Dreamland

Dreamland Plot Summary

Introduction

In the quiet examination rooms of American doctors' offices during the 1980s, a revolution in pain management began that would ultimately devastate communities across the nation. What started as a compassionate effort to address undertreated pain gradually transformed into the deadliest drug crisis in American history. This remarkable transformation occurred not through illegal drug cartels or street corner dealers, but through the legitimate channels of medicine—prescription pads, pharmacies, and FDA-approved medications. The story of America's opioid epidemic reveals the complex interplay between well-intentioned medical advances, corporate profit-seeking, economic desperation, and innovative drug trafficking. It illuminates how a single paragraph in a medical journal could be misinterpreted and amplified until it changed prescribing practices nationwide, how pharmaceutical marketing could normalize the use of powerful narcotics for everyday pain, and how rural communities devastated by economic decline became epicenters of addiction. For anyone seeking to understand how a medical revolution intended to alleviate suffering instead created unprecedented harm, this historical account provides essential insights into one of the most consequential public health disasters of our time.

Chapter 1: The Pain Revolution: Shifting Medical Paradigms (1980-1995)

For most of the 20th century, American doctors approached opiates with extreme caution. Medical textbooks warned of addiction risks, and physicians generally reserved these powerful drugs for end-of-life care or post-surgical pain. This cautious approach stemmed from America's earlier experiences with opiate addiction in the late 19th century, when morphine and opium were widely available without prescription. By the 1980s, however, this medical consensus began to fracture under the weight of new ideas about pain management. The catalyst for change came from an unexpected source: a five-sentence letter to the editor published in the prestigious New England Journal of Medicine in January 1980. Written by Dr. Hershel Jick of Boston University, the brief note mentioned that among nearly 12,000 hospitalized patients who received opiates, only four developed addiction. Though Jick later clarified that his observation applied only to hospitalized patients under close supervision, his letter—which became known simply as "Porter and Jick" after its authors—took on a life of its own. It was transformed from an obscure paragraph into what medical textbooks would eventually call a "landmark study" demonstrating that less than 1% of patients who took opiates for pain became addicted. Simultaneously, pioneers in pain management were advocating for more aggressive treatment approaches. Dr. John Bonica, who had suffered chronic pain from his earlier career as a professional wrestler, established America's first multidisciplinary pain clinic at the University of Washington. His approach treated pain as complex, requiring physical therapy, psychological support, and lifestyle changes alongside medication. At Memorial Sloan Kettering Cancer Center, Dr. Kathleen Foley demonstrated that cancer patients could receive long-term morphine without becoming addicted. These successes with terminal patients raised an important question: if opiates helped the dying, why not use them for those suffering from chronic non-cancer pain? The World Health Organization added momentum to this shift when it published its "Pain Ladder" in 1986, establishing freedom from pain as a universal human right and recommending opiates when non-opiates failed. That same year, Russell Portenoy and Kathleen Foley published an influential paper in the journal Pain, suggesting that chronic pain patients rarely became addicted to opiates. Their paper cited the Porter and Jick letter, further cementing its misinterpreted findings in medical consciousness. Organizations like the American Pain Society began promoting the concept of pain as "the fifth vital sign" alongside pulse, blood pressure, temperature, and respiration. By the early 1990s, economic factors accelerated these changes. Insurance companies began restricting coverage for multidisciplinary approaches to pain management, which were time-consuming and expensive. Simultaneously, they pressured doctors to see more patients in less time, making quick-fix medications more appealing than comprehensive treatment plans. As one physician noted, "Nothing cuts short a patient visit like a prescription pad." State medical boards, which had once aggressively investigated doctors who prescribed too many narcotics, began passing "intractable pain" laws that protected physicians from disciplinary action for prescribing opiates. This perfect storm of misinterpreted research, evolving medical philosophy, and economic pressures created fertile ground for the massive expansion of opiate prescribing that would follow. The medical community had been persuaded that opiates were safe for long-term use in non-terminal patients, setting the stage for pharmaceutical companies to capitalize on this shift with powerful new medications. What began as a well-intentioned effort to address undertreated pain would ultimately lead to consequences that no one anticipated.

