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The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth
Apple Best Books of 2021 Longlisted for the Andrew Carnegie Medal * Shortlisted for the Zocalo Book Prize From the New York Times bestselling author of Dreamland, a searing follow-up that explores the terrifying next stages of the opioid epidemic and the quiet yet ardent stories of community repair. Sam Quinones traveled from Mexico to main streets across the U.S. to create Dreamland, a groundbreaking portrait of the opioid epidemic that awakened the nation. As the nation struggled to put back the pieces, Quinones was among the first to see the dangers that lay synthetic drugs and a new generation of kingpins whose product could be made in Magic Bullet blenders. In fentanyl, traffickers landed a painkiller a hundred times more powerful than morphine. They laced it into cocaine, meth, and counterfeit pills to cause tens of thousands of deaths-at the same time as Mexican traffickers made methamphetamine cheaper and more potent than ever, creating, Sam argues, swaths of mental illness and a surge in homelessness across the United States. Quinones hit the road to investigate these new threats, discovering how addiction is exacerbated by consumer-product corporations. “In a time when drug traffickers act like corporations and corporations like traffickers,” he writes, “our best defense, perhaps our only defense, lies in bolstering community.” Amid a landscape of despair, Quinones found hope in those embracing the forgotten and ignored, illuminating the striking truth that we are only as strong as our most vulnerable. Weaving analysis of the drug trade into stories of humble communities, The Least of Us delivers an unexpected and awe-inspiring response to the call that shocked the nation in Sam Quinones's award-winning Dreamland.
408 pages, Kindle Edition
First published November 2, 2021
635 people are currently reading
11635 people want to read
About the author
Sam Quinones
16 books539 followersSam Quinones is a long-time journalist and author of 3 books of narrative nonfiction.
He worked for the LA Times for 10 years. He spent 10 years before that as a freelance journalist in Mexico.
His first book is True Tales from Another Mexico: The Lynch Mob, the Popsicle Kings, Chalino and the Bronx, published in 2001, a collection of nonfiction stories about drag queens, popsicle-makers, Oaxacan basketball players, telenovela stars, gunmen, migrants, and slain narco-balladeer, Chalino Sanchez.
In 2007, he published Antonio's Gun and Delfino's Dream: True Tales of Mexican Migration. In this volume he tells stories of the Henry Ford of velvet painting, opera singers in Tijuana, the Tomato King of Jerez, Zacatecas, the stories of a young construction worker heading north, and Quinones' own encounter with the narco-Mennonites of Chihuahua.
His third book was released in 2015. Dreamland: the True Tale of America's Opiate Epidemic recounts twin tales of drug market in the 21st Century. A pharmaceutical company markets its new painkiller as "virtually nonaddictive" just as heroin traffickers from a small town in Mexico devise a system of selling heroin retail, like pizza. The result is the beginning of America's latest drug scourge, and the resurgence of heroin across the country.
The book has received rave reviews in Salon.com, Christian Science Monitor, Wall Street Journal, American Conservative, Kirkus Review, and National Public Radio.
Amazon readers gave Dreamland 4.7 stars and called it "a masterpiece" and "a thriller."
"I couldn't put it down," said one. Said another: "This book tells one of the most important stories of our time."
Following Antonio's Gun, the San Francisco Chronicle called Quinones "the most original American writer on Mexico and the border out there."
He has done numerous Skype sessions with book groups that have chosen his books to read.
Quinones also writes True Tales: A Reporter's Blog, at his website, http://www.samquinones.com.
For several years, he has given writing workshops called Tell Your True Tale. Most recently the workshops have taken place at East Los Angeles Public Library, from which have emerged three volumes of true stories by new authors from the community.
For more information, go to http://www.colapublib.org/tytt/.
He worked for the LA Times for 10 years. He spent 10 years before that as a freelance journalist in Mexico.
His first book is True Tales from Another Mexico: The Lynch Mob, the Popsicle Kings, Chalino and the Bronx, published in 2001, a collection of nonfiction stories about drag queens, popsicle-makers, Oaxacan basketball players, telenovela stars, gunmen, migrants, and slain narco-balladeer, Chalino Sanchez.
In 2007, he published Antonio's Gun and Delfino's Dream: True Tales of Mexican Migration. In this volume he tells stories of the Henry Ford of velvet painting, opera singers in Tijuana, the Tomato King of Jerez, Zacatecas, the stories of a young construction worker heading north, and Quinones' own encounter with the narco-Mennonites of Chihuahua.
His third book was released in 2015. Dreamland: the True Tale of America's Opiate Epidemic recounts twin tales of drug market in the 21st Century. A pharmaceutical company markets its new painkiller as "virtually nonaddictive" just as heroin traffickers from a small town in Mexico devise a system of selling heroin retail, like pizza. The result is the beginning of America's latest drug scourge, and the resurgence of heroin across the country.
The book has received rave reviews in Salon.com, Christian Science Monitor, Wall Street Journal, American Conservative, Kirkus Review, and National Public Radio.
Amazon readers gave Dreamland 4.7 stars and called it "a masterpiece" and "a thriller."
"I couldn't put it down," said one. Said another: "This book tells one of the most important stories of our time."
Following Antonio's Gun, the San Francisco Chronicle called Quinones "the most original American writer on Mexico and the border out there."
He has done numerous Skype sessions with book groups that have chosen his books to read.
Quinones also writes True Tales: A Reporter's Blog, at his website, http://www.samquinones.com.
For several years, he has given writing workshops called Tell Your True Tale. Most recently the workshops have taken place at East Los Angeles Public Library, from which have emerged three volumes of true stories by new authors from the community.
For more information, go to http://www.colapublib.org/tytt/.
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March 7, 2022
I have been working as a therpaist in addiction recovery in Los Angeles for the past decade.
I began my career working in a methadone clinic in South LA.
The clinic was mostly African American and Latinx elders, many of whom began using heroin in the 1970’s and 80’s.
Around 2013, the demographics of the clinic began to change abruptly, as young white kids started pouring in from all over the country.
I remember a flyer circulating around the clinic warning the clients about a batch of dope that was going around LA that had fentanyl in it.
That was the first time I heard about fentanyl.
My boss informed me that it had killed hundreds of people in Chicago a few years prior, and he was really concerned for the safety of the community.
Shortly there after, I started working at a residential treatment center in West Hollywood.
Over the next year or two, meth and fentanyl were suddenly everywhere.
The young gay men in the clinic were getting pulled into the death trap of meth fueled grinder hookups known as chemsex.
Scores of other young people became hopelessly ensnared in shooting meth and fentanyl together.
A death sport known colloquially as goof-balling.
People were dying left and right.
It was devastating.
Here we are, a decade into the opioid epidemic, and the situation is escalating well beyond what anyone could have imagined ten years ago.
The Least Of Us is author Sam Quinones’s investigation of how precisely all of this came to be.
Quinones’s previous book Dream Land chronicling the first wave of the opioid epidemic, traced the influx of strong, inexpensive heroin to a relatively small group in Mexico, and linked it all to the prescription opioid debacle that we’re only recently getting to the bottom of.
The Least Of Us picks up where Dream Land left off, and explains how and why literal tons of even cheaper, even more deadly fentanyl and “super meth” are flooding into America.
According to Quinones. Early efforts to quell meth production focused on limiting access to ephedrine, a key ingredient in homemade meth labs. That’s why CVS keeps that shit under lock and key and asks for your ID when you buy cold and allergy medications with ephedrine in it.
More recent meth production methods bypasses the need for ephedrine via a chemical compound known as P2P, which incidentally makes it cheaper, easier and safer to produce in large batches.
The good old fashioned meth made with ephedrine was primarily D-Methamphetamine (D-MAMP).
D-MAMP elicits the energized euphoria sought after by recreational users.
The new P2P methods produce a variant refered to as L-methamphetamine (L-MAMP), which almost exclusively elicits the severe schizophrenia type psychosis previously mentioned.
P2P MAMP and Fentanyl are being made from wholesale chemicals produced in China, and assembled in Mexico just outside the boarder.
It’s easy to disguise and transport.
I recently saw a news story about a bust that found hundreds of pounds of meth pressed into the shape of onions coming across the boarder as if it were a shipment of produce.
It’s dirt cheap.
And it’s everywhere.
It’s global capitalism’s chickens coming home to roost.
And knowing how hard it is to recover from that situation.
I’m very afraid we are nearing the point of no return.
This is a really good book.
Quinones does it again.
Crucial read.
5/5 stars.
I began my career working in a methadone clinic in South LA.
The clinic was mostly African American and Latinx elders, many of whom began using heroin in the 1970’s and 80’s.
Around 2013, the demographics of the clinic began to change abruptly, as young white kids started pouring in from all over the country.
I remember a flyer circulating around the clinic warning the clients about a batch of dope that was going around LA that had fentanyl in it.
That was the first time I heard about fentanyl.
