For almost a decade, an epidemic has swept silently through America, affecting major cities, small towns and rural areas alike. In 2015, respected author Sam Quinones published “Dreamland,” a book that chronicled the spread of opioids throughout the country. The book went a long way toward yanking this deadly issue from out of the darkness.
This past week, Quinones visited Ohio University and the community at large to speak to students, faculty, health-care providers and the general public about combating the opioid epidemic that has swept through southeast Ohio and the rest of the country.
The series of talks and forums was presented by OU’s College of Health Science Professionals in conjunction with OhioHealth. They included a Grover Lecture Wednesday at the OU Walter Rotunda, a faculty/student forum after that lecture, a community discussion at Nelsonville-York High School Wednesday evening, and a forum for frontline professionals Friday morning at the Athens Community Center.
One of the main issues Quinones addressed while in Athens and Nelsonville was the way that health-care professionals manage pain, noting that the majority of heroin addicts started on prescription painkillers such as OxyContin, Vicodin and Percocet, then switched to cheaper black-market heroin once they were addicted.
“I have met very, very few people who got involved with heroin that did not start with the pills first,” he said in an interview on Thursday. “Overprescribing of pain pills is how people get into that mostly.”
Though mainstream media often focus on heroin, Quinones believes the root of the issue is in highly potent prescription painkillers, which are often prescribed in large quantities.
“That’s creating more addicts and thus more demand [for heroin],” he said.
The opioid crisis has battered Cincinnati, Columbus and other big Ohio cities, but according to Quinones, small towns have taken a harder hit.
“A lot of these towns have serious economic problems and don’t have the resources to deal with it,” he said.
In Athens County, a taskforce called Athens HOPE (Halting Opioid Abuse Through Prevention and Education) was recently formed to educate people on opioids and addiction.
Another southern Ohio community that has been greatly affected by opioids is Portsmouth in Scioto County, which is where Quinones’s book, “Dreamland,” got its title.
Dreamland was the name of a public pool that served as the community center for Portsmouth, until a hurting economy dragged the city into pill addiction, heroin, and eventually the crisis that persists today.
Since his book was published in 2015, Quinones has seen more public advocacy, media attention and government intervention targeting the opioid epidemic.
“When I started, I didn’t think anybody cared,” Quinones said. Media coverage of opioids, whether prescription painkillers or black-tar heroin, was almost non-existent, he said.
But “Dreamland”’s publication had a major impact on public awareness. “What you’re seeing now, in the two and half years since the book has come out, is lots and lots of people being affected, and you’re seeing them be more vocal about it,” Quinones said.
Although public awareness has increased, the landscape of the drug world has changed since “Dreamland” was published.
To complicate mattes, according to Quinones, a new, more potent drug has emerged on the black market: fentanyl.
Fentanyl is a synthetic opioid that can be manufactured without the opium poppy that is typically used to make heroin. It can be 50-100 times more potent than heroin, according to the federal Drug Enforcement Administration.
“You got pills first, and then people transition to heroin because it’s cheaper and readily available. Now the black market has kind of said, ‘Instead of heroin we’re going to give you fentanyl because its so much cheaper for us,’” Quinones said.
In Ohio alone, some 2,357 overdose deaths involved fentanyl in 2016, according to the Ohio Health Department. Since 2011, that number has seen more than a 3,000 percent increase.
Before writing “Dreamland,” Quinones worked as a reporter in his hometown of Los Angeles.
“When I came to the L.A. Times and I was put on a team of reporters to work on the drug-trafficking wars in Mexico. That’s when I began to write about it and try to understand it and learn a lot of the history,” he said.
Since publication of “Dreamland,” which was awarded the National Book Critics Circle Award in 2015, Quinones said he has seen more attention gravitate to this issue from the public, the media and government officials throughout the country.