Our national opiate-addiction epidemic is different from other American drug scourges for many reasons.
It’s the deadliest and the most widespread. It didn’t begin with drug mafias, but through the promotion of narcotic painkillers by pharmaceutical companies to doctors, who were pressured by we Americans, demanding an easy solution
to our pain.
But the epidemic is also remarkable for whom it has forced to its frontlines.
Librarians make up one such group.
I’m in Ohio this week, speaking at four regional conferences of librarians around the state. Today was Gallipolis — pop. 3500, in rural Gallia County, along the quiet, majestic Ohio River.
I stayed after my talk to listen to a panel made up of a university librarian, an elementary school librarian, and a public librarian talking about their experiences with this epidemic.
We heard about needles in the bushes, about how a child who lives in a drug house smells, about calling 911 because a customer had overdosed in a bathroom, about the look of some people who come into the library high. The epidemic has made danger zones of innocuous public places.
One school librarian, I was told, suspects two girls at her school are being abused. They come to school smelling badly. She takes their clothes home and washes them.
I was also struck by the stories many in the audience (80 people or so) had to tell about addiction in their families. Several librarians were raising their addicted relatives’ children.
Librarians are also perfectly poised, though, to be great catalysts for change – community organizers in the fight against this plague. That’s what I believe. They have the spaces, the local trust and credibility, and often small towns need folks like librarians to bring them together — and this is happening.
As I said to the group I spoke to, who better than purveyors of the book to be the leaders in this fight.
Plus, librarians are looking for new roles to play – rebranding libraries as community centers, places where people can come together. This catastrophe is offering libraries and librarians that moment to reinvent themselves towns and counties.
In the afternoon, I drove through the pristine southern Ohio farmland – white houses, white churches, silver siloes, blue sky, and acres of green corn.
I stopped at the Dairy Queen in Washington Court House, another small town with a bunch of opiate addiction problems.
Tomorrow Dayton – then Findlay and, finally, Twinsburg.
Next week I speak in Weber County, Utah, and after that Brunswick County, North Carolina.
All frontlines in America’s epidemic of opiate addiction.
“Always Be Closing” is the motto that salesmen live by in the movie/play Glengarry Glen Ross.
If you haven’t seen the movie, do so. It’s great: Al Pacino, Jack Lemmon, Alex Baldwin, Kevin Spacey. It’s about an office of desperate sales guys hawking shady real estate investments. ABC — “Always Be Closing” — is the way each is supposed to approach every sales call.
The suit was filed in May by the office of Tennessee Attorney General Herbert Slatery. It alleges a lot of things, but in general that Purdue used deceptive marketing practices to push its signature drug, OxyContin. This took place, the suit alleges, between 2009 and 2012, well after the company and three of its executives pleaded guilty (in 2007) to a federal misdemeanor of false branding and paid a $634 million fine, while also committing to a series of measures to ensure they were not marketing to doctors who were prescribing unscrupulously.
The company moved to seal the lawsuit, but a judge in Knoxville recently decided against that idea, allowing the office to send me, and others, a copy.
In general terms, what I find interesting the lawsuit is how it displays the changes in pharmaceutical sales in this country, much of that coming during the life of OxyContin, though not due to it.
Up to the mid-1990s, drug salesmen in the United States were usually older men, often with backgrounds in pharmacy or medicine. They were often from the communities they sold to, knew the doctors they sold to, and became credible sources of information for those same doctors as medicine began to change rapidly.
Then the industry went another route. Those older folks were shown the door. In what can be called a sales force arms race, drug companies hired more and more reps. These reps were usually much younger, very good looking. They didn’t know much about they were selling but they have backgrounds in sales. They inundated doctors with visits and giveaways, of pens, calendars, lunch, sometimes trips for continuing medical education seminars. The companies were aware that by massaging a doctor’s staff, the doctor would soon be an easier mark.
Many companies did this. The numbers of sales rep rose through the 1990s from 35,000 nationwide to over 100,000 by the end of the decade. But other companies were selling blockbuster drugs to deal with cholesterol, hypertension and others. Purdue was among the few that used these techniques, and this enhanced salesforce (numbering eventually 1,000), to sell a narcotic painkiller.
“Always Be Closing” was, apparently, part of that push at Purdue. So, allegedly, was mention of the movie. All of this coming after the 2007 criminal lawsuit.
In Tennessee, (pop. 6.6 million people), the company made 300,000 sales calls to health care providers in the 2007-17 decade, during which time doctors prescribed more than 104,000,000 OxyContin tablets; more than half of those tablets were at the strongest doses the company made: 40mg and above.
Those of you who’ve read my book Dreamland know that, to me, supply is the crucial factor in this, and really in any drug scourge. What the lawsuit describes is a company hard at work at creating a vast new supply of opioids.
Company instructional materials pushed sales folks to “expand the physician’s definition of the appropriate patient” to which opioids might be prescribed; to “never give someone more info than they need to act”; and to develop a “specific plan for systematically moving physicians to move to the next level of prescribing.”
“We sell hope in a bottle,” said one guide for incoming salespeople, who were also instructed to encourage doctors to increase patients’ daily doses.
