On the shelf
The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth
By Sam Quinones
Bloomsbury: 432 pages, $ 28
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When journalist Sam Quinones went looking for a buyer for the book that became “Dreamland” a decade ago, there was little interest. Only one publisher was interested in the story of an every town in Ohio that was first destroyed by painkiller Purdue Pharma and then by Mexican black tar heroin cartels.
“No one really knew what an opioid was,” recalled Quinones, who at the time was a Los Angeles Times staff writer.
The book from 2015 became a commercial and critical hit and won a National Book Critics Circle Award. Others followed with works on the opioid epidemic, including Beth Macy’s “Dopesick,” now a Hulu series, and Patrick Radden Keefe’s “Empire of Pain,” about Purdue’s owners, the Sackler family. The company eventually crumbled into bankruptcy under the weight of thousands of lawsuits.
Quinones’ latest book, “The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth,” is – despite its somewhat optimistic subtitle – an equally disturbing read. Mexican drug smugglers have figured out how to make more harmful drugs cheaper and more effectively control drug addicts and communities across the United States
Quinones are cutting back on the nasty trade news with stories of innovative rehab programs, drug courts and addicts getting clean. But these victories look miserable in comparison to the traffickers, who count their victories in tons or in hundreds of millions of dollars.
One of Quinones’ subjects, a longtime addict in Kenton, Ohio, kicks heroin and gets a job as a 911 operator. That’s “a good story” for the book, he admits. When the man relapses, he seems to be asking the reader not to lose hope: “This is not a Hollywood movie. It’s life, and it’s hard. ”
Quinones spoke to The Times last week from Nashville, where he now lives, about the current state of addiction, how a new type of meth can explain LA’s homelessness problem, and why he remains hopeful. The conversation has been edited.
When you finished “Dreamland”, did you think you would write another drug book?
No, because I was still thinking about old school, and I was thinking what could be worse [than heroin]? I also did not think anyone would read [“Dreamland”]. I had it awful, awful finding people … who would talk about it. And then I just thought to myself, no one is really interested in that. Then it happened that the book really helped turn on a lot of attention. More and more people felt the courage to come out of the shadows. I saw fentanyl take hold. I saw the meth problem get very creepy. So all of that made me feel like this was some kind of new era.
The general public did not really understand the opioid epidemic when “Dreamland” came out. Now, after “Dopesick” and “Empire of Pain”, Sacklers are public enemies. You may feel a sense of justification.
I remember touring in this very, very poor neighborhood of southern Ohio where the OxyContin addiction was just rampant. It was just awful what it had done to the little place. These are people who already live in trailers. And I remember thinking to myself, there is no way that this company, so powerful, so money and so removed, will ever be held accountable for this.
When I handed in the manuscript, there were three lawsuits against these drug companies. Now there are – I do not remember – 2,600, 3,000. I have spent the last five years being amazed at what has happened.
As this new book makes clear, the substances in your first book are old history now. They are like the drug world’s landlines: No one uses them anymore.
We awakened this very sophisticated giant of an underworld industry in Mexico to this new consumer base that we had created with the opioid epidemic. Fentanyl is superior in every way [to heroin] if you are a trafficker. No more need for land, growing seasons, farmers, harvest. You only care about shipping ports.
Conventional wisdom is that if demand in the United States stopped, Mexican human trafficking would cease. You say no.
Yes, the vendors are running the show now. They have then flooded the country, from Vermont to LA, with this very potent, extraordinarily cheap methamphetamine. Now you will find people who were addicted to opioids [who] has switched to meth. The human trafficking world perceived that there was this new massive consumer base of drug users who wanted to buy everything that was cheap, potent and relentless. So they have changed demand with supply.
You theorize that the homeless explosion in LA can be traced to a change in the formulation of methamphetamine in Mexico 15 years ago. I had not heard that before.
I definitely think that’s what happened. In 2008, the Mexican government decided to make ephedrine [a stimulant long used in making meth] actually illegal. And the trafficking world had to shift to another form [known as the P2P method]. In 2012, 2013, test [on seized meth] from the DEA [Drug Enforcement Administration] showed that it was all made with P2P.
What is only now becoming clear is that P2P meth carries with it deep symptoms of schizophrenia, primarily paranoia and hallucinations. Ephedrine meth was a solid substance, large in the gay community. A kind of euphoric thing. But now this meth is putting people into their own brains. There is not much of it that wants to be with other people.
So when you drive through LA and see people naked, people crawling on the ground, what you see is P2P meth?
Yes. Also when I see large stacks of bicycle frames, shopping carts. These things seem to breed hoarding in a spectacular way. It seems to drive people crazy and unable to live with other people very quickly.
This is not what I would call an optimistic book, but the subtitle refers to hope. Were you worried that people would not buy more bad news?
That’s a complicated answer. I’ve been a journalist for 34 years, and yet I’m not cynical. I began to believe while working in all of this that what had really gotten us into a lot of this problem was that we wanted big, sexy, magical answers to very complicated problems. It appears to be a harmful drug in itself and creates all sorts of unintended consequences.
The right way to promote change is to work in small ways, small steps, without looking for credit. I set out to find the smallest, least noticed, least sexy stories about Americans involved in societal reparations that I could find. It became just as much or more important to me than this very creepy story about methamphetamine and fentanyl.
You had a heart attack while writing this book and were ironically treated with fentanyl. Writing this kind of book seems to be really stressful. Why are you doing it?
Well, this is one of the great stories of our time. Very early on, I thought I was writing about drugs and drug trafficking and drug marketing. And I actually wrote about America. It’s all about who we are, what we have been, what we have become as a country. I would also say that I am interested in everything. Stories that fascinate me could be very bleak [or] very hopeful. But they fascinate me just as much. That’s why I became a journalist. That’s why it’s the best job in America.