Dreamland: The True Tale of America's Opiate Epidemic

by Sam Quinones

He was immediately shocked at the patients in the UW clinic. “These were people on tons of opioids for a long time, completely broken and abused. We’re talking hundreds of milligrams of morphine-equivalent doses. Doses I’d never seen in my life: four hundred, five hundred, six hundred milligrams a day.” What’s more, no one tracked the effects of opiates on a patient’s pain, function, depression, sleep. He called colleagues elsewhere and found this to be true across the United States. “Not one center had measurements-based pain care. This is 2008,” he said. “It would all be subjective: They’re doing fine or not doing fine. There was a pain rating scale: one to ten. It was insane. A multibillion-dollar industry was based on no measurements whatsoever.”