A nonprofit publication of the Kentucky Center for Public Service Journalism

Dreamland author says opioid epidemic leads to discussion of addiction, first step to finding solutions


By Melissa Patrick
Kentucky Health News

Since Dreamland: The True Tale of America’s Opiate Epidemic was published in 2015, the author says the nation has seen both positive and negative changes in the epidemic that is sweeping Kentucky and other states.

“The negative changes are pretty dramatic,” Sam Quinones said in a telephone interview with Kentucky Health News. “The number of people who are dying from this is every year more, and there doesn’t seem to be an end in sight. . . It’s a very scary time.”

On the other hand, individuals and families have “come out of the shadows” and are now telling their stories of addiction, which he said will help lead to solutions.

Sam Quinones

Quinones came to Kentucky to speak at the Foundation for a Healthy Kentucky’s annual Howard Bost Memorial Health Policy Forum on Monday in Lexington.

He said in the interview that it’s hard for him to talk about positive reactions to the epidemic, given the torment it has caused so many families. But he’s glad there is talk.

“And that’s what happened with AIDS. When people came out of the shadows, we found solutions to AIDS,” he said. “With more awareness, more people are working together on this . . . and I definitely believe that is a crucial part of this whole response.”

He added, “You have a lot more political action, you’ve got a lot more budgetary action, you’ve got media paying far, far greater attention to this than even a few years ago — and so all of that is for the positive.”

He also said the epidemic has caused people to question old dogma and re-think how the nation, the state and communities have treated addiction and its victims.

“In Kentucky, I would say one of the most radical ideas that has been tried – I would give it enormous applause – is you have two dozen counties at least that are now transforming part of their jails, pods that are within their jails, to full-time rehabilitation clinics,” he said. “I think that is magnificent.”

Dreamland, named for a huge, old swimming pool in Portsmouth, Ohio, a town ravaged by the opioid epidemic, is a collection of stories that traces the origins and effects of the epidemic, which started 20 years ago.

It tells the story of a society that wants to be pain-free, both physically and emotionally; an extremely addictive prescription painkiller and its aggressive marketing campaign; the subsequent shift in how the medical community viewed pain, and how it became the fifth vital sign; and how a heroin trafficking operation out of Mexico, using a customer-service business model, forever changed how illicit drugs are delivered in America.

Quinones emphasized that he left his “politics at the door” when he wrote Dreamland and encouraged others to do the same when they read it, and not “cherry-pick” aspects of the book that suit their point of view, which he said sometimes happens.

“It’s a big picture,” he said. “It’s a mosaic of things that went into this and you need to consider them all.”

He said it will take a variety of responses to deal with the epidemic, including individual and humane care for patients who are addicted to prescription opioids, instead of just cutting them off; appropriate use of medication-assisted therapies, along with supportive group therapies; and a shift in the way we view pain, both physically and emotionally.

Quinones said the epidemic seems to be calling into question parenting practices that aim to protect children from all pain, such as the practice of giving all kids in an event a participation trophy; to question whether or not possessions actually lead to happiness; and to examine the role of personal responsibility related to diet and exercise as ways to approach issues of physical pain.

“I think there are a lot of ways in which this epidemic is calling us to question how we’ve been living.”


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