Pain pills and heroin addiction are sweeping through many Native communities. According to the National Survey on Drug Use and Health the percentage of Native Americans reporting current use of prescription drugs for nonmedical purposes is higher than that for any other racial group.
Where did it come from? How did this happen? White people do those drugs, right? Glad you asked.
When I read a book or watch a movie, whether I try or not, I always filter it through the lens of “How does this affect my community?” I think that’s natural—if a tornado happens, it’s common to want to know if your house is going to get blown over before you think of everyone else. This book, Dreamland: The True Tale of America’s Opiate Epidemic is about drugs and movement and social organization. Specifically, Dreamland is about how Oxycontin, Oxycodone and later heroin (collectively called “The Morphine Molecule” in this book) came to be an epidemic all over America within the past 20 years. Those drugs have taken over whole towns and communities by storm and seem to have come from no place and seem to work in concert. Where the heck did they come from and how did that happen? This book does a pretty amazing job of answering those questions.
Dreamland, by Sam Quinones, chronicles the development of morphine from the first time it’s distilled in 1804 through today’s various brand name oxycodone medicines. The book also chronicles how the Food and Drug Administration (the “FDA”), prompted by (extremely) laissez-faire capitalism and lobbying, came to allow Oxycontin to misrepresent its addictiveness. “Sales of oxycodone—the drug in OxyContin, but also sold in smaller-dose generic pills—rose almost ninefold between 1999 and 2010.” It’s pretty galling—Dreamland shows how easy it is to circumvent the FDA’s mission of “protecting the public health by assuring the safety, efficacy and security of human and veterinary drugs…” People die when the FDA gives in to lobbying or special interests or just laziness. People die because there are unscrupulous doctors who are willing to kill to build their own empires. The FDA continues to harm people in modern times, by the way—under the Obama Administration the FDA approved the use of Oxycontin for kids as young as 11 years old less than a year ago.
It’s about money.
That’s the human component—ultimately this book is about greed at every single level, greed that is willing to prey upon whomever to get more. The characters in Dreamland are well-developed and you learn about their role in the epidemic: names like the Xalisco Boys or the FDA or the Dirty Doctors who paved the way for the current heroin crisis. It doesn’t matter: everyone’s trying to get over. It’s like that series “Breaking Bad”—everybody is dirty. And oftentimes, oddly, the only folks in Dreamland who are “victims” are the pill and heroin addicts, junkies, the people who would typically be the subject of the most judgment. Those junkies who many times are seen as making a choice to become addicts, well not so much. Dreamland explains, through story and interview, why that is not always the case.
On a personal level, Dreamland should be required reading for any person who deals with courts, drug addiction or IHS for your particular tribe. It’s important to understand this pill/heroin epidemic at a larger level—no, those young kids who are becoming addicted to pills are not “weak” or “stupid.” The 40-year old who lived a clean life all of their life and then lost their homes and their jobs because of a heroin addiction is not having a mid-life crisis. Maybe under normal circumstances, but this wave of addiction is not about choices. It’s about greed and capitalism and the people of all ages who get caught up are simply pawns in a much larger game that’s going on. Many (certainly not all) of these addicts were given prescriptions from a doctor who is supposed to have their best interests at heart that was monitored by an FDA that is supposed to tell the truth about harmful drugs that are on the market. Neither of those systems worked and the addicts that we see are the result of a massive and lethal system failure.
I repeat: many of the “pill heads” and heroin addicts on our reservations oftentimes did not have a choice in their addiction. It seems hard to fathom, but it makes a certain amount of sense that IHS—which already has a checkered history with Native people—or contract care doctors who do not care about Native people might not have our best interests at heart.
That is the biggest takeaway from Dreamland—it’s a great story. Absolutely. But more importantly, Dreamland will grow your empathy and hopefully help to create a plan to face a scourge that is many, many times larger and more lethal than either the crack epidemic or the meth plague.
Wesley Roach, Skan Photography
Gyasi Ross, Editor at Large
Blackfeet Nation/Suquamish Territories