From Dreamland to Nightmareland

With the CDC estimating last month that drug overdose deaths rose over 30 percent in the first twelve months of the pandemic to nearly 100,000, Sam Quinones’ outstanding new sequel to his award-winning 2015 book Dreamland: The True Tale of America’s Opiate Epidemic is definitely timely.

Quinones’ The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth brings us up to date on the disastrous drug developments of the past half-dozen years.

Dreamland explained how the Sackler family promoting OxyContin to doctors as a “non-addictive” synthetic opioid painkiller in the late 1990s set off what I call the White Death that quietly killed so many working-class whites in the first decade of this century.

Then, as the medical profession became less irresponsible about writing pain-pill prescriptions, Mexican drug smugglers stepped in to supply cut-off pill addicts with heroin.

While Dreamland was superbly reported, its prose style was occasionally slightly off. In contrast, The Least of Us is elegantly written. And Quinones has perfected his method of merging big-picture cause-and-effect analyses of the economics and neuroscience of drugs with illustrative human-interest stories of Americans swept up in this national catastrophe.

First, the good news about what has happened since Dreamland: Heroin has largely disappeared from much of America.

The bad news: That’s because heroin has been replaced by the synthetic anesthetic fentanyl, which is much stronger and deadlier.

The worse news: Fentanyl is so cheap that drug dealers have taken to sprinkling it into most of the other drugs they sell, such as cocaine and methamphetamine, because a dash of fentanyl makes all drugs more euphoric. Plus, it’s extraordinarily addictive, so you can become a fentanyl addict without even knowing you have been ingesting it. You just want your dealer to sell you more of that good stuff.

On the other hand, you probably won’t be a fentanyl addict for long because just a tiny excess amount can kill you. And drug dealers aren’t good at quality control when mixing white powders. When stepping on their product, Quinones says, local dealers invariably rely on $29.88 Magic Bullet blenders, which are great at mixing liquids for smoothies, but are terrible at mixing powders, so nobody can tell how much fentanyl wound up in your particular dose.

Therefore, Quinones warns that the era of recreational drug use is over:

That concept belongs to a past when drugs were far more expensive, harder to procure and less potent and more forgiving…. Now, every line of cocaine, every “pill” [counterfeit OxyContins are often fentanyl] at a party is an invitation to Russian roulette. On the streets of America, there’s no such thing as a long-term fentanyl user.

Fortunately, in 2019 the Chinese government banned fentanyl manufacturing. Unfortunately, Chinese companies responded by exporting the raw ingredients to Mexican labs to manufacture and then sneak into America.

Quinones points out that the 21st-century history of drugs is supply-side-driven. Few drug addicts dream up new highs and make them happen. Instead, global capitalists, whether the Sacklers, Chinese manufacturers, or Mexican cartels and entrepreneurs, invent new drugs to solve their business problems.

Second, there’s more good news in The Least of Us: Crack, which was such a disaster for America in the late 1980s, is fading in popularity.

The bad news: Mexican crystal meth has taken over from crack. Meth, long the low-rent white drug, has spread to Latinos and now blacks.

The worse news: Meth is now really cheap because huge Mexican drug labs have replaced the old ephedrine-based meth with a high-volume recipe that Quinones calls P2P meth that can be made from common industrial chemicals without requiring any controlled substances like ephedrine.

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