Chapter 2: OxyContin's Rise: Corporate Marketing and Medical Adoption (1996-2001)

In December 1995, the FDA approved OxyContin, a timed-release formulation of oxycodone developed by Purdue Pharma. Unlike previous painkillers that combined smaller amounts of opiates with acetaminophen or other drugs, OxyContin contained large doses of pure oxycodone in a patented time-release formula. The FDA granted Purdue a unique label claim that the drug's controlled-release formulation was "believed to reduce" its appeal to drug abusers compared to immediate-release oxycodone. This seemingly minor regulatory decision would have enormous consequences for public health. Purdue Pharma launched an unprecedented marketing campaign for OxyContin, particularly remarkable given that it was a Schedule II narcotic with high abuse potential. The company tripled its sales force to over 1,000 representatives who targeted primary care physicians—doctors with minimal training in pain management but who saw the most patients with chronic pain complaints. These salespeople received extraordinary incentives, with bonuses sometimes reaching $100,000 per quarter in regions like southern Ohio and eastern Kentucky. The company spent millions training this sales force to emphasize that the risk of addiction was "less than one percent" when OxyContin was prescribed for pain. Central to Purdue's marketing strategy was the claim that OxyContin was virtually non-addictive due to its timed-release formula. Sales representatives repeatedly cited the misinterpreted Porter and Jick "study" to assure doctors that addiction was rare. The company distributed thousands of branded promotional items—from fishing hats to music CDs with slogans like "Swing in the Right Direction with OxyContin"—and gave out coupons for free prescriptions, ultimately redeemed by 34,000 patients. Purdue also funded continuing medical education seminars at luxury resorts, where pain specialists (often paid by Purdue) promoted aggressive opiate prescribing. The medical establishment increasingly embraced these new approaches to pain management. In 2001, the Joint Commission for Accreditation of Healthcare Organizations implemented new standards requiring healthcare organizations to assess pain in all patients and treat it aggressively. These standards were developed with financial support from Purdue Pharma. Hospitals began displaying posters showing pain as a 1-10 scale, with smiling and frowning faces. Nurses were instructed to ask patients about their pain levels during every interaction. Doctors faced increasing pressure to prescribe, as patient satisfaction surveys included questions about pain relief. The marketing campaign worked spectacularly. OxyContin prescriptions for chronic pain skyrocketed from 670,000 in 1997 to 6.2 million by 2002. Annual sales exceeded $1 billion by 2001. Primary care physicians, who had once been taught to avoid opiates, were now prescribing powerful doses for conditions like back pain, arthritis, and fibromyalgia—often after just brief patient visits. What Purdue either failed to anticipate or chose to ignore was how easily the timed-release mechanism could be defeated. Users quickly discovered that crushing the pills released all 12 hours' worth of oxycodone at once, creating an intense high when snorted or injected. By 2000, reports of OxyContin abuse were emerging from rural areas in Appalachia, where the drug earned the nickname "hillbilly heroin." Seniors realized they could supplement their income by selling their prescribed pills to younger users. Treatment centers began filling with patients addicted to a drug that had been marketed as virtually addiction-proof. The seeds of a national crisis had been planted, watered by aggressive marketing and fertilized by a healthcare system increasingly focused on quick solutions rather than comprehensive care.