My boss informed me that it had killed hundreds of people in Chicago a few years prior, and he was really concerned for the safety of the community.
Shortly there after, I started working at a residential treatment center in West Hollywood.
Over the next year or two, meth and fentanyl were suddenly everywhere.
The young gay men in the clinic were getting pulled into the death trap of meth fueled grinder hookups known as chemsex.
Scores of other young people became hopelessly ensnared in shooting meth and fentanyl together.
A death sport known colloquially as goof-balling.
People were dying left and right.
It was devastating.
Here we are, a decade into the opioid epidemic, and the situation is escalating well beyond what anyone could have imagined ten years ago.
The Least Of Us is author Sam Quinones’s investigation of how precisely all of this came to be.
Quinones’s previous book Dream Land chronicling the first wave of the opioid epidemic, traced the influx of strong, inexpensive heroin to a relatively small group in Mexico, and linked it all to the prescription opioid debacle that we’re only recently getting to the bottom of.
The Least Of Us picks up where Dream Land left off, and explains how and why literal tons of even cheaper, even more deadly fentanyl and “super meth” are flooding into America.
According to Quinones. Early efforts to quell meth production focused on limiting access to ephedrine, a key ingredient in homemade meth labs. That’s why CVS keeps that shit under lock and key and asks for your ID when you buy cold and allergy medications with ephedrine in it.
More recent meth production methods bypasses the need for ephedrine via a chemical compound known as P2P, which incidentally makes it cheaper, easier and safer to produce in large batches.
The good old fashioned meth made with ephedrine was primarily D-Methamphetamine (D-MAMP).
D-MAMP elicits the energized euphoria sought after by recreational users.
The new P2P methods produce a variant refered to as L-methamphetamine (L-MAMP), which almost exclusively elicits the severe schizophrenia type psychosis previously mentioned.
P2P MAMP and Fentanyl are being made from wholesale chemicals produced in China, and assembled in Mexico just outside the boarder.
It’s easy to disguise and transport.
I recently saw a news story about a bust that found hundreds of pounds of meth pressed into the shape of onions coming across the boarder as if it were a shipment of produce.
It’s dirt cheap.
And it’s everywhere.
It’s global capitalism’s chickens coming home to roost.
And knowing how hard it is to recover from that situation.
I’m very afraid we are nearing the point of no return.
This is a really good book.
Quinones does it again.
Crucial read.
5/5 stars.
November 8, 2021
The Least of Us: True Tales True Tales of America and Hope in the time of Fentanyl and Meth (2021) is the incisive follow-up to Dreamland: The True Tale of America’s Opiate Epidemic (2015) written by bestselling award-winning author Sam Quinones, who is recognized for his compelling storytelling narratives in investigative journalism.
Staggering amounts of cheaply manufactured Mexican crystal methamphetamine “P2P” are smuggled into the US that flood American streets across the nation. The new synthetic chemical compounds are highly addictive, toxic, and corrosive. Virtually anyone can order the chemicals on the internet from internationally operated Chinese labs.
Unlike the black tar heroin or the ephedrine meth, the “Shake and Bake” derived from farming the soil provided addicts with a euphoric high. The new drug, P2P, has entirely eliminated the concept of recreational drug use, easing the pain of withdrawal until the next dose. The symptoms that addict’s eventually exhibit seem similar to people with SMI's (serious mental illness): schizophrenia, extreme paranoia, hallucinations, fixation and hoarding of useless junk. Rehab counselors report that many addicts are impaired by brain damage that leave them devoid of personality, unable to eat, speak, or comprehend situations around them. The story of Starla Hope Hoss (1986-2019) is relatable to such observations: Starla was cared for in an Elizabethton, Tennessee nursing facility in a permanent vegetative state after a near fatal overdose. The daughter she delivered afterward was adopted by Angie Odom (and her husband), a social worker that ran a homeless shelter.
Comparisons between the Sackler’s and Purdue Pharma that made billions of USD grossly profiteering from the sales of OxyContin and the Mexican drug trafficking operations are extremely slim. The “Oxy Sackler’s” were connected to the “era of opioids” and responsible for the aggressive marketing techniques that targeted overworked physicians and nurse practitioners pressuring them heavily prescribe Oxy without considering the consequences that left millions of Americans addicted to Purdue's opioid substances. The Sackler’s have denied any responsibility, and blamed addicted individuals for their affliction. Over 500,000 Americans have died from opioid related conditions since 1999.
Courageous individuals join the fight against addiction and are restructuring their communities with outreach and new business: from Bakersfield California, to Muncie Indiana, to Portsmouth Ohio. Lou Ortenzio, a physician from Clarksburg, W. Virginia lost his license to practice medicine due to addiction, and is currently invested in helping addicts. Rashad Martin, from Columbus Ohio, currently incarcerated, gave away his drug money to help needy families in his community. The new drug courts are designed to quickly separate clients from their drugs freeing them from the torment of addiction. Everything from the Covid 19 pandemic, to Black Lives Matter, force examination of our individualism in American culture and how we relate to others in an “equally impolite fashion” according to Quinones; and we must consider our most vulnerable people as we share in any measure of success.
Staggering amounts of cheaply manufactured Mexican crystal methamphetamine “P2P” are smuggled into the US that flood American streets across the nation. The new synthetic chemical compounds are highly addictive, toxic, and corrosive. Virtually anyone can order the chemicals on the internet from internationally operated Chinese labs.
Unlike the black tar heroin or the ephedrine meth, the “Shake and Bake” derived from farming the soil provided addicts with a euphoric high. The new drug, P2P, has entirely eliminated the concept of recreational drug use, easing the pain of withdrawal until the next dose. The symptoms that addict’s eventually exhibit seem similar to people with SMI's (serious mental illness): schizophrenia, extreme paranoia, hallucinations, fixation and hoarding of useless junk. Rehab counselors report that many addicts are impaired by brain damage that leave them devoid of personality, unable to eat, speak, or comprehend situations around them. The story of Starla Hope Hoss (1986-2019) is relatable to such observations: Starla was cared for in an Elizabethton, Tennessee nursing facility in a permanent vegetative state after a near fatal overdose. The daughter she delivered afterward was adopted by Angie Odom (and her husband), a social worker that ran a homeless shelter.
Comparisons between the Sackler’s and Purdue Pharma that made billions of USD grossly profiteering from the sales of OxyContin and the Mexican drug trafficking operations are extremely slim. The “Oxy Sackler’s” were connected to the “era of opioids” and responsible for the aggressive marketing techniques that targeted overworked physicians and nurse practitioners pressuring them heavily prescribe Oxy without considering the consequences that left millions of Americans addicted to Purdue's opioid substances. The Sackler’s have denied any responsibility, and blamed addicted individuals for their affliction. Over 500,000 Americans have died from opioid related conditions since 1999.
Courageous individuals join the fight against addiction and are restructuring their communities with outreach and new business: from Bakersfield California, to Muncie Indiana, to Portsmouth Ohio. Lou Ortenzio, a physician from Clarksburg, W. Virginia lost his license to practice medicine due to addiction, and is currently invested in helping addicts. Rashad Martin, from Columbus Ohio, currently incarcerated, gave away his drug money to help needy families in his community. The new drug courts are designed to quickly separate clients from their drugs freeing them from the torment of addiction. Everything from the Covid 19 pandemic, to Black Lives Matter, force examination of our individualism in American culture and how we relate to others in an “equally impolite fashion” according to Quinones; and we must consider our most vulnerable people as we share in any measure of success.
November 8, 2021
This is a book every American should read whether they live in cities being overrun by the homeless on meth or opioids or whether they live in the country where much the same phenomenon is occurring. Sam Quinones's The Least of Us: True Tales of America and Hope in the Age of Fentanyl and Meth tells of a pernicious infestation of Americans by opioids (now frequently laced with fentanyl) and meth.
Sam Quinones is a Los Angeles based journalist who is known for his reportage on opioids and Mexicans in the US. This book has just been released, and I predict it will send shock waves across the country.
One problem I have seen over and over again is just how to describe the problem of homelessness. People act as if we found some housing for most of the homeless, they would gladly abandon the tents surrounded by piles of garbage in which they live. In fact, most of the homeless population couldn't handle the responsibility of being housed. Why? There is a brutal combination of mental illness, alcoholism, and drug addiction that feeds upon itself in a tight loop.
With the prevalence of cheaper and more dangerous synthetic drugs such as fentanyl and meth, addicts become schizophrenic and paranoid and would prefer to be left alone. We are, I feel, just at the beginning of being able to understand what is happening on our streets.
This is an excellent book, other than a few problems regarding the organization of the material. The message, however, comes out clearly: We can't rely on the police and the correctional system to solve the problem.
Sam Quinones is a Los Angeles based journalist who is known for his reportage on opioids and Mexicans in the US. This book has just been released, and I predict it will send shock waves across the country.
