A Peak into “Dreamland”

A Peak into “Dreamland”


“Naloxone isn’t the antidote for heroin.   Community is.”

Recently,  Sam Quinones, journalist and author of “Dreamland,” addressed the Maryland Patient Safety Center conference regarding the opioid scourge in America.  His talk was so profound that it’s worth sharing a few highlights.  (Note:  all quotes are his.)

  • A 1979 brief letter to the Journal of American Medical Association (JAMA) is cited for decades to promote that opioids are safe. Author of the letter, Dr. Herschel Jick of the Boston University School of Medicine, reviewed a database of some 11,000 hospital inpatients and stated only four became addicted.  There was no data about how long drugs were given, how often, the dose, or what the patients’ ailments were.

“This one letter became the intellectual cornerstone of the pain revolution.”

  • In the 1990s “pain” becomes the fifth vital sign. Hospitals and doctors are evaluated on how well a patient’s pain is treated.  Their reimbursement depends on high scores.
  • At the same time, the growth of Managed Care forces physicians to spend less time with patients. Prescribing pills is quick and easy.
  • Purdue Pharma comes up with the “miracle drug” OxyContin in 1986. Overnight, attractive, young women are trolling doctors’ offices and hospital halls hawking the drug, offering lavish lunches, free trips and samples.

                                               “Before OxyContin there was no bridge to heroin.”

  • Americans develop unrealistic expectations about pain. We want ease, comfort and convenience – without accountability.  We seek to avoid pain.

                                              “We don’t even let our kids play outside anymore, skin their knees, or let them fail.  Is it any wonder they hide in their rooms?”

Originally, Quinones thought his book was about drug trafficking and pharmaceutical marketing.  Today he believes it’s really about the theme of isolation verses community.

                                              “Heroin is the antithesis of community.  Isolation is heroin’s natural habitat”

If you haven’t yet, read “Dreamland.”


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