The lawsuit goes on to claim that Purdue sales reps in Tennessee were urged to make frequent sales calls, as evidence showed that that increased the number of prescriptions. According to the lawsuit, the company urged its salespeople to “focus on doctors who had more patients, less likely to have pain management expertise, and have less time to appropriately monitor patients on opioids.”
During these years, Purdue sales reps, according to the lawsuit, focused their efforts on primary care doctors, nurse practitioners and physicians assistants, whom the company “knew or should have known … had limited resources or time to scrutinize the company’s claims.” Together, people in those three profession prescribed 65 percent of all OxyContin tablets in Tennessee during these years. By 2015, Tennessee had the third highest prescription rate of opioids in the country.
A major part of the lawsuit goes on to discuss specific examples of Tennessee doctors who were leading the state in opioid prescribing, often with signs that their practice was out of control or they were incompetent or unscrupulous, yet who were nonetheless aggressively marketed to by Purdue salespeople.
Today a startup in the small town of Portsmouth, Ohio comes out with a line of t-shirts called DREAMLAND LIFEGUARD.
The shirts, designed by a company called 3rd and Court, also feature the words “Time to Turn So You Don’t Burn,” which was a jingle a local radio station broadcast every half hour, knowing that most of its listeners were at the legendary pool.
I’m proud that the designers say they were inspired by my book about our national opiate epidemic, which as many of you know has a lot to say about Portsmouth, and which took its title from the town’s Dreamland pool, which was razed in 1993.
But more than that, I’m impressed with the entrepreneurial DIY energy and imagination that 3rd and Court represents in a town that for years wallowed in a plague of narcotic negativity.
When the fog of dope lifts, creativity and passion have room to blossom. Something like that feels like it’s happening in Portsmouth. A lot of abandoned buildings are under renovation. Downtown has a lot of artists staking their claim.
I spoke with Connor Sherman, 23, who designed the shirts. Connor was partly raised in the Portsmouth area, then went to Shawnee State in town, and graduated with a degree in visual design.
“I see a lot of people, their mindset has changed to entrepreneurship and moving forward,” he said. “Not that I’m going to get out of school and somebody’s going to hand me something, like a job 9-to-5. It’s more about creating something out of nothing.”
The building at 3rd and Court streets in downtown Portsmouth has become a hive for small startups. Years ago, it was an auto shop. Then like so much of Portsmouth it stood vacant for a good while. Finally, it was renovated and PSKC Crossfit occupied the space. (This is part of Portsmouth’s recovery from opiates. Several workout gyms have opened in town. “A lot of people take pride in restoring themselves and restoring others,” Connor told me.)
The crossfit was a place for people to commune.
They began to share ideas and, in time, to discuss business possibilities. That had been lacking for many years in Portsmouth. Really ever since the pool closed in 1993. For years, with the town in decline, buildings abandoned, and half the population leaving, the only place people really saw each other was Walmart.
The new incarnation of the building at 3rd and Court emerged as part of some new alternatives to that isolation.
Soon, Doc Spartan, a maker of natural lotions and hand creams for workout aficionados, started in the building. They advertise their “Combat Ready Ointment” as made from coconut oil, beeswax, eucalyptus oil, vitamin E and more, and good for “cuts scrapes knicks rips rashes razor burn blistered feet rope burn diaper rash chapped skin and calluses.” (Check them out here.)
That was followed by 3rd and Court apparel, making “small town” summer clothes. “Apparel dedicated to the lovely Portsmouth, Ohio and other small towns like ours,” – reads their website.
“My desire to do design instead of something else that someone tells me to do all day is what made me want to start looking for opportunity,” Connor told me.
So the town where for years noxious pill mills were the only locally owned businesses to open is displaying capitalist effervescence of a more wholesome kind.
I get asked by people all over the country what the solution is to this nationwide pill-and-heroin epidemic. Honestly, I don’t always know what to say. But I do believe in harnessing the creativity of folks who are in recovery, or, like Connor, never did dope to begin with.
So here it is:
3rd and Court is offering DREAMLAND LIFEGUARD t-shirts in men’s and women’s sizes, plus a unisex tank top – each for $24.99.
I’m speaking today in a mansion near Portsmouth Ohio built by a doctor named David Procter – known around here as `The Godfather of the Pill Mill’ – whose story I told in Dreamland.
A reader I’ll call Karen, who grew up in Portsmouth, wrote to me a while ago:
“For some reason I feel compelled to tell you that Dr. Procter was the catalyst that destroyed my family.
The house, in South Shore, Kentucky on the Ohio River, has been converted to a drug rehabilitation clinic run by a company called Recovery Works.
“My dad worked at the prison as a guard. He hurt his back, falling from a ladder during some sort of training assignment.
“I only knew that my dad got hurt at work, and [Procter] was his doctor. And that my mom hated him with a passion. I can remember going to his office and my mom coming out so upset. I found later that it was because she would go there and beg him to stop giving my dad pills. Lines out the door. I can still remember my mom and my aunt and my grandmother in the car discussing all the people.
Pharmaceutical companies and pain specialists viewed the pain-pill revolution that transformed American medicine as a boon to doctors. They sold the opiate painkiller pill as a way of addressing the lack of time doctors had with patients, and pain patients in particular.