Chapter 3: The Xalisco Model: Black Tar Heroin's Innovative Distribution System

While prescription opioids were flooding American communities through legal channels, a parallel development was taking place in the illicit drug market. Beginning in the early 1980s, young men from the small town of Xalisco in the Mexican state of Nayarit began developing an innovative system for selling black tar heroin in the United States—one that would eventually intersect with the prescription opioid crisis with devastating consequences. Unlike traditional drug cartels with hierarchical structures and violent enforcement methods, the Xalisco networks operated as independent, family-based cells. These weren't hardened criminals but rather ambitious farm boys from sugarcane-growing families seeking economic opportunity beyond their limited prospects at home. They developed a retail delivery system for heroin that resembled a pizza delivery service—customers called a central number, and drivers carrying small balloons of heroin in their mouths would meet them in parking lots of fast-food restaurants or shopping centers. This system had several revolutionary aspects that made it highly effective: it brought the product to the customer, eliminating the need for addicts to venture into dangerous neighborhoods; drivers carried only small amounts of heroin at any time, meaning arrests resulted in minor charges rather than major trafficking cases; and the cells operated without violence or weapons, avoiding police attention. The Xalisco Boys, as law enforcement came to call them, initially established themselves in the San Fernando Valley of Los Angeles in the 1980s. They targeted areas with existing heroin users, particularly around methadone clinics where they could find customers already dependent on opiates. They employed American addicts as guides to help them expand to new cities, paying them in heroin for introducing the system to local users. By the early 1990s, the Xalisco networks had spread to cities across the western United States—Portland, Denver, Salt Lake City, Las Vegas, Phoenix, and others. Each cell operated independently but followed the same business model. What made this system particularly dangerous was its business-like approach to expansion. The Xalisco Boys weren't interested in establishing monopolies or fighting for territory—they simply identified underserved markets and moved in with their efficient delivery system. Their non-violent, low-profile approach meant they often operated for years before law enforcement recognized the pattern connecting these seemingly scattered heroin operations across multiple cities. As one DEA agent observed, "We realized this is corporate. These are company cars, company apartments, company phones." By the late 1990s, the Xalisco heroin networks had saturated many western cities. Competition among cells drove prices down and cut into profits. This economic pressure, combined with the entrepreneurial spirit that characterized the Xalisco system, pushed these networks to seek new territory east of the Mississippi River—areas traditionally dominated by powder heroin from different sources. The timing of this eastward expansion proved tragically fortuitous for the Xalisco Boys. As they were establishing their delivery networks in these new territories, the first wave of OxyContin addicts was emerging. Many of these users eventually turned to heroin as a cheaper alternative when their prescriptions became too expensive or were cut off. The Xalisco system represented a fundamental innovation in drug trafficking. Rather than focusing on wholesale distribution, they vertically integrated their operation from production to retail sales. The opium poppies grew in the mountains above Xalisco, were processed into black tar heroin locally, and then delivered directly to consumers in America by their own employees. This allowed them to maintain quality control and maximize profits by eliminating middlemen. Their customer-friendly approach would prove particularly appealing to former prescription opioid users accustomed to the predictability of pharmaceutical products, creating what one investigator called "the perfect storm" of addiction.

Chapter 4: From Pills to Heroin: The Deadly Transition (2000-2010)