One problem I have seen over and over again is just how to describe the problem of homelessness. People act as if we found some housing for most of the homeless, they would gladly abandon the tents surrounded by piles of garbage in which they live. In fact, most of the homeless population couldn't handle the responsibility of being housed. Why? There is a brutal combination of mental illness, alcoholism, and drug addiction that feeds upon itself in a tight loop.
With the prevalence of cheaper and more dangerous synthetic drugs such as fentanyl and meth, addicts become schizophrenic and paranoid and would prefer to be left alone. We are, I feel, just at the beginning of being able to understand what is happening on our streets.
This is an excellent book, other than a few problems regarding the organization of the material. The message, however, comes out clearly: We can't rely on the police and the correctional system to solve the problem.
December 14, 2021
The author seems deeply emotionally connected to the suffering of addicts and the pain caused by overdose deaths.
However, this book crosses the line from fairly "reporting" what people say about addiction, which often reflects juke science, moralizing, and 12 step propaganda, to essentially supporting these dangerous views.
With a heaping helping of poverty porn and coastal elite guilt, the book turns the rural white addiction counselors into a sort of new noble savage. In the process, despite all mainstream public health analyses, incarceration is promoted as a solution to addiction. Drug courts, notoriously attacked for "net widening" and extending the violence of the state surveillance into relatively minor infractions, often leading to longer sentences when people fail to meet their onerous demands, are praised as a "bipartisan" solution to addiction.
Despite a claim to be "informed" by science, a full-blown scare around p2p meth mimics concerns about "crack zombies" getting brain damage from adulterated drugs. Addicts are infantilized, claiming their "prefrontal cortex" is too eroded to be seen as responsible decisions, including the author saying we must reject the "housing first" approach because these meth addicts are "a new breed of addicts" too irresponsible for housing.
The author does not acknowledge the danger of these "drug scares" and "drug exceptionalism", and while acknowledging that the core of the issue is the drop in price, the author continues to claim "this p2p meth is just built different", creating the sort of exceptional conditions where in the past people have been charged for murder for selling adulterated product, ignoring the disparate racial impacts of these sentences and the system of mass incarceration this sort of thinking has promoted.
Carl Hardt's entire career has been to push back against these blanket assumptions around those experiencing addiction not having agency or rational decision-making facilities, work the author seems to have not read or is purposefully ignoring on behalf of anecdotical analysis about the unique impacts of P2P meth. The role of p2p meth in homelessness is asserted to the point where he uses it as a criticism of housing advocates working on systemic issues, claiming "I don't know anyone on skid row who got kicked out for higher rents. They were all there for meth". One can have a criticism of housing nonprofits without using the existence of meth addiction as a tool to attack those actually attempting to do work on the structural issues addressing housing in high rent cities like LA, but in his haste, the author seems less interested in thinking through these details.
Even in his critique of the Sacklers, his critique is one of them being monopolies and not diversifying beyond Oxycotin, a perversion of the pure capitalism he champions as a solution to addiction by releasing people entrepreneurial energies on a small scale. This is a direct contradiction to the actual expert on structural causes of dislocation leading to addiction, Bruce Alexander, who sees global capitalism as inherently tied to sources of disruption and stripping of community cohesion that is a generator of addiction. It is also a contradiction of every other part of this book, where the author tells a story of sugar addiction and tech addiction priming minds for drug addiction.
That all this is inexorably tied to capitalism is rejected by the author, who argues that minor interventions like Obama care and increase work by nonprofits and churches, we can, essentially, make capitalism great again. An analysis of nonprofits being inexorably tied to smoothing the functioning of capitalist accumulation, and the nonprofit industrial complex bringing in white saviors to do work in black communities is so far beyond the scope of this text as to be glaring in its omission.
Despite saying "we can't arrest our way out of the problem" the book clearly advocates arrests as a critical part of the solution to addiction. Despite claiming to be informed by science, the book promotes a 12 step ideology formed through evangelic theory from the 1930s.
Synthetic drugs no doubt raises the stakes of addiction, but throwing out analysis of the systemic building of alternative systems in the name of doubling down on the system we currently have reflects a horrible lack of imagination on the question of political solutions to these problems. BLM, a potential source of this alternative worldview, is given lip service, but the entire context of the book is "we need cops/jails and it's the fault of social justice warrior that addicts are being released too soon and falling back into addiction", and thus run antithetical to much of the work of this movement. I believe the author might have literally said "Black live can't matter if they are dead from overdose", a specious bit of word play that reflects the author's naturalization of the status quo.
The call of drug policy folk everywhere is that, just as cops not doing their job is not an indictment of defunding police, the pandemic era of few arrests of addicts is not a fair description of a world of decriminalization, where an alternative service ecosystem would fill in the gaps of service currently being fill by cops and jail. The authors seem to have not even considered this analysis and simple says the rise in overdoses over the pandemic is a reason we should not do drug decriminalization.
When you are desperate to see progress, to feel as if there is some way out from a terrible situation, it is understandable that you grasp what is in front of you. That Quinones would champion drug courts, prison, and 12 steps as part of a "new awakening of community" is understandable, as that is the community that is visible in the current world. It is the job of a journalist to chronicle the world as he sees it, but it is the job of the folks doing work on the ground to express what has to be done to produce the world that can be. Unfortunately, Quinones's work seems too wedded to the world that is, to the point where it's an impediment to the folks doing to work to create a better world to come.
This is sad. I liked Dreamland. This book feels rushed and the author feels to be a bit frantic in his desire to blame someone for the addiction crisis as sees some light in the midst of what appears to be quite a bit of darkness around the issue of overdose.
However, this book crosses the line from fairly "reporting" what people say about addiction, which often reflects juke science, moralizing, and 12 step propaganda, to essentially supporting these dangerous views.
With a heaping helping of poverty porn and coastal elite guilt, the book turns the rural white addiction counselors into a sort of new noble savage. In the process, despite all mainstream public health analyses, incarceration is promoted as a solution to addiction. Drug courts, notoriously attacked for "net widening" and extending the violence of the state surveillance into relatively minor infractions, often leading to longer sentences when people fail to meet their onerous demands, are praised as a "bipartisan" solution to addiction.
Despite a claim to be "informed" by science, a full-blown scare around p2p meth mimics concerns about "crack zombies" getting brain damage from adulterated drugs. Addicts are infantilized, claiming their "prefrontal cortex" is too eroded to be seen as responsible decisions, including the author saying we must reject the "housing first" approach because these meth addicts are "a new breed of addicts" too irresponsible for housing.
The author does not acknowledge the danger of these "drug scares" and "drug exceptionalism", and while acknowledging that the core of the issue is the drop in price, the author continues to claim "this p2p meth is just built different", creating the sort of exceptional conditions where in the past people have been charged for murder for selling adulterated product, ignoring the disparate racial impacts of these sentences and the system of mass incarceration this sort of thinking has promoted.
Carl Hardt's entire career has been to push back against these blanket assumptions around those experiencing addiction not having agency or rational decision-making facilities, work the author seems to have not read or is purposefully ignoring on behalf of anecdotical analysis about the unique impacts of P2P meth. The role of p2p meth in homelessness is asserted to the point where he uses it as a criticism of housing advocates working on systemic issues, claiming "I don't know anyone on skid row who got kicked out for higher rents. They were all there for meth". One can have a criticism of housing nonprofits without using the existence of meth addiction as a tool to attack those actually attempting to do work on the structural issues addressing housing in high rent cities like LA, but in his haste, the author seems less interested in thinking through these details.
Even in his critique of the Sacklers, his critique is one of them being monopolies and not diversifying beyond Oxycotin, a perversion of the pure capitalism he champions as a solution to addiction by releasing people entrepreneurial energies on a small scale. This is a direct contradiction to the actual expert on structural causes of dislocation leading to addiction, Bruce Alexander, who sees global capitalism as inherently tied to sources of disruption and stripping of community cohesion that is a generator of addiction. It is also a contradiction of every other part of this book, where the author tells a story of sugar addiction and tech addiction priming minds for drug addiction.
That all this is inexorably tied to capitalism is rejected by the author, who argues that minor interventions like Obama care and increase work by nonprofits and churches, we can, essentially, make capitalism great again. An analysis of nonprofits being inexorably tied to smoothing the functioning of capitalist accumulation, and the nonprofit industrial complex bringing in white saviors to do work in black communities is so far beyond the scope of this text as to be glaring in its omission.
Despite saying "we can't arrest our way out of the problem" the book clearly advocates arrests as a critical part of the solution to addiction. Despite claiming to be informed by science, the book promotes a 12 step ideology formed through evangelic theory from the 1930s.
Synthetic drugs no doubt raises the stakes of addiction, but throwing out analysis of the systemic building of alternative systems in the name of doubling down on the system we currently have reflects a horrible lack of imagination on the question of political solutions to these problems. BLM, a potential source of this alternative worldview, is given lip service, but the entire context of the book is "we need cops/jails and it's the fault of social justice warrior that addicts are being released too soon and falling back into addiction", and thus run antithetical to much of the work of this movement. I believe the author might have literally said "Black live can't matter if they are dead from overdose", a specious bit of word play that reflects the author's naturalization of the status quo.