That doctors accepted them so readily tells us how serious were the time pressures they felt.
The more you prescribed them, though, the more the pills became a curse – just like morphine molecule they contained. They wore down a doctor. A doctor known as an easy touch was soon overwhelmed with patients who filled his waiting room, waving cash in front of him, insisting. Soon he was accepting only cash – addicted to it, accepting the lies his patients told him, believing too that nothing was wrong.
From this emerged the medical mutation known as the Pill Mill. Nothing showed the corrosive effects of for-profit medicine like the pill mill.
David Procter was notorious in Portsmouth for prescribing large amount of pain pills to patients, with almost no diagnosis.
“The day my parents marriage finally ended, was the day my mother threw all of my dad’s pills Down The Gutter and he removed the manhole cover and crawled down to get them. I remember her taking her wedding ring off then and telling him that she wanted a divorce. His head was literally sticking out of the manhole. Sad time.” Karen
David Procter was a product of that, I believe.
He had come in 1977, and been beloved. Amid economic decline, doctors held the key to life strategies like worker’s comp and SSI. Procter became the quickest doc around in preparing worker’s comp papers.
In 1988, the Kentucky Board of Medical Licensure investigated him for the first time. Those reports seem to describe a man losing his bearings but still trying to maintain some semblance of medical and moral rectitude, still looking for second opinions and trying to find alternatives to pills for his pain patients.
Ten years later, a second investigation, and that doctor had vanished.
In the interim, OxyContin and the Pain Revolution had come. Jobs were gone, Main Street was an empty shell. Ohio River towns had lost huge population. Dreamland pool had closed.
As a doctor in a desperate place, he had been unaccountable for too long and grown corrupt, the Kentucky public record documents. Now, investigators found a man who extorted sex for pills from vulnerable and addicted women, who preyed on girls tormented about abortions. His waiting room was a corral of drug addicts, all there with eyes downcast, desperate. He stayed open well past his posted business hours. His records were shoddy or nonexistent.
After a car accident, he began hiring doctors with drug and alcohol problems to run his clinics. This is what gave him lasting importance to this story, for those doctors in turn left to start their own pain clinics.
The problem metastasized like a cancer. Procter became the Ray Kroc of the Pill Mill.
Drugs have hit my family hard. My uncle’s stepdaughter and her daughter were both murdered in Lucasville. They still haven’t found their murderers. The daughter was a beautiful sixteen-year-old girl who didn’t deserve anything that she got. Apparently her mother was selling Oxycontin. My aunt’s step-daughter is doing life right now for murdering another girl in a town near Portsmouth. I have two uncles who both died of heroin overdoses in the last 6 years.
And some of my friends from high school, their daughter has been missing for about 6 years. Due to drugs as well, I’m sure of it. I could go on and on. I’m so glad that I left that area in 1989 and made a better life for myself. However the county that I am living in and have been living in for 27 years is starting to feel the sting. It’s happening. Karen
David Procter eventually went to prison for 12 years. He was released in 2014 and, being Canadian, was deported. He leaves behind a strange painting of a monkey looking into a mirror, with Dr. Procter’s reflection looking back at him, and a seven-bedroom, six-bath, seven-car mansion on 34 acres that is now occupied by 16 addicts working on their recovery.
My dad OD’d in 2009, but he really died years before. He was a good dad once. I’m glad that I have those happy memories.
I know Procter’s house well. We always called it the house that pills built. Beautiful place. Fitting that it’s now a rehab. Karen
These next several weeks I’ll be traveling to many parts of the country for speaking engagements about Dreamland: Dallas/Fort Worth, Huntington WV, Indianapolis (twice), Logan, OH, Salt Lake, and South Shore KY, among other places (full list below).
These follow many events over the last year. I can’t wait!
It’s been wonderful, after spending so long writing about a fairly depressing topic, to see communities like Scott County IN and Marysville OH plan to use Dreamland to begin discussions/alliances focused on combating the problem of opiate addiction, now nationwide.
I’m a storyteller not a policymaker nor an advocate, but I do feel overwhelmed at times at the intensity of the response and so honored that these towns would invite me to visit them to talk about this.
I want to say thank you to the hundreds of folks I’ve already met while signing books at numerous events – half of whom have stories so powerful that they might have ended up in Dreamland had I met them while I was writing. It’s become one of the joys of touring, meeting folks like this, going to places like these.
I note, too, that many of these place are not towns on a typical book tour. But this is not a typical book nor, I suppose, a typical time.
I love that I’ve been able to visit Peoria IL (home of Caterpillar) and Chillicothe OH (Go Cavaliers!), but it also shows you where the problems with opiate addiction are now in our country.
