How the ‘quietest’ drug epidemic has ravaged the U.S.


August 12, 2015 at 6:20 PM EDT

Former Los Angeles Times reporter Sam Quinones examines the dramatic surge of heroin use in the U.S. in his new book, "Dreamland: The True Tale of America's Opiate Epidemic." Quinones paints a graphic portrait of the national problem in a conversation with Jeffrey Brown.


GWEN IFILL: Now the latest addition to the NewsHour Bookshelf.

According to the Centers for Disease Control, heroin usage in the U.S. has doubled among young adults in the last decade and deaths have quadrupled.

Former Los Angeles Times reporter Sam Quinones looks at what’s driving that surge in his new book, “Dreamland: The True Tale of America’s Opiate Epidemic.”

He recently talked with Jeffrey Brown and painted a graphic portrait of a national problem.

SAM QUINONES, Author, “Dreamland: The True Tale of America’s Opiate Epidemic”: This is the quietest epidemic, drug epidemic or drug scourge, we have ever had in this country, certainly in the last 50, 60 years.

No public violence is associated, not like crack, where the people were battling for street corners and this kind of thing. People are dying alone in their bedrooms, in a McDonald’s bathroom. And there’s no publicity. Families are stigmatized, horribly mortified that their kids are addicted and then that their kids die of this stuff.

JEFFREY BROWN: So, this came from reporting on the drug trade in Mexico and the U.S. What grabbed your attention?

SAM QUINONES: Well, I discovered in the course of my reporting the story of one small town in Mexico on the Pacific Coast, where everybody in that town had migrated to the United States, had developed a system for selling heroin.

They were master heroin retailers in the United States, selling heroin like pizza, like delivery model. And they had used this system to, first of all, employ hundreds of people in the town and spread across the country, so they were in like half the country.

What I also came to understand, though, was that they had this enormous market for heroin. This one small town became one of the major suppliers of heroin to the United States. That market was due entirely to a whole new supply of addicts who got addicted to prescription painkillers.

JEFFREY BROWN: So it’s actually a tale of two kinds of drugs, right, two opiates.

SAM QUINONES: Two opiates.

JEFFREY BROWN: One is legal in the U.S., prescription drugs for pain.


JEFFREY BROWN: And then there’s this heroin market on top of that.

Somehow, they’re linked.

SAM QUINONES: Yes. And what connects them is that this is a new kind of drug trafficking in a sense. It’s all based on branding and marketing.

It’s no longer based on the old style of gunplay and shoot-outs for street corners and all that kind of scuff.

JEFFREY BROWN: It’s not the cartels that we have been hearing, where all the violence is.

SAM QUINONES: Exactly. These are the anti-cartels, the anti-“Scarface,” you might say. These guys are all about low profile. They’re all about branding their drugs, making sure that you know, every time you buy a little 10th-of-a-gram balloon of heroin from them, that you know exactly what’s in it, that you can call if it’s no good and have it replaced.

At the same time, though, the companies that promoted the pills have also used branding and marketing to convince doctors all across America that these pills can be used without risk, without risk of addiction, virtually nonaddictive when used to address…


JEFFREY BROWN: Well, that is where the story starts in the U.S., right, is the rise of these kinds of pills that many people are familiar with, whether you’re an athlete or any — all kinds of people, right?

SAM QUINONES: Sure. Right.

JEFFREY BROWN: Pain, you get prescribed these kinds of pills. And you were told that they were nonaddictive, or mostly not addictive.

SAM QUINONES: You were told they were nonaddictive, or you weren’t told anything. You were just given a big whack of pills. I had my appendix out, they gave me 60 Vicodin to take home. The message in that bottle was, doesn’t matter how many of these you take. It’s not going to addict you.

You’re not — they didn’t tell me anything about what was in them. I think is kind of common practice all across the country because of this pain revolution that took place in the ’80s and well into the ’90s, gaining a lot of momentum then.

JEFFREY BROWN: Much of it to benefit to people, right?

SAM QUINONES: Of course. No, these are legitimate pills, and many people use them to great benefit. And it has assuaged the pain of many, many people, chronic pain, as well as post-surgical pain.

The problem is, there is not a lot of attempt to just determine who should be taking them, how many pills they should take home with them. And there is not a lot of time spent by doctors on dealing with maybe a patient’s history of addiction, say, in the past, what — do you have any addiction, history of alcoholism?

JEFFREY BROWN: And what’s been the result? This is — you describe it, throughout Middle America especially.


JEFFREY BROWN: An epidemic? What do you see?

SAM QUINONES: I see epidemic.

I see a scourge that has attacked communities that are completely unprepared for this. They have never seen anything like it. It’s families who never really had this kind of addiction to hard drugs ever in their lives. It’s hitting rural areas. It’s hitting suburban areas.

Athletes — it now seems to me, frankly, that at times football is almost a gateway to heroin addiction, because so many football players are treated for their chronic pain with these pills. They then get addicted and eventually — if it’s not treated, eventually, you have to transition to heroin after using these pills.

JEFFREY BROWN: So, what kind of awareness is there now, either in the medical community, in government? What is or could be done?

SAM QUINONES: I think what needs to be happen is very much what began happening with the AIDS epidemic, and that is a recognition and talking a lot about it, removing that stigma.

Once you remove it, then people who get — who are new to it can figure out what their kids need. But that’s what has not happened. That’s why I think it has spread.

JEFFREY BROWN: All right, the book is “Dreamland.”

Sam Quinones, thank you so much.

SAM QUINONES: My pleasure. Thank you.