In Dreamland, Quinones describes the alarming and silent epidemic of opioid addiction growing across the interior of the US; spread by both pharmaceutical companies aggressively marketing Oxycontin and the distribution of black tar heroin from Mexico. This has eaten up and hollowed out already dwindling communities, increasing social isolation - affecting prosperous and poor neighbourhoods alike.
Trying to understand what is going on in the US right now has turned me into a news and social media fiend. The news is a constant source of alarm and distraction but hasn’t really provided any clarity and zero fun….although I have found some insights.
One gem has come from Angus Deaton (FT, Atlantic) talking about his research into the rise in mortality and morbidity among the middle-aged white people in the US. These research findings provide some insight into the current political situation. That is, people feel helpless, are in pain and dying at an alarming rate of drug overdose. I suppose taking drugs is one way of gradually exiting the world-as-we-know-it, and voting for Trump is another.
Dreamland provides more substance to Deaton’s data analysis, with a focus on the opioid epidemic. It interviews junkies, cops, drug dealers, parents and epidemiologists to understand a complex situation with many players – creating the perfect storm of social disaster.
The book highlights how important the public sector is to cope with a social fallout such as the opioid epidemic, or any such public health crisis. However, at the same time, government welfare policy (Medicaid paid for the OxyContin prescriptions) and lack of proper regulation were also contributing factors to the epidemic (Deaton suggests the FDA has been captured by those it is supposed to regulate). The other scary perspective is seeing how similarly the criminal drug networks and the pharma companies operate.
The other sad message is how the selfishness of the opioid addict reflects the increasing selfishness and isolation of people generally, contributing to the decrease of community in the US (and elsewhere in the west, or maybe...everywhere). The book opens with an account of a public pool where everyone gathered – the whole town, for the whole summer - called Dreamland. The pool closed as the town’s economic activities wound down, hastening social decline. If we create more public spaces where everyone can congregate and socialize, it would reduce the risk of such isolation and addiction (and promote better health generally, see this and this).
I am definitely grateful to all the parks and gardens around me in Bangalore – which get me out of the house and meeting people from the community......and away from online news sites and social media.