Sam Quinones > Quotes

“The front of the brain has to develop through mistakes. But the first reaction of the addicted person is to head back to the family: ‘Will you rescue me?’ Whatever the person’s rescued from, there’s no learning. There’s no experiences, no frontal brain development. They’re doing well and then some idea comes into their head and they’re off a cliff. It may not be a decision to use. Most relapse comes not from the craving for the drug. It comes from this whole other level of unmanageability, putting myself in compromising situations, or being dishonest, being lazy—being a fifteen-year-old.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Through all this, patients were getting used to demanding drugs for treatment. They did not, however, have to accept the idea that they might, say, eat better and exercise more, and that this might help them lose weight and feel better. Doctors, of course, couldn’t insist. As the defenestration of the physician’s authority and clinical experience was under way, patients didn’t have to take accountability for their own behavior.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“The U.S. medical system is good at fighting disease, Cahana believes, and awful at leading people to wellness.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“After more than a decade in which chronic pain was treated with highly addictive medicine, there still was no attempt to bring the studies of pain and addiction together. Specialists in pain and in addiction operated in different worlds.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“2008:  Drug overdoses, mostly from opiates, surpass auto fatalities as leading cause of accidental death in the United States.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“In heroin addicts, I had seen the debasement that comes from the loss of free will and enslavement to what amounts to an idea: permanent pleasure, numbness, and the avoidance of pain. But man’s decay has always begun as soon as he has it all, and is free of friction, pain, and the deprivation that temper his behavior.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Yes the fact was that, coincidentally or not, this change of heart was happening among conservatives just as opiate addiction was spreading among both rural and middle-class white kids across the country, though perhaps most notably in the deepest red counties and states. Drug enslavement and death, so close at hand, were touching the lives, and softening the hearts, of many Republican lawmakers and constituents. I’ll count this as a national moment of Christian forgiveness. But I also know that it was a forgiveness that many of these lawmakers didn’t warm to when urban crack users were the defendants. Let’s just say that firsthand exposure to opiate addiction can change a person’s mind about a lot of things. Many of their constituents were no longer so enamored with that “tough on crime” talk now that it was their kids who were involved. So a new euphemism emerged—“smart on crime”—to allow these politicians to support the kind of rehabilitation programs that many of them had used to attack others not so long ago.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“If a child was sick, maybe her mother was tense. Valium was marketed above all to women, pitched as way of bearing the stress of lives as wives and mothers. Before the feminist movement, women were presumed to need that kind of help for the rest of their lives, thus there was no worry then about its addictiveness.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“The morphine molecule exerts an analogous brainwashing on humans, pushing them to act contrary to their self-interest in pursuit of the molecule. Addicts betray loved ones, steal, live under freeways in harsh weather, and run similarly horrific risks to use the molecule. It became the poster molecule for an age of excess. No amount of it was ever enough. The molecule created ever-higher tolerance. Plus, it had a way of railing on when the body gathered the courage to throw it out. This wasn’t only during withdrawals. Most drugs are easily reduced to water-soluble glucose in the human body, which then expels them. Alone in nature, the morphine molecule rebelled. It resisted being turned into glucose and it stayed in the body. “We still can’t explain why this happens. It just doesn’t follow the rules. Every other drug in the world—thousands of them—follows this rule. Morphine doesn’t,” Coop said. “It really is almost like someone designed it that way—diabolically so.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Like no other particle on earth, the morphine molecule seemed to possess heaven and hell. It allowed for modern surgery, saving and improving too many lives to count. It stunted and ended too many lives to count with addiction and overdose. Discussing it, you could invoke some of humankind’s greatest cultural creations and deepest questions: Faust, Dr. Jekyll and Mr. Hyde, discussions on the fundamental nature of man and human behavior, of free will and slavery, of God and evolution. Studying the molecule you naturally wandered into questions like, Can mankind achieve happiness without pain? Would that happiness even be worth it? Can we have it all?”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“OxyContin is a simple pill. It contains only one drug: oxycodone, a painkiller that Germans synthesized in 1916 from thebaine, an opium derivative. Molecularly, oxycodone is similar to heroin.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“The number of Ohioans dead from drug overdoses between 2003 and 2008 was 50 percent higher than the number of U.S. soldiers who died in the entire Iraq War.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“We can talk morality all day long, but if you’re drawing five hundred dollars a month and you have a Medicaid card that allows you to get a monthly supply of pills worth several thousand dollars, you’re going to sell your pills.