Dreamland by Sam Quinones

If I were to write out a list of words describing Dreamland, it would not include pleasant, fun, or even inspiring. Rather, it would include words like educational, eye-opening and alarming. It was not an easy book to read, despite the fact that it is well written and thoroughly researched. There were times that I had to set it down and walk away. It hit too close to home. I've known numerous friends and coworkers who've dealt with opiate addiction, some of whom ultimately lost their struggle. It was difficult to read about addiction and prescription drug abuse in such blunt terms. However, the very same experiences that made reading the book painful, also made it feel necessary. I felt driven to read and understand the forces that created such widespread devastation, to better understand the uphill struggle that addicts face in recovery, a struggle which ends in failure all too often. And in this department, Dreamland absolutely delivered. 

I was a bit skeptical when I first began reading. Quinones chose an interesting organizational format, and it took awhile for me to get the hang of it. Chapters alternate between investigative reporting, particularly focusing on the rise of prescription opiates, and personal narratives describing the lives of addicts and people whose lives have effected by addiction. By the middle of the book it's obvious that this style is a real asset to the overall narrative as you rarely get bogged down in dry, factual data. The personal accounts keep things moving forward and also give faces to all the statistics and numbers.. The draw back is that the first few chapters are a bit confusing as it's unclear where the book is headed.

Another area where Quinones excels is managing the complicated web of people and facts. The book is fairly long, and the story is a complex one. It involves some towns and villages in Mexico and unique cultural aspects of the people who live there. Similarly, it involves the science behind opiates and the culture of medicine and doctors. Also, shifting American opinions on pain and addiction. The list goes on. But Quinones manages to weave them together in a way that is accessible, a way that makes sense. As the book moves along, there are times that he reiterates important points from previous chapters, a tactic which can feel repetitive, but which also helps to remind you how many different factors contributed to the current state of affairs.  This is particularly helpful if you have to read the book more slowly as it reminds you of important facts which you may have forgotten. 

I believe that Quinones also deserves recognition for the lack of judgement in Dreamland. This is not a book that aims to beat down addicts using guilt and condemnation. Nor does he even condemn those who were selling the drug. Despite the fact that many of the people he discusses in the book did things that are deplorable, he relates their stories factually alongside all the other factual data. All of them, addicts, dealers and victims alike, suffer from circumstances beyond their control. Whether it's an impoverished community which conflates wealth with personal value or a football team that's routinely prescribed with pain killers, people from both groups go on to suffer and struggle. Ultimately, the lack of judgement embues the book with a sense of hope and empathy that would have been lacking otherwise. Quinones does not condemn any of them as worthless. Instead, he outlines what prospects are on the horizon, whether those are improved treatment facilities or new employment opportunities. This point of view is essential if you plan on reading the book. 

As I said, Dreamland is not an easy book, but I am very glad that I read it. It makes opiate addiction more real and less terrifying. It is not a beast lurking in every bottle of medication lying in wait to capture the innocent. It is preventable, treatable. With education, to patients, doctors, and the general public, it can be avoided. Dealing with opiate addiction more broadly in America will require frank and open discussion. I recommend that you read Dreamland, as understanding the past is the first step in breaking away and creating a better future.