Dreamland Summary

1-Sentence-Summary: Dreamland blows open the story of the United States’ opioid crisis, from the frustrating greed and oversight that created it, how drug dealers accelerated it’s spread, and what we’re doing now to stop it.

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Everyone knows that the opiate crisis in the United States is serious. Even the top leaders of the country, including President Donald Trump, are aware of it. And yet it’s still here, threatening people’s lives and society as a whole.

To call it an epidemic seems an understatement almost. But that’s just the title that the US Drug Enforcement Administration, back in 2015, used to describe overdose deaths, particularly from heroin and prescription drugs.

Interestingly, this problem seems to only be limited to America. Although that’s not a huge surprise when you consider the country’s outlook on science, crime, the media, poverty, addiction, and especially health care.

Where did it all go wrong and what is being done to curb the devastating effects of this epidemic? You’ll find these answers and more in Sam QuinonesDreamland: The True Tale of America’s Opiate Epidemic.

Here are just 3 of the many mind-blowing lessons I’ve learned from this book:

  1. OxyContin is a small pill that’s had a significant impact on the opiate crisis.
  2. The statistics surrounding this epidemic are grim.
  3. Many affected by opiate addiction have been suffering in silence for decades, but some are finally speaking out and making a difference.

Let’s dive right in and see what Dreamland has to teach us!

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Lesson 1: The massive opiate crisis is a result of deception and greed around one small pill called OxyContin.

Although the widespread effects of this dilemma are obvious now, it began slowly back in the 1980s. 

It was 1984 when a drug company named Purdue came out with MS Contin, a morphine-based, time-release pain treatment pill. While it was originally for people on their death beds or those just out of surgery, it’s success soon got Purdue carried away.

In 1996, the company released a similar pill by the now infamous name of OxyContin. Its active ingredient was the opium derivative called oxycodone, which is similar to heroin. 

The company again touted the pill’s time-release technology. Purdue got the FDA to approve the drug on the belief that this mechanism would limit addiction by restricting the highs and lows that opiates normally brought.

This became the hallmark of Purdue’s marketing tactics for OxyContin, bringing wild success.

Lurking underneath, however, was a lot of bad science. For one, the perceived addiction rates were so low because it was only used for testing in controlled hospital conditions instead of by the doctors outside hospitals that the company marketed the drug to.

What’s worse, one doctor who was simply compiling a hospital database found some information that would be misconstrued for years. Looking at the roughly 12,000 patients, he noticed only four developed painkiller addictions.

After publishing the finding in a short paragraph in the New England Journal of Medicine, the information spread like cancer. Some even mistakenly called it a “landmark study.”

It wasn’t long before the crisis was in full swing, only for drug dealers to make it worse.

Lesson 2: Grim statistics are just one marker of the awful effect this epidemic is having on individuals and families.

By the time 2000 rolled around the opiate crisis was in full swing. Of the roughly 100 million Americans suffering from chronic pain, almost all of them were on opiates of some kind. 

Of the world’s entire supply of oxycodone, the US alone was consuming 86%. And the use of hydrocodone, another opiate, was up to 99% and the most prescribed individual drug in the country.

Still today there are about 136 million prescriptions for these kinds of drugs every year.

Along with a rise in prescriptions has also come a rise in recreational use as well. From 2002 to 2011 alone, 25 million Americans consumed prescription pills in a way other than their intended use. 

And the age at which people were abusing these drugs was dropping, too. According to the 2010 National Survey on Drug Use and Health, 2.4 million people 12 years old and up had consumed prescription pills nonmedically for the first time in the previous year.

Deaths from overdose have shot up as well. In 1999 a normal average was just 10 a day, but by 2012 the number was up to 48, almost five times higher.

What’s worse, just 10 years after OxyContin was first prescribed, 6.1 million United States citizens had abused it. That’s 2.4% of the entire population, or one in 40 people!

Lesson 3: Although many have suffered from this crisis, some are beginning to take a stand against it and are making changes happen.

Sadly, these issues have been happening for decades but the only real change has come in the last few years. With over 16,000 fatal overdoses yearly, it’s a wonder that there weren’t more than only a few groups raise awareness of this issue.

There is hope, though, and we’re beginning to make progress.

Jo Anna Krohn’s story is just one horrific example of the effects of this epidemic on families. Her son was playing with a gun while high on OxyCodone and shot himself.

As he was dying in a hospital bed, Krohn committed to using her voice to speak up about this issue. Her hope was that she might be able to spare another family from the pain she was going through.

She later began SOLACE to help parents grieving the deaths of their children who died of opiates. With her efforts, it quickly grew to have chapters in 16 counties.

Brad Belcher is another who has worked to raise awareness. After having been sober for five years, he decided to plaster signs all over his town that read “HEROIN IS MARION’S ECONOMY”. 

Although the authorities got ahold of most of the signs the night he put them up, enough remained that a picture of one made its way onto the internet. The image went viral and the town finally admitted it had to act. 

While we’re far from done with this epidemic, awareness is increasing and hopefully one day it will be over.

Dreamland Review

Wow, Dreamland unexpectedly had me on the edge of my seat while reading it! This story is crazy and disappointing and enraging all at the same time. I’m glad we’re starting to get control of this epidemic and feel for all the individuals and families who have had to suffer for the laziness and greediness of a few pill manufacturers.

Who would I recommend the Dreamland summary to?

The 64-year-old European that doesn’t understand the United States’ opiate issues, the 34-year-old who is just beginning their career in the medical field, and anyone that wants to become more aware of the devastating effects of OxyContin and other pain pills.

Last Updated on September 19, 2022

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Luke Rowley

With over 450 summaries that he contributed to Four Minute Books, first as a part-time writer, then as our full-time Managing Editor until late 2021, Luke is our second-most prolific writer. He's also a professional, licensed engineer, working in the solar industry. Next to his day job, he also runs Goal Engineering, a website dedicated to achieving your goals with a unique, 4-4-4 system. Luke is also a husband, father, 75 Hard finisher, and lover of the outdoors. He lives in Utah with his wife and 3 kids.