Author Tells Multi-Pronged Story of America’s Opiate Epidemic

On March 16, more than 150 faculty, staff, students, and community members listened to award-winning journalist and author Sam Quinones unfurl the complex story of America’s addiction to opiates.

Sponsored by the Michigan Center for Interprofessional Education, with support from the U-M School of Kinesiology,
Quinones’ talk mirrored the subject matter of his newest book, Dreamland: The True Tale of America’s Opiate Epidemic. His research traces how 30 years of increasingly easy heroin access and the relentless marketing of pain pills has led to one of the deadliest drug scourges and most pressing health issues of our time.

In the mid-1990s, Quinones says, America was on the cusp of a “pain revolution” – patients, doctors, and drug manufacturers pushed to label pain as the fifth vital sign, and treat it accordingly. At the same time, insurance companies began to cut back on multidisciplinary pain therapy coverage and encourage pain medication as a cheap and easy “magic bullet.”

1996 brought the wide release of OxyContin. This new drug was a game-changer but overzealous drug manufacturers began pushing it to doctors as though it were an over-the-counter medication. OxyContin became a typical pain solution, easier for doctors to prescribe for a variety of ailments and easier for patients to ask for, receive, and become addicted to. At the height of the OxyContin boom, 20,000 patients were prescribed 9 million painkillers in one year.

Quinones has identified Appalachia as ground zero of the American opiate epidemic. Portsmouth, OH, on the northern end of the region, was, as he puts it, “the canary in the social coal mine.” Once an economically stable small town with a strong sense of community, Portsmouth began to decline in 1993 after the closure of its steel mill. Citizens lost their jobs, Main Street became a ghost town, and Dreamland, a public pool and community center, turned into a parking lot. The town was vulnerable, its residents isolated from each other, and ripe for addiction. Pills, not cash, became local currency, and an entire generation of Portsmouth citizens became hooked on painkillers.

Meanwhile, cheap black tar heroin began to spread across the nation, delivered like pizza by an entrepreneurial network of dealers all hailing from the same small county in Mexico. With innovative marketing and distribution, including aggressive discounts for repeat customers, heroin soon replaced pills for many dependent users.

Quinones points to the disintegration of community as a key factor in the rise of opiate use. Addicts turn away from their families and communities to focus on the consumption of one product. We all become isolated from each other out of fear – kids don’t play outside, neighbors don’t greet one another, families don’t ask for help.

Despite this bleak outlook, Quinones has discovered a few bright spots: It’s now a felony to run a pain clinic. Parents of addicted young athletes are breaking their shamed silence. And Portsmouth has a new sense of accountability for its socioeconomic health – 10% of its 20,000 citizens are now in recovery and SOLE Choice, a shoelace company, has created hundreds of new jobs for its hometown.

During a networking event after the talk attendees were able to grab some lunch and discuss their thoughts in small groups. Quinones stayed to mingle and sign copies of his book.