The call of drug policy folk everywhere is that, just as cops not doing their job is not an indictment of defunding police, the pandemic era of few arrests of addicts is not a fair description of a world of decriminalization, where an alternative service ecosystem would fill in the gaps of service currently being fill by cops and jail. The authors seem to have not even considered this analysis and simple says the rise in overdoses over the pandemic is a reason we should not do drug decriminalization.
When you are desperate to see progress, to feel as if there is some way out from a terrible situation, it is understandable that you grasp what is in front of you. That Quinones would champion drug courts, prison, and 12 steps as part of a "new awakening of community" is understandable, as that is the community that is visible in the current world. It is the job of a journalist to chronicle the world as he sees it, but it is the job of the folks doing work on the ground to express what has to be done to produce the world that can be. Unfortunately, Quinones's work seems too wedded to the world that is, to the point where it's an impediment to the folks doing to work to create a better world to come.
This is sad. I liked Dreamland. This book feels rushed and the author feels to be a bit frantic in his desire to blame someone for the addiction crisis as sees some light in the midst of what appears to be quite a bit of darkness around the issue of overdose.
August 10, 2021
This review comes a good two months before the publication date because I received an eBook Advanced Reader Copy. Sam Quinones is an amazing journalist and storyteller. On November 8, 2017 I was able to see him up close at my old high school, which was the venue for his speech that evening. Fentanyl was creeping in already, especially in a border county to Cook County/Chicago. There is no room for mistake anymore, as Quinones thoroughly details.
But this is a book review, eh? This book is great even though it's about some rough topics. I really enjoyed how Quinones ended his chapters; the writing was very well done. I am a professional librarian who is also way into harm reduction on the side. I have read many, many books about this general topic. The specific topic of fentanyl is a little more sparse, though if you're seeking more check out Fentanyl, Inc. by Ben Westhoff (he goes undercover in a Chinese lab, it's WILD). Quinones discusses China but he is more focused on Mexico. He also brings up some tough questions regarding the myriad & patchwork, trial & error solutions to the opioid epidemic. A lot of it is make-it-up-as-you-go and that is important to consider, especially as it continues to move into different directions. You don't have to read Dreamland to read this book, however this book does call back to Dreamland periodically. They compliment one another.
But this is a book review, eh? This book is great even though it's about some rough topics. I really enjoyed how Quinones ended his chapters; the writing was very well done. I am a professional librarian who is also way into harm reduction on the side. I have read many, many books about this general topic. The specific topic of fentanyl is a little more sparse, though if you're seeking more check out Fentanyl, Inc. by Ben Westhoff (he goes undercover in a Chinese lab, it's WILD). Quinones discusses China but he is more focused on Mexico. He also brings up some tough questions regarding the myriad & patchwork, trial & error solutions to the opioid epidemic. A lot of it is make-it-up-as-you-go and that is important to consider, especially as it continues to move into different directions. You don't have to read Dreamland to read this book, however this book does call back to Dreamland periodically. They compliment one another.
February 2, 2022
I loved Dreamland and learned a lot from it, so I was very disappointed by this follow-up. Quinones consistently talks about people who use drugs in dehumanizing tones. (Even the New York Times does not refer to people as "addicts" any more.) I was put off by that, the detours into the "addictive" properties of sugar and fast food, the full-throated endorsement of coercive treatment through drug courts, and the utter lack of imagination about alternatives to a poisoned drug supply. I was also disappointed that the author recognizes the Sacklers as the monsters they are, but has nothing to say about a system that enables and encourages them.
Two stars because the factual information presented was interesting, but no stars for the author's perspectives and conclusions based on those facts.
Two stars because the factual information presented was interesting, but no stars for the author's perspectives and conclusions based on those facts.
June 22, 2022
Good audiobook. Was a little repetitive (and a bit preachy at the end) but overall an eye-opening story of what’s happening. I thought the opioid crisis was bad (and it was!) but it just keeps getting worse and worse.
September 26, 2021
** I won this book from a Goodreads giveaway. **
What a roller coaster of emotions this was! I don’t think I’ve ever read a nonfiction book that has made me feel sad, afraid, shocked, furious, intrigued, and hopeful the way that this book has done. Going into this book, I thought I was going to read some personal accounts of what Fentanyl and Meth addiction looks like today in America. However, I got so much more than that. Not only did this book pull at my heartstrings, it also contained some educational information. This book discussed how prescribed pain pills (along with greed) helped boost the opioid epidemic, the neuroscience behind addiction, how incredibly accesible these illicit drugs were, and what is being done to help addicts rehabilitate. This book has accounts from a wide range of people directly affected by this epidemic, including; doctors, law enforcement, dealers, former addicts, and kind-hearted, selfless people who want to help those afflicted by this epidemic. Definitely a heavy topic but a must-read!
(Because I did receive an advance reading copy, I found an abundant amount of editing errors. Almost all of these being a missed space in between two separate words. A bit annoying, but not too distracting.)
5 ⭐️
What a roller coaster of emotions this was! I don’t think I’ve ever read a nonfiction book that has made me feel sad, afraid, shocked, furious, intrigued, and hopeful the way that this book has done. Going into this book, I thought I was going to read some personal accounts of what Fentanyl and Meth addiction looks like today in America. However, I got so much more than that. Not only did this book pull at my heartstrings, it also contained some educational information. This book discussed how prescribed pain pills (along with greed) helped boost the opioid epidemic, the neuroscience behind addiction, how incredibly accesible these illicit drugs were, and what is being done to help addicts rehabilitate. This book has accounts from a wide range of people directly affected by this epidemic, including; doctors, law enforcement, dealers, former addicts, and kind-hearted, selfless people who want to help those afflicted by this epidemic. Definitely a heavy topic but a must-read!
(Because I did receive an advance reading copy, I found an abundant amount of editing errors. Almost all of these being a missed space in between two separate words. A bit annoying, but not too distracting.)
5 ⭐️
August 2, 2021
Quinones does a great job of explaining how many in our society succumbed to fentanyl and meth - often accidentally and too often fatally. There are many to blame for the opioid epidemic - from pharmaceutical companies, to physicians, to government, to drug cartels and street dealers. It is a scary story that strikes at the heart of American society. However, Quinones also gives us hope and shows how communities and individuals have embraced the task of finding a solution one neighborhood, one community at a time. The Least of Us shows us both a terrible past and a hopeful road to the future of innovative ways to overcome this crisis. A must read for anyone who cares about the least of our brothers and sisters and wants to be part of building a better future for all of us.
June 12, 2024
Okay, this one took me a little while to get through. The weight of the stories plus its proximity to aspects of my own community made it slower to digest. The top notch story telling had me coming back, regardless of the intensity of content. Its been almost seven years since I moved into the heart of the city. Over those seven years, I have seen all kinds of troubles and joys play out in the streets in front of me. I first picked up Sam Quinones book because I was looking to understand some of the story of the world in which I've lived. Turns out, these stories helped me put pieces together from my earlier time of living in a rural community as much as over the last 7 years of living in the heart of the city.
The book is made up of a series of repeating tales- following the trails of different experiences in the drug world. After following the trails of the stories through this work I began to have a little more understanding of tell tale signs of a drug crisis in my own neighborhood. The chapter on tent encampments was particularly hard to get through, but the story of the retired grandma who learns to remove tattoos and joins arms with a recovery house was worth all of the hard parts.
Here's what I loved about the book and why I would recommend it to those seeking to understand some of the world of drug use and recovery: Hope. This theme is woven though the whole book- stories of people who stopped, who helped, who invited others into their homes, who kept visiting, who showed up for jail reform meetings, who gave people a chance with a job, who got ripped off, contaminated, stolen from, and still stayed soft-hearted. And the stories of human transformation? They have a refreshingly realistic vibe. Not everyone makes it home. But, one of the final stories in the book of care and faithfulness to those who are weakest among us- it's the modern day prodigal story echoing a line that each one of us lives our whole lives aching to hear:
"I love you, no matter what happened."
Would recommend to anyone working in therapy, social work, public service, or livin' in the hood.
The book is made up of a series of repeating tales- following the trails of different experiences in the drug world. After following the trails of the stories through this work I began to have a little more understanding of tell tale signs of a drug crisis in my own neighborhood. The chapter on tent encampments was particularly hard to get through, but the story of the retired grandma who learns to remove tattoos and joins arms with a recovery house was worth all of the hard parts.
