Book Club in the Time of Trump: Dreamland by Sam Quinones

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I first encountered Dreamland: The True Tale of America’s Opiate Epidemic at the National Book Critics Circle Award Reading—as soon a I heard Quinones read, I got the immediate sensation of both familiarity and a wide, deep gap in my knowledge, understanding and compassion. I knew it was something I had to read to understand people I had known and people I had not known—people from States more rural and decimated by the march of modernism, unable to keep up, than any place I have ever lived. That’s why this got picked. It got picked a long time ago, before this column even existed. Since then, the current White Nationalist Administration has made it a center piece issue, an issue hard to argue with because it is a real and present danger, both to its base and to folks who would rather give themselves to the sea than vote for a White Nationalist. It’s also an issue that can easily make Mexicans into the boogey man, which is exactly what this administration wants and needs. Understanding it very, very clearly is key to at least partially understanding how this administration came to power. The folks hit hardest by the opiate epidemic come from states that went red; they picked this administration to deal with this problem. 

And truly, perhaps that is the most perplexing thing. Because this issue is both caused by and causes almost every major systemic issue endemic in Western society: racism, toxic masculinity, greed and entitlement, class and healthcare, gun violence. You name it, somehow it impacts or is impacted by the opiate epidemic. It’s fully the most complex issue I can think of right now. And they picked…these people. They picked these people to deal with it. President 45 thinks that Amazon somehow doesn’t pay the Post Office to ship packages. So. As you can see, reading this book didn’t fix this gap for me. But it close it somewhat. Because when you have nothing left to lose, what’s a racist dictator anyway?

Anyhow. Your book club questions:

If you are old enough to remember the 90s, when a lot of this book takes place, do you remember any of this happening in your life?

I grew up in New Jersey, in the public school system. And my memory is far more from the early 2000s than the 90s. Early 2000s is when I hit middle and high school—the 90s were only about prosperity and childhood for me. I didn’t have to worry about much. And then, as if over night, I remembered hearing rumors. And that’s all they ever were—rumors. I was a nerdy kid (surprise) and had nerdy friends and we largely weren’t included in the groups who went to Trenton and purchased heroin. But all of a sudden I remember knowing, just through whispers, that New Jersey had a heroin problem and that the problem was teenagers.

And then in 2008, my grandfather was murdered by a heroin user who believed he had money (and she needed money). He didn’t have money. We lived in a fairly small town; things like that don’t happen there. But in 2008, after years of whispers that New Jersey had a heroin problem, it did.

There are a lot of parts of the book that are shocking to read, especially, I suspect, if you come from a place that wasn’t hit as hard. What were some things you had never heard of before reading this book?

The one hundred percent most shocking thing about this book was how much an extension of capitalism the heroin problem is. Not just in the sense that these places are short on money and hope, but that the Xalisco delivery system looks like Seamless and that an entire town’s economy was pills for A WHOLE DECADE. Let me direct your attention to the passage in question, on page 212:

Pills could not be altered or diluted. Pills held their value, and that value was printed on each pill. It helped that OxyContin came in 40 and 80 mg pills, and generic oxycodone came in 10, 15, 20 and 30 mg doses—different denominations for ease of use as currency. The pill mills acted as the central banks, controlling the “money supply,” which they kept constant and plentiful, and thus resisted inflationary or deflationary spikes.
By the late 1990s a critical mass was achieved and for about a decade the value of most goods in Portsmouth, and many services, was measured in pills.

The next couple of pages are marked with exclamation marks, holy shits and, in one case, a note that just says, “are we in hell?”

Did this book change or challenge any closely held ideas for you?

I mean, I already thought insurance was a lie. But this book certainly confirmed it for me. As insurance covered less and less of the occupational solutions to pain and increasingly covered only the pills, it’s no goddamn wonder that people sought out the treatment that wasn’t only for the rich. I also must admit to harboring a little of the things that DARE taught us Jersey public school kids: that addiction is a moral failing, something for folks who fall victim to peer pressure because they don’t have a backbone. I knew in my head that it wasn’t, that it was a disease like any other, and I didn’t realize how much residual bullshit I had regarding addiction until I felt it starting to fall away. Addiction even spreads like a virus.

But the main idea that I brought into this book from the outset was that heroin addicts kill people; this book didn’t have a lot of stories like that. Based on this reporting, it actually seems sort of analogous to those with mental health disorders: they are far more likely to get hurt than to hurt others. My mother has a strongly-held belief that supports this, actually: that my grandfather’s murderer didn’t murder him because she was addicted to heroin, she murdered him because she was a narcissist. So perhaps I shouldn’t have been so surprised. But I admit to it being there, a problematic value I wasn’t aware of before I started reading. And it’s far less there now.

The afterward drew some conclusions based on the reporting in the book, and some of those conclusions were suggestions for going forward. Were they satisfying? Did you agree with them?

Whoo boy, that afterward left something to be desired for me, personally. It felt like Quinones did all this amazing reporting and then instead of reaching an interesting conclusion at the very end of his book, a sum worthy of the myriad interesting conclusions he made during the book, he fell back on some assumptions that seemed to willfully ignore the years and years of reporting he actually did? He leans on essentialism on page 351 when he talks about the damaging effects of overcautious raising of children. “I can say this because I was one: Boys are like dogs; they need to run and run and run.” That’s…that’s children? Children need that? Children of all genders? He demonizes things like privacy and video games and I have no idea where it’s coming from. Yes, the thesis of the book is that it takes a community to battle addiction; everything is interconnected. But I don’t think that means we should be barging into teens rooms to make sure they’re not shooting up.

What I actually think the reporting points to, and what I think goes largely unsaid, is that the nuclear family is killing us. The fetishization of and strict adherence to two parents providing and taking care of a household enables addiction to fester because it atomizes our communities. What Quinones doesn’t push is a solution, which I think is looking to both urban and queer notions of community and family to help solve the problem, or at least mitigate some of the conditions that can lead to this virus catching.

I also feel like this book occasionally ignores racism and sexism? That might be me just looking for something to be pissed about, but occasionally I feel like Quinones makes a broad statement that doesn’t apply to folks of color or to women and doesn’t qualify it in any way. For instance, he keeps saying things like “Portenoy had helped make pain a topic of research” on page 314, but pain that women and AFAB folks feel is still largely ignored; ask anyone who fits either of those categories and they’ll tell you. Or on page 328, he asserts that “Nationwide opiate addiction had achieved a few things—albeit at a frightening cost. There was the remarkable change of heart regarding prison and treatment that was under way, especially in red states, and led by Republican politicians.” But like. Is there a remarkable change of heart when folks of color are involved? Or just white people? Because maybe I’m a suspicious fucker, but I highly suspect it’s just white people. I get that’s not technically in the afterward, but it’s in the denouement of the book and I felt like we really needed to address it somewhere.

And For Next Month’s Book: 1984 by George Orwell

I’ve been avoiding it because I know it’s going to make me really, really upset. But y’all. I think it’s time. I think it’s time to do it. I think it’s time to read 1984

A.E. Osworth is Geekery Editor at Autostraddle, Managing Editor at Barnard Center for Research On Women’s Scholar and Feminist Online, and Part-Time Faculty at The New School, where they teach digital storytelling. They're writing a novel about GamerGate, which is really depressing. Follow them on Twitter or on Instagram.