Between 2000 and 2010, a dangerous bridge formed between America's prescription opioid epidemic and a resurgent heroin market. This transition represented a critical evolution in the crisis, transforming what had begun as a medical problem into a more complex and deadly epidemic involving both pharmaceutical and illicit opioids. The pathway from prescription pills to heroin followed a predictable pattern that would be repeated in communities across the country. The transition accelerated around 2010 when authorities began cracking down on the most flagrant sources of prescription opioids. Florida, which had become notorious for its loosely regulated pain clinics, implemented a prescription drug monitoring program and new regulations that shut down many "pill mills." Operation Pill Nation in 2011 resulted in hundreds of arrests of doctors, clinic owners, and drug dealers who had been supplying prescription opioids to the black market. Similar crackdowns occurred in other states, particularly in Appalachia where the crisis had first taken hold. These efforts successfully reduced the supply of diverted prescription painkillers, but they did nothing to address the underlying addiction that had already developed in millions of Americans. Simultaneously, Purdue Pharma reformulated OxyContin in 2010 to make it more difficult to crush and snort or inject. While this reduced abuse of that specific drug, it left many addicted users searching for alternatives. The street price of OxyContin and other prescription opioids rose sharply as supply decreased, often reaching $1 per milligram—making an 80mg OxyContin cost $80 for a single pill. This created perfect market conditions for heroin, which offered similar effects at a fraction of the cost. A bag of heroin typically sold for $10-20 and provided a stronger high than prescription pills. As one former pill user explained, "It wasn't a choice to try heroin—it was math. I could spend $300 a day on pills or $50 on heroin." Medical professionals observed this transition with alarm. Treatment centers that had once primarily served alcohol and cocaine addicts now found 70-80% of their patients were opioid-dependent, with increasing numbers reporting they had started with prescription pills before switching to heroin. Studies confirmed this pattern: research published in JAMA Psychiatry found that 75% of heroin users in treatment had first become addicted to prescription opioids. This created new demographic patterns in heroin use. Historically, heroin initiation typically occurred in urban areas among young men from disadvantaged backgrounds. The new wave of heroin users were often suburban or rural, older (average age of first use around 23 rather than 16), and more likely to be white and middle-class. The transition from pills to heroin also dramatically increased the risks of fatal overdose. Prescription opioids, while dangerous, contain standardized doses of known substances. Heroin varies widely in potency, and users have no way to determine its strength before using it. Furthermore, heroin was increasingly mixed with fentanyl—a synthetic opioid 50-100 times more potent than morphine—leading to a surge in overdose deaths among users unprepared for its strength. By 2008, drug overdoses surpassed car accidents as the leading cause of accidental death nationwide, a stunning development in public health history. The pill-to-heroin pipeline revealed how thoroughly intertwined the legal and illegal drug markets had become. What had begun in doctors' offices and pharmacies now played out on street corners and in parking lots across America, as the distinction between patient and addict, between medicine and drugs, became increasingly blurred. This transition would prove particularly devastating for communities already struggling with widespread prescription opioid addiction, creating a second wave of the epidemic that would claim thousands more lives.

Chapter 5: Rural America's Transformation: Communities Devastated by Addiction

The opioid epidemic hit rural America with particular ferocity, transforming once-stable communities into what locals sometimes called "junkie kingdoms." Perhaps nowhere illustrated this transformation more vividly than Portsmouth, Ohio, a once-thriving industrial town along the Ohio River that had fallen on hard times after its factories closed in the 1980s and 1990s. Portsmouth had once been known for Dreamland, an enormous swimming pool where generations of residents spent their summers. By the early 2000s, Dreamland was closed, and the town instead became known for its concentration of pain clinics—"pill mills" that dispensed opioids with minimal medical oversight. Portsmouth became ground zero for the pill mill phenomenon. Following the model pioneered by Dr. David Procter, who opened the area's first pain clinic in the 1990s, entrepreneurs with no medical background opened clinics staffed by doctors with troubled histories. These clinics charged cash, saw hundreds of patients daily, and prescribed massive quantities of OxyContin and other opiates with minimal examination. By the early 2000s, Portsmouth had a pill mill for every 1,800 residents. These clinics attracted "patients" from hundreds of miles away, who lined up before dawn and often fought for places in line. As Lisa Roberts, Portsmouth's public health nurse, observed, "It changed everything around here. A judge's kid became addicted. A mayor's kid became addicted. A police chief's kid got addicted." Perhaps the most striking development was the emergence of an "OxyContin economy" in which pills became currency. In Portsmouth and surrounding areas, OxyContin and other prescription opiates were used to purchase groceries, electronics, car repairs, dental services, and even cable TV installation. Shoplifters stole merchandise on order, trading it to dealers for pills at roughly half the retail value. The pills held stable value – an 80mg OxyContin consistently fetched about $80 on the street. The Medicaid card became a crucial element in this economy. People on disability or welfare received not only monthly checks but also Medicaid cards that covered prescription costs. For a $3 Medicaid co-pay, an addict could obtain pills worth thousands of dollars on the street. Families bore the heaviest burden of the epidemic. Parents watched helplessly as children transformed from honor students and athletes into desperate addicts willing to steal from their own families. Grandparents found themselves raising grandchildren when their adult children became unable to parent due to addiction or overdose. In West Virginia, the foster care system became overwhelmed as parental addiction led to record numbers of children needing placement. Schools struggled to educate children suffering from the trauma of living with addicted parents. The economic impact rippled through communities as employers couldn't find workers who could pass drug tests. Local governments strained under the costs of emergency services, law enforcement, and incarceration related to addiction. What made this epidemic particularly devastating was how it undermined communities' traditional support systems. Unlike previous drug crises that had primarily affected marginalized populations, the opioid epidemic struck the very people who typically formed the backbone of community institutions—teachers, nurses, construction workers, and other middle-class professionals. Churches, civic organizations, and volunteer groups lost active members to addiction and death. Perhaps most poignantly, the epidemic revealed the vulnerability of communities that had already lost their economic foundation. In places like Portsmouth, where factories had closed and good jobs had disappeared, opioids filled an existential void. As one addiction counselor observed, "When people have no hope and no purpose, these drugs offer a chemical solution to spiritual emptiness." By 2010, the human cost of the epidemic had become impossible to ignore. Families that once gathered at community pools now came together at funerals and recovery meetings. The American dream of each generation doing better than the last was reversed in communities where parents buried their children, and the institutions that had once provided structure and meaning struggled to function amid widespread addiction.