Anyway, here’s the full lineup:
Sept 19: Scott County, IN (Various events, including Austin High School Auditorium, 7-9pm)
Sept 20: Van Wert, OH
Sept 21: Marion, OH (Palace Pavilion, 3:30-5pm)
Sept 22: Dallas/Fort Worth, TX, Hurst Conference Center, (When the Prescription Becomesthe Problem: A community response to the Opiate Epidemic)
Sept 29: Salt Lake City, UT, Sheraton Hotel (Beyond the Needle and the Damage Done: A law enforcement and health care response to the opioid epidemic)
Oct 1: Huntington WV, Ohio River Book Festival, (12:45-2pm)
Oct 3: South Shore, KY (Recovery Works)
Oct 4: Zanesville, OH (and environs, various events)
Oct 5: Columbus, OH (North Broadway United Methodist Church)
Oct 6: Indianapolis, IN (Indiana Hospital Association)
Oct 6: Logan, OH (Hocking Middle School)
Oct 12: Marysville, OH
Oct 13: Indianapolis, IN (Indiana Attorney General’s Conference, Indiana Convention Center – Indiana Prescription Drug Abuse Prevention Task Force, public invited)
Oct 14: Des Moines, IA (Iowa Medical Examiners Convention)
Oct 24: Hillsdale MI (Hillsdale College, various events)
Back from a busy trip and I wanted to thank Kentucky Gov. Matt Bevin for his kind words recommending my book, Dreamland, during his first budget address to the Commonwealth and Kentucky state legislators last week.
I’m very honored and touched by what he said, and that he followed those words with a commitment to increase funding for opiate-addiction treatment over each of the next two years. [Click here to view his speech. The part I’m referring to begins about 59:30.]
When I began writing the book that became Dreamland, I occasionally received strange reactions from people wondering what on earth I was thinking writing about heroin. Didn’t that, after all, belong to the 1970s?
I didn’t think so. I felt it rumbling beneath the surface and ready to explode, just no one was talking about it in 2012 and 2013, and even in 2014. Most of those who knew about it from personal or family experience were ashamed to speak.
So it feels satisfying that the book is helping people in a position of public influence, among them the governor of Kentucky, a state overwhelmed by this scourge, understand it, talk openly about it, and make policy to address it.
Storytelling will do that. That’s what I’ve long believed. Thanks, governor!
I don’t think I’ll have a nicer time, as an author, than I’ve had in the last few weeks.
For starters, one morning Entertainment Weekly selected Dreamland as among the year’s 10 best books (“like a David Simon TV Show gone cosmic”). That afternoon, Bloomberg Business ran a piece with Princeton Prof. Angus Deaton, Nobel Prize winner for economics, recommending the book as his favorite of the year.
Both ends of the culture endorsing a book on the same day – I don’t think that’s happened before.
I appreciated that because when I began this book I thought I was writing a drug-crime story. Midway through, I realized the book was really about where we are as a country, about what happens when, as a culture, we shred community, export our jobs, build isolation and call it suburbs, claw at government and forgive the private sector its trespasses, and exalt consumption and seek pleasure and call them happiness.
Heroin is simply the embodiment of values we’ve fostered for 35 years. Isolation is its natural habitat. Doesn’t have to be that way. The antidote to heroin isn’t naloxone; it’s community.
I know, it’s hucksterism. But the rules for authors these days are:
1) Write like hell; 2) Rewrite always; 3) Read a lot; 4) Talk to lots of different people; 5) Pay attention; and 6) Always be branding, marketing and promoting yourself because if you don’t, no one else will.
So, given No. 6, I’ll just quietly let you know that, in addition to EW and Bloomberg, in the last few weeks Dreamland was selected in “Best Books of the Year” lists by … Amazon.com, Slate.com, the WSJ, Seattle Times, Boston Globe, St. Louis Post-Dispatch, and Audible.
(In the two weeks after posting this, Buzzfeed, Daily Beast, Texas Observer, and the Guardian also added Dreamland to their Books of the Year lists. My thanks to each of them.)
Drug Czar Michael Botticelli named it his favorite book of the year – that was nice of him. So did the governor of Kentucky, Matt Bevin. Nice of the governor to do that, too.
The last few days have been tumultuous for my family and me – and filled with strong emotions.
But I wanted to say how much I appreciated all those who wrote in, via various media, with kind words, words of support and encouragement. Tens of thousands read the blogpost below. Thousands of people shared the post below on Facebook. Hundreds more tweeted it. I received many e
mails, and (now that my WordPress comments section is fixed) comments on my blog. Many folks wrote in on the 60 Minutes website and the show’s Facebook page to object.
It means so much that you would do that. Thank you!
“People can see the truth,” said one editor and friend. I think that’s probably right.
Journalists and writers sent me notes with their own tales of how 60 Minutes and other shows had taken their stories/books/articles/reports and redone them without giving credit.
“This has been going on for years,” said one.
Maybe, but that doesn’t make it right. I hope writers/reporters will speak up when this happens in the future.
I hope my public objection, calling them out, means that a show like 60 Minutes will think twice before it appropriates the work of others without giving them credit. Television in particular seems afflicted with the weakness for taking the stories of others.
To those who would do that, I say, fine. Just give credit. It’s common decency. Show the work the real reporters did. Show respect. Don’t pretend, as 60 Minutes did so brazenly, that you’re blazing some new trail.
All that show had to do was mention my name, my work, my book, and that I did indeed help them.
That seems unlikely now, given the comments of the show’s spokesman. Let me say for the record: I spoke up not to promote my book. I spoke up because I had to defend my work. Because if I didn’t defend my work, no one else would. 60 Minutes was profiting from my work. I spoke up because this was work that 60 Minutes had not done by themselves. I had and I did it when almost no one in the media cared about this issue; early on, some questioned my judgment for even getting into the topic. Who cares about heroin addiction?