Here's what I loved about the book and why I would recommend it to those seeking to understand some of the world of drug use and recovery: Hope. This theme is woven though the whole book- stories of people who stopped, who helped, who invited others into their homes, who kept visiting, who showed up for jail reform meetings, who gave people a chance with a job, who got ripped off, contaminated, stolen from, and still stayed soft-hearted. And the stories of human transformation? They have a refreshingly realistic vibe. Not everyone makes it home. But, one of the final stories in the book of care and faithfulness to those who are weakest among us- it's the modern day prodigal story echoing a line that each one of us lives our whole lives aching to hear:
"I love you, no matter what happened."
Would recommend to anyone working in therapy, social work, public service, or livin' in the hood.
Read
April 19, 2023There's something uniquely frustrating about someone who's like... 75 percent... right. Someone who's totally wrong, you can write off. Someone who's at 50/50 might be persuadable. And if someone's 90 percent right, you can chalk up your points of disagreement to the narcissism of small differences. 75 percent though? That's a fucker.
And the Sam Quinones of The Least of Us is firmly in that camp. I should add that I liked Dreamland. He sees the ways in which we are kept addicted, sees the ways in which late-stage capitalism fosters the sort of dysfunction he describes in breathless prose.
But at the same time, that 25 percent... His enthusiasm for the dubious and oft-misused system of drug courts (but it's biiiiipaaaartisan!), his casual snipes at unions, his dismissiveness towards housing-first initiatives, and the incredibly stupid, incredibly sentimental, incredibly worst-of-America prioritization of problems of heart and soul over material conditions. All of this made me skeptical at best and enraged at worst. For a more detailed analysis from persons far more knowledgeable than myself:
https://homelessness.ucsf.edu/blog/ho...
And the Sam Quinones of The Least of Us is firmly in that camp. I should add that I liked Dreamland. He sees the ways in which we are kept addicted, sees the ways in which late-stage capitalism fosters the sort of dysfunction he describes in breathless prose.
But at the same time, that 25 percent... His enthusiasm for the dubious and oft-misused system of drug courts (but it's biiiiipaaaartisan!), his casual snipes at unions, his dismissiveness towards housing-first initiatives, and the incredibly stupid, incredibly sentimental, incredibly worst-of-America prioritization of problems of heart and soul over material conditions. All of this made me skeptical at best and enraged at worst. For a more detailed analysis from persons far more knowledgeable than myself:
https://homelessness.ucsf.edu/blog/ho...
November 19, 2021
Compassionate urgently important book about "the least of us" in America.
Those who demand simplistic answers (like "Defund the Police" or "Legalize Drugs") will find themselves deeply challenged by this book.
I know it challenged me, and I learned a great deal about what compassion and help truly mean.
We need to be open minded and humble when it comes to this horrific health and social crisis.
Most of all, we must prioritize the well being of the "least of us" no matter what it takes.
Those who demand simplistic answers (like "Defund the Police" or "Legalize Drugs") will find themselves deeply challenged by this book.
I know it challenged me, and I learned a great deal about what compassion and help truly mean.
We need to be open minded and humble when it comes to this horrific health and social crisis.
Most of all, we must prioritize the well being of the "least of us" no matter what it takes.
November 6, 2021
The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth (2021) by Sam Quinones is a gripping revelation of how hard drugs in the US have changed over the past 15 years. Quinones chronicles the rise of meth and fentanyl made chemically. The book also describes more of how Purdue Pharma pushed the opiod Oxycontin in the US. The book is a follow on to Quinones also excellent book Dreamland.
The best non-fiction combines engaging personal stories as well as factual revelation and The Least of Us does this very well. There are a number of characters whose story Quinones tells while going through statistics of drug overdose deaths and the impact of drugs in modern America. The stories of Angie and Starla, Eric and Mungo and Doc O are vivid and moving. Quinones descriptions of cities across America, particularly in the US Rust Belt are also excellent. As well as being very informative the book is engrossing and is a real page turner.
Along with Dignity by Chris Arnade and San Fransicko by Michael Shellenberger, The Least of Us provides a dramatic view of things that have gone badly wrong in America.
There is a very good interview on the Econtalk podcast with Quinones about the book.
US drug overdose deaths have gone from under twenty thousand in 1999 to ninety three thousand in 2020. This is approaching double the number of US combat fatalities in Vietnam every year. It’s a staggering increase. The US now has death rates from substance abuse that are among the highest in the world and that are three times the rate of Europe, Canada and Australia. In 1990 these death rates were about the same.
In The Least of Us Quinones looks at why. He explains it by the high rate of opioid pain prescriptions which was driven by various drug companies, in particular Purdue Pharma and their owners the Sackler family. Quinones carefully explains how the Sacklers on the board pushed Oxycontin.
In addition Quinones describes how methamphetamine made from Phenylacetone, known as P2P in this context, took over from meth made from ephedrine. This changed the manufacture of meth from something that was done in small cookhouses to something that was done on an industrial scale. Ironically it was the suppression of ephedrine that led to the switch in the process. P2P meth has a much bigger mental impact on users than ephedrine meth did. It makes people schizophrenic and makes treatment much harder.
Similarly Fentanyl, a synthetic opioid first derived by the Belgian chemist Paul Janssen in 1960 it was very successfully used medically in anesthesia before illicit chemists began to manufacture it on a large scale and sell it to the US. It made the production of opioids vastly simpler. Growing and harvesting drugs from opium poppies is much harder and slower. Mexican drug deals began to ship huge amounts Fentanyl. Initially the strength of the drug would often kill addicts and also kill them extremely quickly often without the time to give them Nalaxone. US drug deals also began to add Fentanyl to other drugs and thus got more people addicted.
Quinones looks at the rise in opioid use, the rise in P2P based meth use and the combination of the two that causes so much destruction in people’s lives. The number of towns where the factories closed, people got injured and got on to opioid pain killers and then switched to other opioids is substantial. Many sad stories are in the book.
The book also makes the argument that addictions to sugar, bad food and bad habits set people up for addictions to narcotics. It’s an interesting point.
Finally Quinones looks at how many addicts, after years of drug abuse do manage to turn themselves around. These stories are really uplifting and Quinones also combines the stories with descriptions of how some entire towns are managing to come together and confront their narcotic crises.
The Least of Us is a really excellent book that combines stories of individuals with an over arching picture of the impact of meth and fentanyl in America. It’s a fine read.
The best non-fiction combines engaging personal stories as well as factual revelation and The Least of Us does this very well. There are a number of characters whose story Quinones tells while going through statistics of drug overdose deaths and the impact of drugs in modern America. The stories of Angie and Starla, Eric and Mungo and Doc O are vivid and moving. Quinones descriptions of cities across America, particularly in the US Rust Belt are also excellent. As well as being very informative the book is engrossing and is a real page turner.
Along with Dignity by Chris Arnade and San Fransicko by Michael Shellenberger, The Least of Us provides a dramatic view of things that have gone badly wrong in America.
There is a very good interview on the Econtalk podcast with Quinones about the book.
US drug overdose deaths have gone from under twenty thousand in 1999 to ninety three thousand in 2020. This is approaching double the number of US combat fatalities in Vietnam every year. It’s a staggering increase. The US now has death rates from substance abuse that are among the highest in the world and that are three times the rate of Europe, Canada and Australia. In 1990 these death rates were about the same.
In The Least of Us Quinones looks at why. He explains it by the high rate of opioid pain prescriptions which was driven by various drug companies, in particular Purdue Pharma and their owners the Sackler family. Quinones carefully explains how the Sacklers on the board pushed Oxycontin.
In addition Quinones describes how methamphetamine made from Phenylacetone, known as P2P in this context, took over from meth made from ephedrine. This changed the manufacture of meth from something that was done in small cookhouses to something that was done on an industrial scale. Ironically it was the suppression of ephedrine that led to the switch in the process. P2P meth has a much bigger mental impact on users than ephedrine meth did. It makes people schizophrenic and makes treatment much harder.
Similarly Fentanyl, a synthetic opioid first derived by the Belgian chemist Paul Janssen in 1960 it was very successfully used medically in anesthesia before illicit chemists began to manufacture it on a large scale and sell it to the US. It made the production of opioids vastly simpler. Growing and harvesting drugs from opium poppies is much harder and slower. Mexican drug deals began to ship huge amounts Fentanyl. Initially the strength of the drug would often kill addicts and also kill them extremely quickly often without the time to give them Nalaxone. US drug deals also began to add Fentanyl to other drugs and thus got more people addicted.
Quinones looks at the rise in opioid use, the rise in P2P based meth use and the combination of the two that causes so much destruction in people’s lives. The number of towns where the factories closed, people got injured and got on to opioid pain killers and then switched to other opioids is substantial. Many sad stories are in the book.
The book also makes the argument that addictions to sugar, bad food and bad habits set people up for addictions to narcotics. It’s an interesting point.
Finally Quinones looks at how many addicts, after years of drug abuse do manage to turn themselves around. These stories are really uplifting and Quinones also combines the stories with descriptions of how some entire towns are managing to come together and confront their narcotic crises.
