The American Heroin Epidemic, Volume VI: How Recovery Can Change Towns

This is the sixth article that came out of my interview with Sam Quinones. In this edition, Mr. Quinones talks about how towns that have large recovery populations are rebounding from the heroin plague.


Frank Greenagel: There’s a number of themes that you’ve hit upon here that you also obviously talked about in your book that are reminiscent of a book I read earlier this year by George Packer, the writer for  The New Yorker. He wrote a book called The Unwinding and it’s about the decline of the middle class and the loss of factory jobs and the ruination of communities. In your travels, have you seen any strong American community that’s resisted this or any small town or village that seems to be a tight community and as a result they’re doing okay? The reason I ask that is I was just over I Asia and I spent some time in some poor Thai villages where people didn’t have much, but there were a bunch of healthy kids. They didn’t have a drug problem. My translator looked at me and said, “Well, they live in a village. They know everybody else and they’re totally connected.” This was told to me just as I was reading your book. Now, you’ve also been talking to me about the decline of communities. Is there any place in America that’s doing a good job with the sense of a village or a community?

Sam Quinones: In the very town of Portsmouth you’re seeing some very interesting things going on. Now, it doesn’t look it. If you go to Portsmouth, you will see a town with a lot of abandoned building and a lot of fast food places. You would not think it, but if you get to know the town, it definitely seems to be putting in place a certain kind of … I think it’s a town that is rebounding. That it’s a town that for a long time many have given up or could have easily given up and did not. I think it’s a town that shows how important supply is in all this. Once they got those pill mills, remember those Ohio State legislature passed the law that got rid of those pill mills and those pill mills all shut down? All of a sudden now you have a recovery community in that town that’s enormous. Talk about 10% of the population, roughly. Those are estimates, but 10% of the population is in recovery from opiate addiction. The one thing that’s interesting, when you get a large percentage of people who are in recovery, it’s very much like getting a big influx of Mexican laborers. Mexican immigrants bring energy, optimism, a desire to break through any wall to get ahead, to move on with their lives, to reinvent themselves, and a huge dose of gratitude for a second chance. It turns out, in Portsmouth I think what you’re seeing is that recovering addicts provide the same kind of energy and excitement and gratitude. That’s a very, very healthy thing for a town that has been losing people for decades now and where fatalism had kind of overtaken the town and heroin and those damn pills were just part of that fatalism. I think people need to spend a little bit more time understanding what’s going on in Portsmouth because obviously it’s been dealing with this probably longer than most everybody. For me, I find there was a new attitude. Once you get rid of the supply, the attitude changes. People started getting into recovery and the attitude changes. People say yes we can instead of what’s the point, which is what they were saying for so many years. That’s a very, very potent thing. A mental change, a psychological change like that, is a very, very potent thing, particularly in an area where people have always said what’s the point for 35 years.


Sam Quinones’s Dreamland was published by Bloomsbury in 2015. It provides a complete history of the opiate epidemic and examines the roles of the medical industry, Big Pharma, drug traffickers, law enforcement, drug users, their families, and the government. In December, Bloomsbury gave me permission to reprint a chapter from his book on the History of Heroin. A central theme of Dreamland is the collapse of American towns and the sense of community. Mr. Quinones was born in Claremont, CA and earned his BA in economics and American history from Berkeley. He wrote for the LA Times from 2004 to 2014. Dreamland is his third book. I interviewed him over the phone on December 14, 2015.

In the first article, we discussed the role of the pharmaceutical industry in the current American opiate epidemic. In volume two, we talked about race and how drug policies in the 1980’s with crack are very different than the 21st century policies surrounding opiates. In the third edition, we discussed how Mexican immigrants became some of the key sellers of black tar heroin, does supply or demand lead to bigger drug problems, and we briefly touched upon the rhetoric of Donald Trump. The fourth volume focused on the Affordable Care Act, politicians and how regular Americans can influence public policy. Part five addresses how the collapse of communities and social isolation has contributed to the surge in prescription drug and heroin use.