Chapter 6: Institutional Failures: Healthcare Systems and Regulatory Oversight

The opioid epidemic revealed profound systemic failures across multiple institutions that should have protected public health. These failures weren't merely passive oversights but active breakdowns in regulatory systems, healthcare practices, and corporate accountability that allowed the crisis to develop and expand for years before meaningful interventions began. The Food and Drug Administration (FDA) made a critical error in 1995 when approving OxyContin's label, which allowed Purdue to claim that the drug's timed-release formula resulted in "less abuse potential." This unique claim—never before permitted for a Schedule II narcotic—became the cornerstone of Purdue's marketing. The FDA also failed to recognize that crushing the pills would defeat the timed-release mechanism, and even inadvertently provided a roadmap for abuse in the warning label, which cautioned against crushing the pills because it would release "a potentially toxic amount of the drug." Later investigations revealed that Curtis Wright, the FDA examiner who oversaw OxyContin's approval, left the agency shortly afterward to work for Purdue Pharma, raising questions about regulatory independence. Medical education and continuing education systems became compromised by pharmaceutical funding. Purdue sponsored thousands of educational programs where doctors were taught that opioids were safe for long-term use. These programs often featured pain specialists who received speaking fees from Purdue, creating conflicts of interest that biased the information presented. The pharmaceutical industry's influence extended to medical journals, professional organizations, and even patient advocacy groups, many of which received substantial funding from opioid manufacturers. This created an echo chamber where the risks of opioids were minimized while their benefits were exaggerated. Healthcare accreditation bodies contributed to the problem by establishing pain as a "fifth vital sign" that hospitals were required to assess and treat. The Joint Commission for Accreditation of Healthcare Organizations implemented standards requiring aggressive pain management, while hospitals used patient satisfaction surveys that incentivized doctors to prescribe opioids. Physicians feared being sued for undertreating pain or receiving poor evaluations if they denied patients' requests for painkillers. As one doctor explained, "We were told that pain was being undertreated and that we were allowing patients to suffer needlessly. The message was that we should be much more liberal with opioids because they were the compassionate thing to do." Insurance companies played a significant role by restricting coverage for multidisciplinary pain management approaches while readily paying for prescription medications. Physical therapy, psychological counseling, and other non-pharmaceutical treatments became increasingly difficult to access, pushing patients toward medication-only approaches. Simultaneously, insurance companies pressured doctors to see more patients in less time, making it difficult to properly evaluate complex pain conditions or monitor for signs of addiction. The average primary care visit shortened to about 15 minutes, hardly enough time to address chronic pain properly. State medical boards and licensing authorities, which had once been vigilant about restricting opioid prescribing, reversed course in the 1990s. Many states passed "intractable pain" laws that protected doctors from prosecution for prescribing opioids, even in large amounts. These laws, often promoted as protecting patients' rights to pain relief, effectively removed an important check on excessive prescribing. When some states later attempted to implement guidelines suggesting limits on opiate dosing, they faced significant pushback from both the medical community and pharmaceutical companies. Law enforcement and drug monitoring systems proved inadequate for tracking the massive increase in prescription opioids. The DEA's quota system for controlling the production of scheduled substances failed to limit the supply of oxycodone and other opioids as manufacturers requested and received ever-larger production quotas. Prescription drug monitoring programs were either non-existent or not mandatory in many states, allowing patients to "doctor shop" for multiple prescriptions. When Florida finally implemented such a program in 2009, it was the last state in the nation to do so, after years as the epicenter of pill diversion. Perhaps most troubling was how these institutional failures compounded one another. When doctors overprescribed opioids, creating new addicts, treatment resources were inadequate to help them. When patients could no longer afford or obtain prescription opioids, the heroin networks were ready to fill the void. When communities experienced surging addiction rates, public health systems lacked both the resources and the coordinated response strategies needed to address the crisis effectively. The opioid epidemic exposed how thoroughly America's health protection systems had been compromised—by commercial interests, by misguided policies, by fragmented oversight, and by a collective failure to recognize the gathering storm until it had already devastated thousands of communities across the country.