The Least of Us is a really excellent book that combines stories of individuals with an over arching picture of the impact of meth and fentanyl in America. It’s a fine read.
January 23, 2022
DNF at page 338 of 390. First half of this book this enlightening, full of facts to learn. Somewhere along the way it became the same thing over and over, a too personal tone. This personal tone also borders on condescending at times, infantilizing the subject of its study.
"Her son had a good upbringing," she said. "Now he's seeing cheetahs."
Yeah, okay, another person hallucinating from P2P meth. Another victim who had a "good upbringing." Save me the speech.
"Weaving analysis of the drug trade into stories of humble communities," says the book's description, but I don't feel anything is woven. The insight into these humble communities does not land for me. Quinones does his best writing in a reporting style, analyzing the facts. Anything more personal reads as a shallow sort of sentimentality. It is bad at best, offensive at worst.
Two stars for the first half of the book and its look into fentanyl.
"Her son had a good upbringing," she said. "Now he's seeing cheetahs."
Yeah, okay, another person hallucinating from P2P meth. Another victim who had a "good upbringing." Save me the speech.
"Weaving analysis of the drug trade into stories of humble communities," says the book's description, but I don't feel anything is woven. The insight into these humble communities does not land for me. Quinones does his best writing in a reporting style, analyzing the facts. Anything more personal reads as a shallow sort of sentimentality. It is bad at best, offensive at worst.
Two stars for the first half of the book and its look into fentanyl.
July 27, 2021
The Least of Us by Sam Quinones is an insightful follow up to his previous book, Dreamland. Whereas the previous book focused on opium and heroin, this book explores how fentanyl and methamphetamine have spread and destroyed lives throughout the United States. Through personal stories, Quinones explains how fentanyl was developed and spread. He also details different ways in which communities have addressed this crisis. Recognizing that it will take time and various methods, Quinones reminds us that recovery may not mean abstinence forever but means positive change. This is an important book for anyone who wants insight into the drug issues plaguing the country and the job of recovery facing all of us.
August 27, 2022
I first heard about “The Least of Us” while listening to the “Dr. Drew After Dark” podcast and the subject of P2P meth was brought up. Violent paranoia, hallucinations, rotted teeth, uncontrollable limbs, massive memory loss, jumbled speech, and of course homelessness, are side-effects that are far more terrifying than any work of fiction, and yet by 2014, Skid row was overrun with P2P meth.
Sam Quinones (author) goes on a journey to explain the whole story of both P2P meth and fentanyl addiction in the US. With the origin rooted in pain pills like OxyContin pushed by Purdue all while withholding information about their addictive nature thus creating a domino effect that turned patients into addicts that sought out higher and higher dosages of relief, but in fact it was from withdrawal than pain itself.
The durability of the human body is remarkable, going from pain killers to heroin and then onto fentanyl only to find that the risk of death is far too great and then turning to meth as a cheaper and “safer” high destroyed lives on an unprecedented scale. The downward spiral is one of the most horrific tragedies of the 21st century. Yet somehow, there is a ray of hope. Communities banding together, rebuilding and keeping everyone in town accountable seems to be the answer, but suffering endured to reach that point is simply heartbreaking.
“The Least of Us” is a must read book, Quinones is a fantastic journalist that put together something very special. As far as drug awareness campaigns go, this could do an amazing job in deterring high-school and college students from “experimenting” with illicit substances as well as encouraging them to consider what they put in their body. Sometimes, the doctor doesn’t know what’s best.
Sam Quinones (author) goes on a journey to explain the whole story of both P2P meth and fentanyl addiction in the US. With the origin rooted in pain pills like OxyContin pushed by Purdue all while withholding information about their addictive nature thus creating a domino effect that turned patients into addicts that sought out higher and higher dosages of relief, but in fact it was from withdrawal than pain itself.
The durability of the human body is remarkable, going from pain killers to heroin and then onto fentanyl only to find that the risk of death is far too great and then turning to meth as a cheaper and “safer” high destroyed lives on an unprecedented scale. The downward spiral is one of the most horrific tragedies of the 21st century. Yet somehow, there is a ray of hope. Communities banding together, rebuilding and keeping everyone in town accountable seems to be the answer, but suffering endured to reach that point is simply heartbreaking.
“The Least of Us” is a must read book, Quinones is a fantastic journalist that put together something very special. As far as drug awareness campaigns go, this could do an amazing job in deterring high-school and college students from “experimenting” with illicit substances as well as encouraging them to consider what they put in their body. Sometimes, the doctor doesn’t know what’s best.
Read
July 3, 2023Behind every statistic is a person with full-fledged hopes, talents, loved ones and dreams, and this is the fact that the journalist Sam Quinones aims to buttress in this book, as he tracks down some narratives that uncover the human cost of the drug epidemic in America. Chapters in this book illustrate the life stories of well-loved brothers, sisters, sons and daughters before their lives became haywire and blighted by the trap of addictive drugs; the law enforcement and investigative officers who carefully stalk and plan the prosecution of drug traffickers; and the new kind of adaptive and tech-savvy drug traffickers who sprout to take advantage of the riches to be accreted from the sale of fentanyl, heroin, and meth. These are truly interesting stories that show how the suffering of individual Americans in the visegrip of addiction, also dovetail with the fall of the places they inhabit, the small towns with industrial economic cores, where union jobs for life with laborious demands have been hollowed out to be replaced by withered opportunities in the town Walmart, fast food or telemarketing. Towering over this entire tableau of tragedy is the source that singlehandedly and deliberately manufactured this misery-- the Sackler family that controls Purdue Pharmaceutical, and pushed aggressive sales tactics to doctors of their mono-product even as reports filtering in unequivocally showed that people were dying from their drug.
October 7, 2021
Pharmaceutical fentanyl was developed for pain management treatment of cancer patients, applied in a patch on the skin. Innocent enough: just stick-on grandmother’s arm for 72 hours, and Medicare pays for it.
Fentanyl is also diverted for recreational abuse, theft, burglary... Fentanyl is added to heroin to increase potency or disguised as heroin.
Illegal fentanyl is manufactured in Mexico. Sam takes us on a journey through the logistics across the North American landscape and ride right into the Little League field where your boys practice. This is not an expose the USPS where someone throws away sorting machines in the night. It is written with a crisp prose and tense anxiety. There is no happy ending.
What I learned from this is to ask at the CVS counter for Narcan. For a few minutes of my time, I might save someone’s life, I don’t know someone who secretly uses, but I’m ready.
(FYI Narcan/Naloxone is a medicine that can treat a fentanyl overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs.)
Treatment is no easy fix. Drugs like sublocade may help you or a loved one layered with years of counseling and love.
I received the book as an ARC. I highly recommend this as a factual account, as non-fiction, and also a thriller. Six stars
Fentanyl is also diverted for recreational abuse, theft, burglary... Fentanyl is added to heroin to increase potency or disguised as heroin.
Illegal fentanyl is manufactured in Mexico. Sam takes us on a journey through the logistics across the North American landscape and ride right into the Little League field where your boys practice. This is not an expose the USPS where someone throws away sorting machines in the night. It is written with a crisp prose and tense anxiety. There is no happy ending.
What I learned from this is to ask at the CVS counter for Narcan. For a few minutes of my time, I might save someone’s life, I don’t know someone who secretly uses, but I’m ready.
(FYI Narcan/Naloxone is a medicine that can treat a fentanyl overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs.)
Treatment is no easy fix. Drugs like sublocade may help you or a loved one layered with years of counseling and love.
I received the book as an ARC. I highly recommend this as a factual account, as non-fiction, and also a thriller. Six stars
December 28, 2022
Overall, I am disappointed that the author never came to understand the bigger picture of the overdose epidemic even though it was the whole point of his book. I’ll start off with saying that he uses veryyyy stigmatizing and demeaning language about people who use drugs as often as he can throughout.
He shares heart wrenching and beautiful stories of people who’s lived are shaped by drug use and how the change to a synthetic drug market has ravaged any safety or ability to function with their drug use. He also takes time to discuss how neuro scientific research has proved addiction to be a disease. Despite all this, he leaves with the message that arresting people may be the only leverage point to force someone in to recovery… because they are not capable of that themselves.
He dives deep into the stories where reform in the criminal justice system has saved lives, and uses these points to bluster his own opinion. Yet, he fails to ever entertain the topic of whether our healthcare approaches are sufficiently meeting the medical needs of people with addictions - it is a disease isn’t it?
It’s disappointing to read such a one-sided argument by someone who has spent so much time trying to understand the bigger picture himself.
He shares heart wrenching and beautiful stories of people who’s lived are shaped by drug use and how the change to a synthetic drug market has ravaged any safety or ability to function with their drug use. He also takes time to discuss how neuro scientific research has proved addiction to be a disease. Despite all this, he leaves with the message that arresting people may be the only leverage point to force someone in to recovery… because they are not capable of that themselves.