I spoke up because we’re in a new world, where if you want to do good journalism you almost have to go independent. And if independent journalists are routinely, and with impunity, scavenged by predators without the interest or energy for doing the work themselves, then we are doomed.
I spoke up because 60 Minutes, while taking what I’d taught them in phone conversations and in Dreamland, displayed no interest in advancing the story, taking it new places, teasing out new angles. None of that. Just the “Cliff Notes,” as one retired cop told me, to my book.
After 30 years in this business, three books and more articles than I can count, I’m accustomed to seeing stories that I scooped get picked up by other news outlets. I barely flinch. It’s part of the job. It’s even happened with many news outlets since Dreamland appeared. Everyone seems to be talking about the heroin epidemic in the last six months. Time Magazine, New York Times, Sports Illustrated. That’s great, and one of the reasons I wrote the book.
I called out 60 Minutes because it was such an egregious violation.
They could have gone anywhere in the country and done this story. You’d have to ask them why they didn’t. I suspect they went to the place I told them to go (on the phone and in an email) and where a major part of Dreamland was set – Columbus, Ohio – because it was cheaper to do it that way, with the roadmap I provided them.
The night of the show, I was proud of the parents who were interviewed, several of whom I know. They spoke for millions of mothers and fathers like them across the country who have suffered this nightmare of watching their kids transformed into something like zombies under the influence of pills and now heroin. They pushed along this awakening regarding the opiate epidemic that has been gaining strength across the country in the last six months.
But I also found myself dumbfounded, then outraged as I watched, remembering all the work I’d put in on this topic, the time I spent away from my wife and daughter – all of which 60 Minutes just appropriated as if it belonged to them. After it was over, I apologized to my daughter for my outbursts during the show.
I grew up admiring 60 Minutes for its storytelling and investigative reporting.
So many original stories. No one on television was doing what 60 Minutes was doing then. It looked so exciting and that was part of why I became a journalist.
So six months after the publication of my book Dreamland: The True Tale of America’s Opiate Epidemic, it saddened and appalled me to watch the show last night.
Last night, 60 Minutes ran a piece about heroin in Ohio. I’m very happy that these Ohioans, who I know and like and respect, are getting this megaphone. Their story needed telling.
But I have to stand my ground.
Months ago, my publisher and I pitched 60 Minutes on stories from Dreamland: first, the Xalisco Boys heroin traffickers, and then a story about heroin in Ohio.
Over the span of several months and several phone calls, 60 Minutes decided against both ideas.
The Xalisco story wasn’t doable, they concluded, after I convinced them that it was unrealistic to assume that they could show up and in 3-4 days have someone magically open up a heroin lab for them to film. I argued that there were other ways to tell the story. I found them sources, people with years of experience in the drug underworld who trusted me. That wasn’t good enough. They wanted traffickers who spoke English. I told a producer that the traffickers in the Xalisco system were working-class guys from Mexico without even sixth-grade educations and that they spoke only Spanish. He also insisted that 60 Minutes had to have film of dope being made, and had to have it accessible after three days of reporting on the ground.
The Ohio story that we then pitched 60 Minutes had no such cost/danger/language concerns. The state was awash in heroin now. America’s opiate ground zero – for many reasons I made clear in Dreamland. Pills had taken hold there first, and heroin had come sooner than it had anywhere else. Over lunch, a 60 Minutes producer even asked me what story I would do in Ohio. I gave her some ideas.
60 Minutes did go to Ohio. Made it look as if they had figured out who to talk to, and what questions to ask, all on their own. No mention of what led them there and what explained the whole story to them. When I asked them whether they were going to refer to my book, one producer said they wanted to focus on the personal stories of local folks. They could have done the personal stories of local folks in Alabama, or anywhere else in America, but then they wouldn’t have had a book telling them specifically where to look, whom to talk to, and what the story was.
Parents and others in Ohio and elsewhere are understandably thrilled that major media like 60 Minutes are finally taking an interest in this topic. I’m glad for them and very happy that the issue is now getting attention. Wayne, Brenda, Tracy, Jenna, Rob and others spoke with eloquence and force, and in my opinion saved the piece.
I hope they won’t see this as raining on their long-overdue parade … but I have to say something to defend myself, my family’s sacrifice, and my work. If I don’t, who will?
I spent years working on this story, interviewing hundreds of people, poring over documents, taking collect phone calls from Mexican traffickers in prisons. Before doing it, I lived and wrote for 10 years in Mexico, which made me distinctly prepared to see a part of this story that 60 Minutes producers, judging from our phone calls, knew only because of me.
I took a leave of absence from the LA Times, where my book’s story began (as I note several times). I finally resigned from the paper to finish this book. I went all over the country. Each trip meant time away from my wife and daughter; each trip meant scrimping on meals and motels. When few people were talking about heroin, when most folks I met looked at me askance for researching the topic, I risked my professional career and my family’s financial future: all to find a story that I believed to be profound in its nationwide impact, and in what it says about our country.