Chapter 7: Recovery and Response: Government Action and Grassroots Movements

As the scale of the opioid crisis became impossible to ignore, responses emerged at multiple levels—from federal agencies to local communities. The first significant federal action came in 2007 when the U.S. Attorney's Office for the Western District of Virginia brought criminal charges against Purdue Pharma after a four-year investigation. The case resulted in Purdue pleading guilty to a felony charge of "misbranding" OxyContin and paying a $634.5 million fine. Three executives pleaded guilty to misdemeanor charges, though critics noted that no executives served prison time and the fine represented less than half of what the company earned from OxyContin in a single year. State responses varied widely in their timing and effectiveness. Washington State became the first to issue guidelines suggesting limits on opiate dosing, though they faced significant pushback from both the medical community and pharmaceutical companies. Florida, which had become notorious for its lack of regulation, finally implemented a prescription monitoring program in 2009 after years as the epicenter of pill diversion. Other states passed legislation regulating pain clinics, requiring physician education on opioid prescribing, and expanding access to naloxone, a medication that could reverse overdoses. By 2016, most states had implemented some form of prescription monitoring program, though their effectiveness varied based on whether checking them was mandatory for prescribers. Public health approaches gradually evolved from punitive to therapeutic. Many communities began establishing drug courts that diverted addicted individuals from incarceration to treatment. Police departments in cities like Gloucester, Massachusetts, implemented "Angel Programs" where people could turn in drugs without fear of arrest and be connected with treatment services. Harm reduction strategies gained acceptance, with more communities distributing naloxone to first responders and families of people with addiction. Medication-assisted treatment with methadone and buprenorphine, long stigmatized as "substituting one addiction for another," gained wider acceptance as evidence of its effectiveness mounted. Perhaps the most significant developments came from grassroots movements led by families affected by the epidemic. Unlike previous drug crises where affected families often remained silent due to stigma, the opioid crisis produced a new willingness to speak openly about addiction and demand action. Jo Anna Krohn of Portsmouth, Ohio, exemplified this approach. After her 18-year-old son Wesley died while high on OxyContin, she formed SOLACE (Surviving Our Loss and Continuing Everyday), which became the first parent anti-drug organization to grow from the epidemic's ground zero. Similar parent-led organizations emerged nationwide, providing both emotional support and advocacy for policy changes. Communities began developing innovative approaches to treatment and prevention. Portsmouth, once the epicenter of pill mills, transformed into a center for recovery. The Counseling Center, a local treatment facility, expanded dramatically and employed many recovering addicts, providing them with meaningful work while benefiting from their firsthand understanding of addiction. The recovery movement also spread to college campuses, with schools establishing collegiate recovery programs providing sober dormitories, counseling services, and social activities for students in recovery. Perhaps most significantly, the opioid epidemic began changing fundamental attitudes toward addiction. As the crisis affected people across all demographic groups, the traditional view of addiction as a moral failing gave way to understanding it as a treatable medical condition. Conservative politicians who had once championed harsh drug laws now advocated for treatment and second chances. Communities that had once shunned addicts began embracing them as they recovered. Churches that had previously condemned addiction as sin started recovery ministries. While the epidemic continued claiming lives, these evolving attitudes created space for more compassionate and effective responses, offering hope that communities could eventually heal from the devastating impacts of America's opioid crisis.

