Dreamland: The True Tale of America's Opiate Epidemic

by Sam Quinones

them so mercilessly for wanting their freedom from it.

The morphine molecule exerts an analogous brainwashing on humans, pushing them to act contrary to their self-interest in pursuit of the molecule. Addicts betray loved ones, steal, live under freeways in harsh weather, and run similarly horrific risks to use the molecule.

As the years passed, meanwhile, what Dennis Chavez realized he loved most about his job was the deduction of crime.

Their job is to drive the city with their mouths full of little uninflated balloons of black tar heroin, twenty-five or thirty at a time in one mouth. They look like chipmunks. They have a bottle of water at the ready so if police pull them over, they swig the water and swallow the balloons.

They don’t sell to black people; nor do they buy from blacks, who they fear will rob them. They sell almost exclusively to whites.

This was their American Dream: to return to Mexico better off than they had left it and show everyone back home that that’s how it was.

The Xalisco traffickers were the only immigrant narcotics mafia Chavez knew of that aimed to just go home, and with nary a shot fired.

But drug sales were his pathway out of problemas.

Mesopotamians grew the poppy at the Tigris and Euphrates.

German pharmacist’s apprentice named Friedrich Sertürner isolated the sleep-inducing element in opium and named it morphine for Morpheus, the Greek god of sleep and dreams.

Needles allowed more accurate dosing.

As junkies ever since have discovered, heroin is an effective constipator and was thus marketed as an antidiarrheal.

Thus addiction exploded—to a drug that people believed was safe because doctors said so.

But it was transformed into America’s first prohibition statute when police started arresting doctors for prescribing opiates to addicts.

Addiction was not yet considered a disease, so an addict technically wasn’t a medical patient.

“[Because the addict] is denied the medical care he urgently needs,” one medical journal reported,

Heroin was easy to make, and cheaper than morphine.

An addict craved heroin several times a day, and physically had to have it to function; so he was a terrific customer.

The logic of heroin distribution allowed New York to remain the nation’s principal heroin hub through most of the twentieth century.

Marijuana, like wine, has been hybridized into endless varietals.

“Not only did the price increase, but the level of adulteration as well.”

Injecting begot nasty public health problems—among them, later, ferocious rates of hepatitis C and HIV.

But heroin was never about the romantic subversion of societal norms. It was instead about the squarest of American things: business—dull, cold commerce.

Much of the U.S. market was then supplied by Turkey, Afghanistan, and Southeast Asia half a world away, their dope coming through New York City.

The painkiller known as methadone was synthesized by German scientists in the effort to make Nazi Germany medicinally self-reliant as it prepared for war. The Allies took the patent after the war, and Eli Lilly Company introduced the drug in the United

States in 1947. U.S. doctors identified it as a potential aide to heroin addicts.

The job required imagination, because the dealers were themselves endlessly creative.

As camouflage, these Mexican heroin guys used just-in-time supplying, like any global corporation, to ensure they had only tiny quantities in their cars or apartments.

gossip. Enrique was more afraid of poverty.

Plus it was risky and this beckoned farm boys who saw they had nothing to lose and everything to gain.

Couldn’t it have heaven without hell?

Thus, they concluded, methadone could act as a replacement for heroin.

With this, they justified experimentation on inmates.

ARC staff were the first to conceive of addiction as not a character failing, or a crime, but rather a chronic brain disorder.

But for forty years, all the drugs created in the CPDD’s search for the Holy Grail were tested on inmates at the Narcotic Farm in Lexington, Kentucky.

Within it, morphine was deemed “an essential drug” in cancer pain relief.

WHO went further.

It claimed freedom from pain as a universal human right.

If a patient said he was in pain, doctors should believe him and prescribe accordingly.

With the WHO Ladder, doctors’ concern over the use of opium-derived drugs began to ease. They were, after all, remarkably effective at knocking down pain, which was now a human right. Worldwide morphine consumption began to climb, rising thirtyfold between 1980 and 2011.

Palliative care involved far more than just drugs. It included psychological, spiritual, and family counseling.

MS Contin was intended for cancer and postoperative patients.

“We were trying to teach [patients] that they were the ones who controlled whether they were well or not well,”

Pain was complicated.

“People are entitled to health care. Health care should be a human right. Pain management must be a part of health care. But they are not entitled to pain relief. The physician may not be capable of providing them with pain relief. Some problems are not readily solvable. A patient is entitled to reasonable attempts to relieve the pain by reasonable means. You’re not entitled to pain relief any more than you’re entitled to happiness.

The population wants to be fixed overnight.

They have to learn it’s their body, their pain, their health. The work is done by them.”

He left behind a drug that would change these places, and bring misery to thousands of families.

He liked to think himself a hero to the young men from the small town of Xalisco, Nayarit, whom he recruited and taught to retail the drug.

“We weren’t a cartel. We were all different cells. Everybody’s their own group. There’s the boss of each little group. They all work individually.