As a 43 year old man working in public education I end up in many conversations that begin with “kids today….” Undoubtedly the person I am talking with is describing how the current generation of teenagers is somehow not as well behaved as “our” generation was. What’s interesting is that our internal survey data does not show that. Actually our internal survey data shows that students today participate in less risky behaviors than students of previous generations did. They’re more discerning and show better judgment. Certainly some things have changed over the past 20 years. For one, our recent survey data shows that our students believe that marijuana use is more acceptable and less risky than is cigarette usage. This surprised me but it probably shouldn’t have as national norms have certainly shifted here. And then there is heroin. Our community, like every community in Ohio, has been hit by heroin. Often I’m asked the question, “How did we get to this point? What would make a teenager try heroin?” These are legitimate questions and if you really want to know the answers you need to read Dreamland by Sam Quinones.
“At least 300,000 Americans use heroin, according to the latest statistics. From 2010 to 2013, the number of deaths from overdoses tripled from 3,036 to 8,257. Not coincidentally, since 1999 the number of prescription painkillers prescribed and sold in the United States has quadrupled, although incidents of chronic pain have not. Heroin use thrives on a disturbing symbiosis with painkiller addiction: 3 out of 4 new heroin users have reported they had previously abused prescription painkillers.
And these twin addictions have spread in places one wouldn’t expect: Ohio, West Virginia, Kentucky, Tennessee. The face of opiate addiction is no longer the inner-city homeless or actors in Greenwich Village. It’s suburban white kids in Columbus, soccer moms in Nashville, rural men in West Virginia.
For decades US pharmaceutical companies had been trying to create a non-addictive drug that could effectively control chronic pain. The 1995 FDA approval of Oxycontin, a drug almost chemically identical to heroin, occurred when insurance companies were increasingly reluctant to cover long-term treatment of chronic pain via effective but expensive techniques such as physical therapy and counseling. Purdue Pharma, which owned the patent to Oxycontin, reassured everyone it was non-addictive. When the company sales representatives cited non-existent studies demonstrating that Oxycontin could be used safely to treat chronic pain, doctors were all too willing to listen. Soon patients were hooked. People who didn’t suffer chronic pain but had heard about Oxycontin’s effects were eager to try it. And retirees who could get prescriptions began selling the pills to supplement their retirement income. Scams for getting and selling the drug multiplied.
Then the Xalisco Boys came to town. One of the finest narrative and journalistic accomplishments in this book is Quinones’s portrait of this drug-dealing network whose members are both business paragons and criminal geniuses. They all come from a poppy-growing region of Northwest Mexico and sell black tar heroin, which is cheap, potent, and easy to make. Their dealers are paid a salary, so they have no incentive to dilute their product to maximize sales. Since violence almost always draws the attention of cops, the dealers seldom carry guns. And since police and the press like big drug busts, large quantities of heroin in one location or with one dealer are rare. And they have a customer service ethos that matches Apple’s or Trader Joe’s, along with a delivery policy similar in spirit to “Domino’s 30 minutes or less:” Did a customer feel overcharged? Was the driver late? You’ll get free extra heroin next time. Was a driver unfriendly? Expect an apologetic phone call from his boss.
The Xalisco Boys also multiplied their return on investment in superior product and customer service by seeking out territories where there were no competitors. They avoided the American Southwest and the biggest cities, which were overflowing with drug dealers. The untapped markets were in places like the dying industrial Midwest, where members of families deep in second-generation unemployment were desperate for something that would make them feel like (in the words of one drug user) “king of the world.” They had already discovered Oxycontin and doctors who would write a prescription without asking questions. And if that doctor got caught, the Xalisco Boys were ready to step in with a product that gave the same high. And no more waiting in line at the pharmacy: The Xalisco Boys delivered.”
This is the story of how opiate addiction spread and it’s something we all should read. Please pass the word.
- Trent Bowers, Superintendent