Dreamland: The True Tale of America’s Opiate Epidemic. By Sam Quinones. Bloomsbury; 368 pages; $28 and £18.99.
AMERICA is battling a massive epidemic of heroin and its pharmacological substitutes. By 2008 drug overdoses, mostly from opioids, overtook car crashes as the leading cause of accidental death. In a related development, the number of annual users of heroin jumped from 370,000 in 2007 to 680,000 in 2013.
The epidemic, as Sam Quinones, an American journalist, outlines in “Dreamland”, a meticulously researched new book, has two root causes. One is a failure of regulation in the pharmaceutical industry; the other is retail innovation in the black market.
In 1995 Purdue Pharma, a drug company in Stamford, Connecticut, was given permission by the Food and Drug Administration to market a powerful new opioid called OxyContin for moderate pain. Doctors, wary about prescribing opioids because of their markedly addictive nature, had previously used it for severe pain only. Many patients duly became addicts and “pill mills”, pain clinics that handled...
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