Summary

The American opioid epidemic represents a perfect storm of factors that converged to create the deadliest drug crisis in the nation's history. What began as a well-intentioned effort to address undertreated pain transformed into a public health catastrophe through a series of cascading failures: the misinterpretation of limited research suggesting opioids were safe for long-term use; aggressive pharmaceutical marketing that downplayed addiction risks; healthcare systems that prioritized quick fixes over comprehensive care; regulatory agencies that failed to recognize warning signs; and economic conditions that made both prescription pill diversion and heroin trafficking profitable enterprises in struggling communities. The epidemic's unique characteristic was how it bridged legitimate medicine and illicit drugs, creating a pathway from doctor's office to street corner that millions of Americans tragically followed. The crisis has fundamentally changed how Americans view both pain and addiction. The pendulum has swung from the extreme undertreatment of pain to recognition that opioids are not appropriate for many types of chronic pain. Similarly, addiction is increasingly understood as a complex brain disease requiring comprehensive treatment rather than moral condemnation or incarceration. Perhaps most importantly, the epidemic has revealed the power of speaking openly about addiction and working collectively to address it. As parent advocates, recovering addicts, and community leaders have demonstrated, the path forward lies not in silence and stigma but in honest conversation, evidence-based treatment, and the recognition that addiction touches all of us. While the opioid crisis has been America's tragedy, the recovery movement it has spawned offers hope for healing both individual lives and the social fabric of communities across the nation.

About Author

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Sam Quinones

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 basketball players, telenovela stars, gunmen, migrants, and slain narco-balladeer, Chalino Sanchez.In 2007, he published Antonio's Gun and Delfino's Dream: True Tales of Mexican Migration. In this volume he tells stories of the Henry Ford of velvet painting, opera singers in Tijuana, the Tomato King of Jerez, Zacatecas, the stories of a young construction worker heading north, and Quinones' own encounter with the narco-Mennonites of Chihuahua.His third book was released in 2015. Dreamland: the True Tale of America's Opiate Epidemic recounts twin tales of drug market in the 21st Century. A pharmaceutical company markets its new painkiller as "virtually nonaddictive" just as heroin traffickers from a small town in Mexico devise a system of selling heroin retail, like pizza. The result is the beginning of America's latest drug scourge, and the resurgence of heroin across the country.The book has received rave reviews in Salon.com, Christian Science Monitor, Wall Street Journal, American Conservative, Kirkus Review, and National Public Radio. Amazon readers gave Dreamland 4.7 stars and called it "a masterpiece" and "a thriller." "I couldn't put it down," said one. Said another: "This book tells one of the most important stories of our time."Following Antonio's Gun, the San Francisco Chronicle called Quinones "the most original American writer on Mexico and the border out there."He has done numerous Skype sessions with book groups that have chosen his books to read.Quinones also writes True Tales: A Reporter's Blog, at his website, http://www.samquinones.com.For several years, he has given writing workshops called Tell Your True Tale. Most recently the workshops have taken place at East Los Angeles Public Library, from which have emerged three volumes of true stories by new authors from the community. For more information, go to http://www.colapublib.org/tytt/.

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