Bad Dreams

Dreamland: The True Tale of America’s Opiate Epidemic, A Young Adult Adaptation – Sam Quinones, Bloomsbury, 2019

In his 2016 book, Dreamland, journalist Sam Quinones investigated the many causes, as well as the many bad actors and countless tragic victims, of the opiate epidemic that has since become the subject of even more damning revelations.  Now, Bloomsbury has issued Quinones’s adaptation for young adults, and it fills the need for carefully presented and analyzed information about this national disaster, one which often engulfs teens.  It is gripping and horrifying, without glamorizing addiction, striking a difficult balance between engaging and warning young adults.

Quinones’s chronicle involves “daily exposure to the worst of human nature,” and he carefully builds his story to specify how, when, and why this fact sadly manifests itself in the addiction crisis.  Brief historical background material explains the origins of heroin in nineteenth-century German laboratories, and then relates the changing medical applications of opiates, some based on misinformation, but, later, on the deliberate manipulation and lies of pharmaceutical companies, specifically Purdue Pharma.  Quinones crucially breaks down each link in the chain of manufacturing, promoting, and delivering deadly drugs to customers desperate to find them.  He compares the supply and demand chain to a corporate power structure where each aspect; manufacturing, marketing, advertising, delivery; are coordinated to produce maximum efficiency and profits.

Quinones does not offer easy excuses. His condemnation of drug companies’ moral detachment in the pursuit of money is understated and matter-of-fact in tone.  Readers learn, for example, how the results of a 1980 study implying that opiates were safe in a hospital setting were deliberately falsified by Purdue Pharma to assuage doctors who were initially skeptical about the safety of opiate painkillers. However, some of those doctors themselves were reluctant to believe the accumulating evidence that the medicines which they were broadly prescribing were leading to a public health nightmare.  Several steps beyond that in the chain of responsibility were the health care providers who knowingly participated in addicting their patients in order to easily make huge sums of money, which the honest practice of medicine would never have allowed them to do. Adults reading this type of material may be disillusioned; teens may be devastated.  Quinones provides a “Discussion Guide,” and “Resources” related to the issue.

Quinones presents a bleak picture of the impoverished Mexican communities where some of the drug dealers become involved in their trade.  He does not patronize them by simply ascribing their choices to lack of economic opportunity, although that lack is brutally obvious in his story.  Like everyone else in the book, they are responsible, although the calculated objectives of pharmaceutical executives who are easily able to pay millions of dollars in fines and avoid prison time is clearly the focus on the author’s contempt.  As one bereaved mother accuses them, “You are…nothing more than a large corporate drug cartel.”

The young adult adaptation of Dreamland is a book that parents should read along with their teens. It is also well-suited to high school social studies course reading and discussion.