Some aggressive editing would have made this book more palatable. However, I'm giving it 4 stars for the author's meticulous research and ability to make that information accessible to me. It simultaneously tells the stories of the Xalisco boys, who introduced Mexican black tar heroin to many communities, Purdue Pharma Compan ...more
Sprawly, vivid, fascinating, horrifying journalism. How can you tell if a business that calls itself a pain clinic is an actual pain clinic or a pill mill? Check out the parking lot. If the lot is full of people standing around, wearing pajamas, getting into fistfights, and having pizza delivered, then you are looking at a pill mill.

One of the doctors that Quinones interviews has a theory: America has about the same percentage of addictive personalities that it has always had, but that OxyContin
Max Nova
Nov 25, 2016 rated it it was amazing
Shelves: cultures
This book hit me like a stack of bricks. "Dreamland" tells the story of the rise of OxyContin and the Xalisco heroin operation that have destroyed so many lives in heartland America. Although packed with hard facts, Quionones also follows individual actors in this narco-drama to humanize the supply, demand, and regulatory sides of this horrific market. What emerges is an appalling picture of an opiate epidemic in America - and in my home state of Kentucky in particular - orders of magnitude wors ...more
May 14, 2015 rated it it was amazing  ·  review of another edition
This is a “wowza” of a book. A comprehensive investigation of the pain pill addiction in America and how it led to a new wave of heroin abusers and overdose deaths, this is powerful reading for anyone who works in healthcare, addiction treatment, or has been affected by this crisis.

As soon as I heard about Dreamland, I knew I would want to read it. My career in pharmacy spans much of the time period Quinones covers in the book. I remember Purdue reps and their assured certainty that for patient
Apr 30, 2015 rated it it was amazing  ·  review of another edition
Quinones deserves all manner of credit for writing this book. It could have done with a bit of editing, as it does get repetitive at times, but this doesn't get in the way of the story he is telling about how the marketing of opiates by Big Pharma and their resulting overprescription by physicians "tenderized" the market for heroin provided by the Xalisco Boys, heroin runners from the small town of Xalisco in the Mexican state of Nayarit, whose innovative way of dealing allowed them to take over ...more
Jun 25, 2016 rated it really liked it  ·  review of another edition
This is thorough to progress for this horrific opiate epidemic that has lead to numerous "black tar" heroin overdose deaths. At times in places within the USA that never had a single heroin related problem before this progression of the last fifteen years. This quite beyond the huge number of addictions to opiate pills which ignite the need for more of the same class.

It details the Mexican group/ groups primarily expanding to a huge business within the USA.

It holds 100's of anecdotal stories, bu
Leo Walsh
Oct 04, 2017 rated it really liked it  ·  review of another edition
Amazing account of America's opioid crisis. Sam Quinones' Dreamland traces how the epidemic started with big Pharma acting as legal "pushers" of pain meds. Based on lies and half-truths told to doctors that implied few to no patients with "real" pain will become addicted. They spun this with zero clinical proof.

This made Wall Street happy. Oxycontin, Percocet, and other opioid pain relievers made the drug companies millions. Problem was, those profits were borne on the back of now-addicted pati
Oct 28, 2017 rated it really liked it  ·  review of another edition
This book is heartbreaking and eye-opening. It's almost like the perfect storm of market economics, a shifting culture of medicine, and a decline in the midwest created a fertile ground for opiods to blow through. The four horsemen that brought them were pill mills, big pharma, mexican hustlers, and a culture of silence. The book is well written, fast-paced, and fascinating. There are problems---how do I say this...he sometimes sounds like a racist. I mean, he says things like: "they don't sell ...more
While listening to the audiobook, I kept thinking "What about the people who suffer from chronic pain, don't abuse pain medications, & don't end up addicted to heroin?What about all the doctors who don't over prescribe pain pills & who have seen the benefits to their patients' lives?"
Unfortunately, they weren't interviewed & statistics weren't included related to the percentage of addicts who became addicted to heroin as a result of abusing pain pills vs taking pain pills as directed to actuall
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Sam Quinones is a long-time journalist and author of 3 books of narrative nonfiction.

He worked for the LA Times for 10 years. He spent 10 years before that as a freelance journalist in Mexico.

His first book is True Tales from Another Mexico: The Lynch Mob, the Popsicle Kings, Chalino and the Bronx, published in 2001, a collection of nonfiction stories about drag queens, popsicle-makers, Oaxacan ba

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“The front of the brain has to develop through mistakes. But the first reaction of the addicted person is to head back to the family: ‘Will you rescue me?’ Whatever the person’s rescued from, there’s no learning. There’s no experiences, no frontal brain development. They’re doing well and then some idea comes into their head and they’re off a cliff. It may not be a decision to use. Most relapse comes not from the craving for the drug. It comes from this whole other level of unmanageability, putting myself in compromising situations, or being dishonest, being lazy—being a fifteen-year-old.” 11 likes
“Through all this, patients were getting used to demanding drugs for treatment. They did not, however, have to accept the idea that they might, say, eat better and exercise more, and that this might help them lose weight and feel better. Doctors, of course, couldn’t insist. As the defenestration of the physician’s authority and clinical experience was under way, patients didn’t have to take accountability for their own behavior.” 9 likes
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