I’m thrilled to receive emails like this one, from a retired undercover narcotics officer, who helped in my heroin education:
“The 60 minutes Heroin story last night was the “CliffNotes” version of your book, they needed to have you on that piece! … These news stories are great but they are quickly becoming “old news”. They need to go a few layers deeper. It’s time to talk about solutions! Thanks to guys like you the nation now knows very clearly what the problem is, now it’s time to move the national narrative towards developing real solutions through accountability. … Keep up the good fight Brother …Be Safe!”
It isn’t often that a book more or less scoops radio, TV, and print. But I believe that, to a large degree, is what Dreamland did.
Since its release, I’ve been disappointed to see Time, Sports Illustrated, Washington Post and now the New York Times publish stories on topics that I dealt with first in Dreamland and not mention it. (Btw, my book clearly cites several books to which I am indebted, both in the text and in the acknowledgements.) But 60 Minutes seemed to me to cross a line.
And even after the months of dealing with them, I might not have written this blogpost had not Sunday’s show itself seemed to involve so little original reporting and seemed to rely so heavily on my book.
Is that what it means to be 60 Minutes these days? Just riff off the work of an independent reporter and do nothing to recognize it?
The whole episode reminds me that 60 Minutes is no longer a standard bearer of anything except cost containment. Shows like 60 Minutes no longer set the national debate. They’re followers, imitators, now, where once they were leaders.
Yet I’m also invigorated, exhilarated even, by this experience. For it means that I and many independent colleagues have wide-open spaces now where we can harvest stories. That if we’re willing to put in the work and take the risks, that important stories will be ours to find. It means it’s a great time to be an independent journalist.
The Daily Show made fun of TV cable journalists, and gave respect to real reporters. It taught a generation to be skeptical of what was reported to them on television. The next step is to elevate real independent journalism.
As desiccated titans collapse, abdicating any role in maintaining standards of journalism, we now have this terrain to ourselves. We must work it, push at it, be relentless. But it’s there. People want it, thirst for it, as I’ve found in the reaction to Dreamland. When we find these stories – as now only we are equipped to do – they will probably mean more than ever.
Remember, too, that if you want risk-taking, on-the-edge, original, independent, red-blooded American journalism, then you have to look pretty far past 60 Minutes. The Atlantic is doing some good stuff. As is the Atavist. Might check out the Marshall Project. I thought Grantland looked good before ESPN pulled its plug. I’m sure there are many places I don’t know of – and I invite them to chime in.
Ever since beginning work on my book, Dreamland, I’ve been struck by the way opiates isolate those addicted to them.
As I wrote and researched, they grew into a metaphor for modern American life.
Opiate addiction, seems to me, is some kind of final expression of our own destruction of community, our lack of connection across the country – both in poor communities and wealthy ones.
We exalt consumption and the individual over community and have for a long time now.
These drugs seem to fit that; they turn everyone who abuses them into self-absorbed, lonely hyper-consumers.
The poem below was written by Andrew Smith, one of the thousands of Americans who died in 2014 of a heroin overdose. He was 24.
His mother, Margie Borth, discovered it after his death.
“There were several writings, this one is about scoring heroin and the lonely world that became his life,” she wrote, sending me the poem. “His brilliance still shines in his dark, sad words. His best friend described this as `hauntingly beautiful.’ I knew nothing of his addiction until just five weeks before he died. I was in a blur of grief when I first read it. But now I do see the beauty of his writing. I miss him so much, just like the thousands of other parents who are thrown into this nightmare. “
Simulate the Static
by Andrew Smith
The waiting, oh god
The parking lots, the bathrooms, the empty parks that close after dark
The driveways, the bus stops, the car backseats
The posh bank lobbies, flea bag motel rooms, gas station pumps
Oak trees, palms, and retention ponds meant to beautify
The ditches, the swamps, and one off dead roads that lead to nowhere
And the loneliness of that trap.
The broken windows,
The made for TV dinners
The busted speakers blaring bass on a burner cell phone
The children going hungry, ignored in the corner
Staring at a broken television; simulating static.
The hangers-on, the worn out, the washed up
The good, the bad, the ugly
and the pretty young white girls with the blank eyes
Staring in awe at this newfound world.
The sun is setting and it’s starting to rain
My eyes are closed and I’m wishing I’m somewhere else.
When I hear a tap on my passenger window
Within 30 seconds, he’s gone
And the wait seems like a thousand centuries ago.
In this moment, I rest my eyes a second
Breathe a sigh of relief and know that all is right with the world
Some people think that my use of Dreamland as the title to my book refers to the euphoria addicts are seeking.
In reality, the title refers to an enormous pool that existed years ago in Portsmouth, Ohio, a town mightily afflicted by opiate addiction. Dreamland was the town square, in a sense. Life revolved around it. Kids grew up in public, under the watchful eye of hundreds of parents. It was a place where everyone was equal in bathing suits. The pool embodied the feel of community.
I’m still awed by the letters I continue to get in response to the book. Here’s another …
I grew up in Portsmouth, born in 1952. It was a safe blessed time in post war America. I had 6 cousins in my Catholic school class, picnics with the families on weekends, a perfect childhood of Dreamland every summer day, walking home from school with friends each fall, enduring the brief winter to count the days until Dreamland reopened.