He dives deep into the stories where reform in the criminal justice system has saved lives, and uses these points to bluster his own opinion. Yet, he fails to ever entertain the topic of whether our healthcare approaches are sufficiently meeting the medical needs of people with addictions - it is a disease isn’t it?
It’s disappointing to read such a one-sided argument by someone who has spent so much time trying to understand the bigger picture himself.
February 3, 2022
While this book was certainly well researched, well written and very important, not once in a 400 page book about fentanyl was the phrase “harm reduction” uttered (and if I missed the word it was fleeting and insignificant). Anyone immersed in working with people who use substances know that harm reduction is the present and the future, that sanctions, drug courts, and punishment is the past. Harm reduction is a social justice movement, driven by people who use drugs, that is saving lives everyday. How did this movement not play a front and center role in this book? Quinones clearly understands how impossible it is for many people to stop using. And yet he maintains that sanctions and sticks are the answers instead of hundreds of well researched strategies and a whole social justice movement that saves and improve lives….I have so much more to say about this book that I can’t fit here!
November 28, 2021
Sam Quinones never disappoints. You know what Ilhan Omar said about not being able to hate people when you learn who they are -- he gets so close to his subjects that you can really see how easy it would be to have become an addict, homeless, delusional. If you read nothing else, read the chapter "The Least of Us."
September 1, 2023
This book is riveting. I found his theories about how the drug epidemic could take root so quickly and thoroughly compelling, though I wasn't sure he had a whole lot of actual data for them. I found his proposed solutions less compelling, though I don't know enough about the topics to declare them either right or wrong. I LOVED the story of Angie and Starla. 😭 A book that American Christians should read and ponder.
October 20, 2024
I’ve read a lot about the opioids/illegal drug crisis and I was starting to think I’d read it all - all the perspectives, all the facts, all the stakeholders - but I was wrong. Not only was there more to learn about the move from prescription drugs, to fentanyl, to new meth, or how much more dangerous the new drugs are, or about how drug trafficking is propped up by our lax gun laws, or how we got here chemically, economically, and “morally.”
But there was a perspective hinted at in some other books on this topic, most notably Beth Macy’s work, but very clearly spelled out here in a way I haven’t seen elsewhere: we can solve this crisis, but only if we care. Only through building up communities. Only through working together. Only through policies and laws and actions that support the Least of Us.
But there was a perspective hinted at in some other books on this topic, most notably Beth Macy’s work, but very clearly spelled out here in a way I haven’t seen elsewhere: we can solve this crisis, but only if we care. Only through building up communities. Only through working together. Only through policies and laws and actions that support the Least of Us.
February 28, 2022
I really wanted to like this because Dreamland (Quinones' earlier book about the opioid epidemic) was phenomenal, but this fell short of my expectations. In many ways it's a much-needed follow up about how the original epidemics of prescription drugs and heroin have paved the way for an explosion in fentanyl, which is now poisoning the entire drug supply. And like in Dreamland, he does a great job putting a human face to the crisis, speaking to many former addicts, dealers and other people whose lives have been touched by drugs. However, this book is all over the place in a way that makes it seem scattered--he weaves in a lot of different threads (such as how the fast food industry can create addictive tendencies for fat and sugar) that are worth considering but don't really seem to come together. And some of his main conceits, particularly the argument that the new way meth is being manufactured in Mexico is leading to a huge spike in mental illness and homelessness, are two sweeping for the evidence that he has backing it up. If what Quinones is saying is true then some of our current policies for how we approach addiction treatment might be backfiring...but if they aren't, then much of what he's suggesting just seems like more incarceration for little benefit. This book is great food for thought and a lot of what he addresses should be the subject of more study, particularly how synthetic drugs affect people's brains, but it's not all there yet. My other main issue is that he tries to weave in a lot of ideas about what's causing the addiction epidemic and all of our other ills (hint: it's social isolation and the hollowing out of middle America!) in a way that feels trite. Alec MacGillis' Fulfillment did a much better job of taking those root causes seriously instead of just using them to build a thesis with little evidence. This is a very mixed review but I'm still glad I read it, because there's no denying that this (fentanyl addiction) is a crisis of epic proportions.
November 15, 2021
I highly recommend this book. He updates his groundbreaking Dreamland, one of the first and perhaps the best popularly accessible works to describe the pain pill crisis and the heroin crisis that followed on its heels. This describes the rise of fentanyl and other synthetics and their role in the incredible spike in overdose deaths. It also profiles the inroads of P2P meth into American cities and the attendant mental health and homelessness crises that have been exacerbated by meth. Quinones shines in connecting the upstream (producers and large-scale distributors) to the downstream (addicts and their family members), with profiles of both the CJ folks trying to stop the trafficking and the recovery workers trying to minister to its victims.
Quinones tells the macro stories with recourse to the micro stories - the people behind the statistics. He tells hopeful stories alongside tragic ones, recovering addicts and their outcomes, good and bad. He eschews the silver bullets - MAT or decriminalization or whatever politicized hobby horse is at issue - in favor of community and resilience. If Quinones has a flaw it’s that he connects dots a little too easily - heroin was plenty lethal before fentanyl, Naloxone made headway against fentanyl before the derivatives popped up - but it’s a story few others have told well, and he updates it for new developments. Well worth the read if you want to understand why we lost 93,000 of our brothers and sisters last year and stand to lose a comparable tally this year.
Quinones tells the macro stories with recourse to the micro stories - the people behind the statistics. He tells hopeful stories alongside tragic ones, recovering addicts and their outcomes, good and bad. He eschews the silver bullets - MAT or decriminalization or whatever politicized hobby horse is at issue - in favor of community and resilience. If Quinones has a flaw it’s that he connects dots a little too easily - heroin was plenty lethal before fentanyl, Naloxone made headway against fentanyl before the derivatives popped up - but it’s a story few others have told well, and he updates it for new developments. Well worth the read if you want to understand why we lost 93,000 of our brothers and sisters last year and stand to lose a comparable tally this year.
November 7, 2021
This book feels like a patchwork quilt sewed together by someone's grandmother to document the phases of a child's life. Each square is unique, put together with care, and arranged to tell a broader narrative. But, if one steps back to examine the quilt, it's a garish looking thing.
Quinones' quilt serves its intended purpose; it tells a story, keeps you warm, and offers many opportunities for one to grow curious and learn more about unique topics. At the end of the day, it's still a quilt and any number of blankets can serve the same purpose. The book isn't bad but it doesn't fill a void.
If Mr. Mackey summarized the book, he'd probably say:
Drugs are bad, m'kay
America is primed for addiction to drugs because we're a society who seeks out addictions, m'kay
Food addiction primes people for drug addiction, m'kay
Addiction stories are sad and terrible, m'kay
Drug cartels/dealers evolve to new trends, m'kay
Consequences are necessary, m'kay
Consider the consequences and morals behind capitalism, m'kay
Quinones' quilt serves its intended purpose; it tells a story, keeps you warm, and offers many opportunities for one to grow curious and learn more about unique topics. At the end of the day, it's still a quilt and any number of blankets can serve the same purpose. The book isn't bad but it doesn't fill a void.
If Mr. Mackey summarized the book, he'd probably say:
Drugs are bad, m'kay
America is primed for addiction to drugs because we're a society who seeks out addictions, m'kay
Food addiction primes people for drug addiction, m'kay
Addiction stories are sad and terrible, m'kay
Drug cartels/dealers evolve to new trends, m'kay
Consequences are necessary, m'kay
Consider the consequences and morals behind capitalism, m'kay
April 14, 2022
“This journey from judgment to empathy was one the addiction crisis had pushed the country into as well. It revealed stories that made clear to many Americans that addicts were all around them, and always had been.”
I found this quote emblematic to Quinones’ addition of hope to this book, a marked difference from “Dreamland.” Like in his previous work, I think he knocks it out the park with his boots-on-the-ground approach, visceral depictions of the horrors of addiction, and indictment of those responsible for the ongoing epidemic. I appreciate the intimacy the author takes with the subject. He doesn’t recite numbers, he tells stories, and I find this a remarkably effective approach.
Even in the hope we’re reminded that recovery is not a linear process, that this plague never fully recedes. But Quinones strikes an uplifting tone and reminds us that hope, compassion, and community shouldn’t be underestimated in our fight against drug abuse. “The Least of Us” hits every emotion.
I found this quote emblematic to Quinones’ addition of hope to this book, a marked difference from “Dreamland.” Like in his previous work, I think he knocks it out the park with his boots-on-the-ground approach, visceral depictions of the horrors of addiction, and indictment of those responsible for the ongoing epidemic. I appreciate the intimacy the author takes with the subject. He doesn’t recite numbers, he tells stories, and I find this a remarkably effective approach.
Even in the hope we’re reminded that recovery is not a linear process, that this plague never fully recedes. But Quinones strikes an uplifting tone and reminds us that hope, compassion, and community shouldn’t be underestimated in our fight against drug abuse. “The Least of Us” hits every emotion.