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Oxy prescriptions for chronic pain rose from 670,000 in 1997 to 6.2 million in 2002.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Drug overdoses passed fatal vehicle accidents nationwide for the first time in 2008.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“After kicking opiates, “it takes two years for your dopamine receptors to start working naturally,” Paul”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“With the managed care movement of the 1980s and 1990s, insurance companies cut costs and reduced what services they’d pay for. They required that patients give up their longtime physicians for those on a list of approved providers. They negotiated lower fees with doctors. To make up the difference, primary care docs had to fit more patients into a day. (A Newsweek story claimed that to do a good job a primary care doctor ought to have a roster of eighteen hundred patients. The average load today is twenty-three hundred, with some seeing up to three thousand.)”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Children of the most privileged group in the wealthiest country in the history of the world were getting hooked and dying in almost epidemic numbers from substances meant to, of all things, numb pain. “What pain?” a South Carolina cop asked rhetorically one afternoon as we toured the fine neighborhoods south of Charlotte where he arrested kids for pills and heroin. Crime was at historic lows, drug overdose deaths at record highs. A happy façade covered a disturbing reality. I grew consumed by this story.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Overdose deaths involving opiates rose from ten a day in 1999 to one every half hour by 2012. Abuse of prescription painkillers was behind 488,000 emergency room visits in 2011, almost triple the number of seven years before.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“A pill mill was a pain-management clinic, staffed by a doctor with little more than a prescription pad. A pill mill became a virtual ATM for dope as the doctor issued prescriptions to hundreds of people a day.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“These drugs were advertised mostly to primary care physicians, who had little pain-management training and were making their money by churning patients through their offices at a thirteen-minute clip.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Valium was marketed above all to women, pitched as way of bearing the stress of lives as wives and mothers. Before the feminist movement, women were presumed to need that kind of help for the rest of their lives, thus there was no worry then about its addictiveness.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“trick, though. Treatment has always been more effective and cheaper than prison for true drug addicts. What’s changed, Norman said, is that no longer are most of the accused African American inner-city crack users and dealers. Most of the new Tennessee junkies come from the white middle and upper-middle classes, and from the state’s white rural heartland—people who vote for, donate to, live near, do business with, or are related to the majority of Tennessee legislators.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Most of the country’s hundred million chronic-pain patients were now receiving opiate painkillers,”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“Every patient who was prescribed the drug stood a chance of soon needing it every day. These people were willing to pay cash. They never missed an appointment. If diagnosis wasn’t your concern, a clinic was a low-overhead operation: a rented building, a few waiting rooms, some office staff. And bouncers. These clinics did require bouncers.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“The Press Ganey patient surveys, it turned out, had an unintended effect in this context. It was to subtly pressure doctors to write unnecessary scripts for opiates. A doctor reluctant to write them was more likely to get a poor patient evaluation. Too many bad scores and a hospital began asking questions.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“But across America, thousands of people like Matt Schoonover were dying. Drug overdoses were killing more people every year than car accidents.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“The cost savings weren’t what did the trick, though. Treatment has always been more effective and cheaper than prison for true drug addicts. What’s changed, Norman said, is that no longer are most of the accused African American inner-city crack users and dealers. Most of the new Tennessee junkies come from the white middle and upper-middle classes, and from the state’s white rural heartland—people who vote for, donate to, live near, do business with, or are related to the majority of Tennessee legislators.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“They demanded legal clarity. So, beginning with California, states passed laws exempting doctors from prosecution if they prescribed opiates for pain within the practice of responsible health care. Numerous states approved so-called intractable pain regulations: Ohio, Oregon, Washington, and others. Soon what can only be described as a revolution in medical thought and practice was under way. Doctors were urged to begin attending to the country’s pain epidemic by prescribing these drugs. Interns and residents were taught that these drugs were now not addictive, that doctors thus had a mission, a duty, to use them. In some hospitals, doctors were told they could be sued if they did not treat pain aggressively, which meant with opiates. Russell”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic

“We overtest, perform surgery, stick needles; these people are worse off,” he said. “If we work on their nutrition, diet, sleep habits, smoke habits, helping [them] find work—then they improve.”
― Sam Quinones, Dreamland: The True Tale of America's Opiate Epidemic