I left after high school and did college at Ohio Wesleyan where my husband and I met. We moved to PA and I did law school as my husband served the United Methodist churches of Central PA. We made semi-annual trips to Portsmouth with our three children to see family. Each time we went, the town was more depressing. Family members became drug addicts. We were stolen from at my mothers funeral. I rescued my dad from a nursing home where the facility clearly had users on staff. This was in 2013. He was not safe in his own home due to a family member selling drugs right under my dad’s nose.
He died in 2014, in PA, after having lived 92 years in Portsmouth. He knew Branch Rickey, Rocky Nelson, and the great years of Portsmouth. 4 of his six brothers served our country; my dad was deferred due to problems after having polio and rheumatic fever. I have Ohio River blood in my veins.
Thank you for making me understand a bit more that the addictions which decimated my family were not totally their fault. I worked 35 years as an attorney in health care law and I knew the power of the pharmaceutical companies and the collision of profit in healthcare.
If you would like to take on another pharmaceutical issue in the future, let me suggest Lyrica. It was presented as the holy grail for nerve pain. I am no longer practicing law as I had to quit due to seizures after using Lyrica. Facebook even has a Lyrica survivors page of which I am a member. It is another sad tail of “big pharma” all over again.
Thank you again for your wonderful work of Dreamland.
I’ve been getting amazing, intense email letters in the two weeks since Dreamland was released. I hope to be adding some of them to my blog. Here’s one.
I almost lost my beloved 23-year-old son (he is now 26) to heroin addiction, which had progressed from OxyContin to black tar heroin. We are a family of hard working professionals in a university town.
Like most families, we cherish our kids and do everything we can to help then live an honest successful life. When this happened, my son was a pre-med college student. I was and am very close to him, and he had always been a very good student and loving son and brother. He was kind, funny, highly gifted, devoted to music and passionate about becoming a doctor. He was also prone to depression at times.
When I found out, he was in his 4th year of college, and getting As and Bs in hard science courses such as organic chemistry, but could not seem to manage on his college budget. He kept running out of money. He started having vague physical symptoms, like constipation, malaise and abdominal discomfort. His grades in his last year of college started to slip. At Christmas, we visited my sister’s family in Midwestern farm country. Later, my sister, bless her heart, confided in me that her Oxy pills that had been prescribed for shingles had disappeared from her medicine cabinet when we were staying with her. She was reluctant to tell me as she did not want to make anyone uncomfortable or blame anyone. I am so very grateful that she told me this.
I immediately put together that my son had stolen the pills and had a life-threatening problem. I knew it in my gut to be true beyond any doubt. Perhaps because I am a child of the 60s and knew too many friends who were lost to drug addiction: classmates who were drafted and came back from Vietnam addicted to heroin, and 2 college roommates who went to federal prison for smuggling cocaine as an airline stewardesses. We also have a family history of alcohol abuse and addiction, which my mom told me way too many times.
I freaked out! I knew that he had to be addicted to do something so desperate as steal my sister’s pills. This explained everything – his money problems, dropping grades, and vague feelings of being sick. I could not sleep for fear he would soon be dead. I confronted him in tears and said I knew he had stolen the Oxy. He of course denied it, but finally admitted he had stolen the pills. He admitted he was addicted to Oxy pills, which he had started using after being given a script for narcotic pills after a foot laceration.
I immediately called an addiction doctor I know and, in tears and panicking, offered to pay her anything if she could please help save my son. She drove in from out of town and (at a high hourly rate) met with him and helped him realize he was an addict. She personally went with him to an NA meeting (she is a former cocaine addict and involved in NA). I would have paid anything for any chance to save him.
He went to the NA meeting and started to see addiction therapists, which we paid for, but he remained in denial. He kept saying it wasn’t a big deal and he could kick the habit. He went to some NA sessions, but over the course of 18 months he relapsed 3 times, each time worse than the last. During one of the relapses, he called his father to say goodbye after injecting what he thought was a fatal suicidal dose of black tar heroin in his arm. He had started getting the heroin from a “friend” – a former college football player who had been selling him Oxy and was now selling him heroin once he could no longer afford the street price of Oxy.
His father found him in his apartment unresponsive, but he survived. He was so ashamed that he could not defeat the problem that he said he couldn’t live with the shame and did not find life worth living. We did family interventions and told him we would not give up on him and brought him to more therapists.
He almost died three more times. After the first relapse, I demanded to know his dealer’s name as I wanted to kill him. I traced his phone calls (I was paying for his cell phone) and had repetitive thoughts about killing the demon who sold him the drugs and taught him to inject heroin. I wasn’t sure how I could go on living if I lost him.
When using, he would not see me as he knew that I would know if he was using. So he moved to LA and declined rapidly. His father went to see him and told me that I should go visit him, as he would not be alive long. I did. He looked like a skeleton. He was taking Suboxone, as well as additional narcotics and probably other drugs. I kept saying that I would pay for any addiction therapy he could find, but would never give up on him and not give a penny to his habit. My life was hell.
Thank God, he found an addiction therapist in LA (a former Vietnam vet heroin addict) who he really connected with. He started seeing this therapist while still using. I got a “call” (God how we fear those calls!), but it was not that he had died. It was that he had voluntarily decided to go into “long term” drug rehab. We found an inpatient facility in Utah that the addiction specialist recommended. I knew the enslaving power of heroin addiction and how statistically unlikely it was that he would voluntarily say goodbye to heroin.