April 17, 2022
Sam spoke at an event for logal government entities getting opioid Settlement money that I attended for work last month, and I got him to autograph a copy of this for me. It's a very engaging read, his style is very accessible, and you don't quite realize how long it really is. As a science nerd, I appreciated how he went into how the changes in drug chemistry used to make various illicit drugs have impacted what we see on the streets and then our jails and courtrooms. I disagree with some of his conclusions as to remedies, but I think there is a need for a multiplicity of solutions here, and I welcome all comers to the table. Worthwhile read.
March 10, 2022
This is an important book and one I’d highly recommend as an introduction to the opioid epidemic, rise of synthetic drugs, and the widespread impact of addiction on communities across the country. The journalistic quality is exceptional. I especially appreciated the stories of recovery, of folks finding purpose and rebuilding their lives, and was fascinated by the spotlight on small cities, towns, and churches rebuilding community. Where it fell short for me was the less polished analysis on the structural and societal factors intensifying the opioid epidemic.
October 27, 2022
I don’t know, this one was just a slog for me. Took me ages to get through and I always dreaded coming back to it but was determined to finish it because it seemed like an important topic. Obviously I’m in the minority here bc it has pretty high ratings.
I really liked this quote:
“Pleasure is fleeting; happiness is long-lived. Pleasure comes from taking or getting; happiness comes from giving. Pleasure is achieved alone; happiness with others. Pleasure comes from substances or things; happiness does not. Pleasure releases dopamine in our brains, the constant search for more; happiness releases serotonin, producing feelings of contentment, an end to consumption.”
Overall though, I found the way the information was organized to be very….disorganized. It felt like it jumped all over the place and covered so many different places and people and topics from different angles that it was jarring to me as a reader and I never really found a compelling throughline.
I also thought it was weird that there was a whole section castigating Walmart for helping addicts shoplift as if Walmart was colluding to expand drug addiction???
“Walmart stores made theft easy in many towns just as the population of drug addicts was exploding.”
I did find it interesting to learn about these new lab created chemical drugs that are so horrible and learn why they have such a terrible impact on the brain, how minuscule amounts of fentanyl can kill people and understand why fentanyl is so prolific right now. Very scary.
And I appreciated his insights on capitalism
and legalization, which I thought were really the best part of the book — well-presented and very valid:
“I don’t trust American capitalism to do drug legalization legalization responsibly. The last fifty years are replete with examples of corporations turning addictive services and substances against us, fine-tuning their addictiveness, then marketing them aggressively.
Remember when social media was going to be the great technological connective tissue, bringing people together, inaugurating a new era of understanding? Instead, it midwifed an era of virulent tribalism.
The opioid epidemic began with legal drugs, irresponsibly marketed and prescribed. The Sacklers are only one example of a tendency that nestles into every corner of American capitalism when it is allowed to extract maximum profit from products and services that neuroscience shows our brains are vulnerable to.
Meanwhile, alcohol and cigarettes kill more than any other drug by far, because they are legal and widely available. Alcohol also drives arrests and incarceration more than any other single drug. Our brains are no match for the consumer and marketing culture to emerge in the last few decades. They are certainly no match for the highly potent illegal street drugs now circulating. Marijuana, up to now, gives me little reason to adjust that opinion. Pot can be responsibly legalized. Instead, we are choosing the route we took with opioids: a now-legal, potent drug is being made widely available and marketed with claims about its risk-free nature. Big Pot is only a matter of time. Altria, which owns Marlboro, is moving into legal marijuana. The final absurdity is that as we face climate change’s existential threat, we make a weed that thrives under the sun legal to grow indoors, with a huge carbon footprint
I’m sympathetic to the idea of decriminalizing drugs, as well. Yet I believe it misunderstands the nature of addiction and ignores the unforgiving drug stream every addict must face today. One reason overdose deaths during the coronavirus pandemic skyrocketed is that police in many areas stopped arresting people for the minor crimes and outstanding warrants that are symptoms of their addictions. Left on the street, many use until they die.
Decriminalizing drugs also removes the one lever we have to push men and women toward sobriety. Waiting around for them to decide to opt for treatment is the opposite of compassion when the drugs on the street are as cheap, prevalent, and deadly as they are today.
We used to believe people needed to hit rock bottom before seeking treatment. That’s another idea made obsolete by our addiction crisis and the current synthetic drug supply. It belongs to an era when drugs of choice were merciful. Nowadays people are living in tents, screaming at unseen demons, raped, pimped, beaten, unshowered, and unfed. That would seem to be rock bottom. Yet it’s not enough to persuade people to get treatment.
In Columbus, Ohio, Giti Mayton remembers a meth addict who was hospitalized with frostbitten, gangrenous hands, yet who left the hospital in midwinter to find more dope. San Francisco and Philadelphia, two cities with years of experience with heroin, are seeing users homeless and dying like never before. The dope is different now. Today, rock bottom is death. We need to use arrests, but not as a reason to send someone to prison. Instead, criminal charges are leverage we can use to pry users from the dope that will consume them otherwise.”
I really liked this quote:
“Pleasure is fleeting; happiness is long-lived. Pleasure comes from taking or getting; happiness comes from giving. Pleasure is achieved alone; happiness with others. Pleasure comes from substances or things; happiness does not. Pleasure releases dopamine in our brains, the constant search for more; happiness releases serotonin, producing feelings of contentment, an end to consumption.”
Overall though, I found the way the information was organized to be very….disorganized. It felt like it jumped all over the place and covered so many different places and people and topics from different angles that it was jarring to me as a reader and I never really found a compelling throughline.
I also thought it was weird that there was a whole section castigating Walmart for helping addicts shoplift as if Walmart was colluding to expand drug addiction???
“Walmart stores made theft easy in many towns just as the population of drug addicts was exploding.”
I did find it interesting to learn about these new lab created chemical drugs that are so horrible and learn why they have such a terrible impact on the brain, how minuscule amounts of fentanyl can kill people and understand why fentanyl is so prolific right now. Very scary.
And I appreciated his insights on capitalism
and legalization, which I thought were really the best part of the book — well-presented and very valid:
“I don’t trust American capitalism to do drug legalization legalization responsibly. The last fifty years are replete with examples of corporations turning addictive services and substances against us, fine-tuning their addictiveness, then marketing them aggressively.
Remember when social media was going to be the great technological connective tissue, bringing people together, inaugurating a new era of understanding? Instead, it midwifed an era of virulent tribalism.
The opioid epidemic began with legal drugs, irresponsibly marketed and prescribed. The Sacklers are only one example of a tendency that nestles into every corner of American capitalism when it is allowed to extract maximum profit from products and services that neuroscience shows our brains are vulnerable to.
Meanwhile, alcohol and cigarettes kill more than any other drug by far, because they are legal and widely available. Alcohol also drives arrests and incarceration more than any other single drug. Our brains are no match for the consumer and marketing culture to emerge in the last few decades. They are certainly no match for the highly potent illegal street drugs now circulating. Marijuana, up to now, gives me little reason to adjust that opinion. Pot can be responsibly legalized. Instead, we are choosing the route we took with opioids: a now-legal, potent drug is being made widely available and marketed with claims about its risk-free nature. Big Pot is only a matter of time. Altria, which owns Marlboro, is moving into legal marijuana. The final absurdity is that as we face climate change’s existential threat, we make a weed that thrives under the sun legal to grow indoors, with a huge carbon footprint
I’m sympathetic to the idea of decriminalizing drugs, as well. Yet I believe it misunderstands the nature of addiction and ignores the unforgiving drug stream every addict must face today. One reason overdose deaths during the coronavirus pandemic skyrocketed is that police in many areas stopped arresting people for the minor crimes and outstanding warrants that are symptoms of their addictions. Left on the street, many use until they die.
Decriminalizing drugs also removes the one lever we have to push men and women toward sobriety. Waiting around for them to decide to opt for treatment is the opposite of compassion when the drugs on the street are as cheap, prevalent, and deadly as they are today.
We used to believe people needed to hit rock bottom before seeking treatment. That’s another idea made obsolete by our addiction crisis and the current synthetic drug supply. It belongs to an era when drugs of choice were merciful. Nowadays people are living in tents, screaming at unseen demons, raped, pimped, beaten, unshowered, and unfed. That would seem to be rock bottom. Yet it’s not enough to persuade people to get treatment.
In Columbus, Ohio, Giti Mayton remembers a meth addict who was hospitalized with frostbitten, gangrenous hands, yet who left the hospital in midwinter to find more dope. San Francisco and Philadelphia, two cities with years of experience with heroin, are seeing users homeless and dying like never before. The dope is different now. Today, rock bottom is death. We need to use arrests, but not as a reason to send someone to prison. Instead, criminal charges are leverage we can use to pry users from the dope that will consume them otherwise.”
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