I don’t know how he had the strength, but he got on the plane, flew to the University of Utah hospital where he admitted himself into the psych unit for several days of detox. He then voluntarily admitted himself into a Utah inpatient facility for 30 days, then into 90 days sober living, and then underwent 18 more months of therapy and voluntary monitored UAs.
My son is now 35 months completely clean, and is in medical school. He keeps track of every single day he is sober. He says that every day remains hard work. BUT, he has done the work and gotten his life back. He started exercising, working and studying steadily. He took premed courses and passed grueling medical school exams.
My son is now successfully finishing his first year of medical school. He wants to be an addiction doctor and find a way to help others survive this hell.
I still worry about him every day. But we cannot talk about this, as most people do not feel comfortable with the topic. I also need to not jeopardize my son’s career. He tells some people and is doing an internship this summer at rehabilitation clinic. He was open with them when he applied for the position. He answers all questions honestly, but does not bring the topic up with others unless they are very close friends.
I have read every book about addiction that I can get my hands on, and some are excellent, such as “Beautiful Boy.” But no other book so skillfully and adeptly addresses this huge crisis like yours, nor does any other book touch me in terms of what I have lived with like your book.
I’m in Little Rock for the Arkansas Literary Festival, a very nice book festival held downtown.
So here’s what happened yesterday. Flew in, met my fellow panelists, learned that Southwest lost my bag, went to the hotel, took a quick nap, went to a festival reception, met someone with an opiate addict in the family (the family member is a woman in her 60s or so).
Little Rock is no different from every other part of the country I’ve visited recently.
Researching our national addiction to pain pills and heroin to write my book, Dreamland, I’ve been struck by the normalcy of addiction nowadays. Everywhere, strike up a conversation, you find someone with a family member or friend or co-worker addicted to opiates.
It’s far more prevalent than crack use was, I believe, and certainly infinitely more deadly.
I remember starting the research, flying to Dallas a couple years ago. On the plane was an elderly couple from rural Oklahoma. We got to talking and before long, they were telling me of their oldest son, addicted to OxyContin.
Not long after that, in a tavern on New Year’s Day in Covington, KY, I met a family, celebrating a young girl’s birthday. Before long, we’re talking about two people in that extended family dead from heroin overdoses.
There are many reasons why this is so.
First: the massive over-prescribing of pain pills nationwide. We often debate whether supply or demand drives drug plagues. This one is supply driven. Pain pills eventually lead to heroin addiction – as the pills are molecularly similar to heroin and much cheaper; in some areas, like those serviced by the Xalisco Boys I write about in Dreamland, heroin is easier and more convenient to obtain the pills.
But this is also driven by silence. There’s no violence to fuel public ire. Meanwhile, though, parents are loathe to talk about their children’s addiction. When they die, they camouflage it in some palatable cause of death. Some parents are going public. But far too few given the huge numbers.
The result is silence, and stories you never hear until you’re sitting next to someone on a plane, or chatting with them at a cocktail party.
When neck-deep in writing a book, I’m never sure if it’s any good. Too much time spent laboring over every phrase, whether one clause should be separated by a comma or a semicolon, which adjective best describes a person’s mood – on top of all the facts that, like cats, need to be corralled and herded in one direction or another.
And new facts you learn every day that may change everything.
Then there’s the rewriting – which is what writing is all about.
So I’m thrilled to hear reaction to the book – that people couldn’t put it down. Love hearing that, I have to say.
I’ve had great appearances at the LA Times Bookfest and at Vroman’s, with more to come at Powell’s Books in Portland, Elliott Bay Town Hall in Seattle and Bookstore West Portal in San Francisco, not to mention the Arkansas Literary Festival in Little Rock, where I’m heading as I write.
Amazon.com chose Dreamland one of its Best Books of the month, alongside books by Toni Morrison, TC Boyle and others. That was nice of them.
The NY Times ran a column of mine on the front page of its Sunday Review opinion page. Nice of them, as well.
KPCC in LA aired an interview i did on their show, Take Two, and CSPAN did the same with an interview at the Bookfest, then covered the LA Times Bookfest panel I was on with some terrific nonfiction crime authors – Ruben Castaneda, Barry Siegel, and Deanne Stillman, and Tom Zoellner doing a bang-up job moderating.
All in all, an exhausting but fulfilling first few days to a book’s life.
Thanks to all who’ve bought the book, and especially to those who’ve written me about it with such feeling.
Two weeks from today, my third book, Dreamland: The True Tale of America’s Opiate Epidemic (Bloomsbury Press), is officially released.
The story of this epidemic involves shoelaces, rebar, Levi’s 501s, cellphones, football, Walmart, American prosperity, with marketing, with Mexican poverty and social competition, and with the biggest swimming pool in the US and what happened when that was destroyed.
It’s about the marketing of prescription pills as a solution to pain of all kinds, and about a small town in Mexico where young men have devised a system for retailing heroin across America like it was pizza.
The tale took me from Appalachia to suburbs in Southern California, into one of the biggest drug-abuse stories of our time – and one of the quietest, and whitest as well.