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Author ties together causes of opiate epidemic

4/20/2017 - West Side Leader
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By Kathleen Folkerth

Author Sam Quinones spent the day in Akron April 12 and talked about the roots of the country’s opiate epidemic. He is shown at left during his address at the Akron-Summit County Main Library.
Photo: Carla Davis
DOWNTOWN AKRON — Award-winning journalist Sam Quinones laid out the case for what has led to unprecedented increases in addiction and deaths resulting from heroin and other opiates during a talk at the Akron-Summit County Main Library April 12.

His research led him to discover how Mexican drug organizations marketed their powerful and cheap black tar heroin to meet the need that was created by the U.S. pharmaceutical industry’s massive campaign to make its potent painkillers a staple in medicine cabinets, he said.

But there’s more to it than that, Quinones told the near-capacity crowd in the auditorium.

“It’s what we have become as Americans,” he said.

Using the example of Portsmouth, Ohio, a former shoe factory town that fell into decline once the jobs went away, Quinones said the increasing insular nature of our culture is what’s creating more problems.

“People are afraid of each other,” he said.

His book on the subject, “Dreamland,” got its title from the football field-size community pool that used to serve as a gathering place in Portsmouth, a town located about 90 miles south of Columbus. The pool was eventually paved over to make way for a strip mall.

The city ended up being the epicenter of the “pill mill” problem, in which some unscrupulous medical professionals realized they could make a fortune by overprescribing pills like OxyContin, Quinones said.

A former Los Angeles Times reporter who has covered immigration and crime in his nearly 30-year career, Quinones said black tar heroin wasn’t uncommon in California. But in other parts of the country, especially east of the Mississippi, it was nonexistent, as drug dealers instead pushed their more expensive but less potent product that came from the Far East.

Poor young Mexican men whose destiny seemed to lie in avocado or sugar cane farming turned to drug making and dealing to increase their prospects for a better life, Quinones said.

“They just wanted a way up,” Quinones said.

When he heard about black tar heroin being the cause of an increase in overdoses in Huntington, West Virginia, about a decade ago, Quinones started asking questions. His research led him to discover that the Mexican dealers — who all came from the same small farming community — had spread out to cities like Columbus and Cincinnati.

The dealers’ success, he added, came because they sold in small quantities and used tried and true marketing techniques.

“These guys used capitalist, good old-fashioned marketing and branding,” he said.

They also delivered to users, directed to addresses by a dispatcher who took their calls for product, just like pizza delivery.

Quinones thought that was going be the story he was devoted to, but then he started realizing that the dealers crossed over the Mississippi in response to demand from those who had become addicted to painkillers. That led him to research the medical and pharmaceutical communities’ part in the epidemic.

In the 1990s, Quinones said there was a “revolution in pain management” due to the introduction of opiate drugs that doctors were told were nonaddictive. In reality, Quinones said there had been little research done to confirm that. Also, originally the medications were to be used to help terminally ill patients who were dealing with pain.

Those who became addicted could wind up spending $200 to $300 a day on pills, Quinone said, so they started looking for a less expensive but equally or more potent alternative on the streets, and that’s where the black tar heroin came in.

“We would not have a heroin problem without OxyContin,” he said.

He said the American consumer is also to blame, though, for demanding that doctors treat pain with pills.

“They wanted comfort and were convinced they were entitled to a life free of pain,” he said, even though pain is part of life.

And as health care companies put greater stock in patient surveys, doctors became fearful of losing their jobs if they didn’t comply with patient demands for prescriptions.

Quinones also tied the issue into the changing philosophy in the U.S. in which the private sector — such as pharmaceutical companies —  is exalted and the public sector — like government — is vilified. But the public sector, such as the Drug Enforcement Administration, police departments and public health officials, are the ones left to deal with the problem.

“We have gone indoors, fearing the public, much to our peril,” he said. “We wound up just like Portsmouth after Dreamland closed.”

The solution to the problem is to look to many solutions, he said, such as leveraging the talent and expertise in every community.

“It’s time we stopped believing there’s an easy way out,” he said.

Community is a big part of that, he said. So are patients realizing that some of their health problems are the result of lifestyle and not something a doctor or pill can change.

And while parents of children who died due to heroin overdoses were at one time unwilling to talk to Quinones or in public about what happened, he’s encouraged to see that is changing.

“This problem is no longer private,” he said. “Parents are stepping out and adding truth to obituaries.”

Quinones also spoke before a sold-out audience at the Akron Roundtable that day in addition to taking part in a morning panel discussion on the community response to the epidemic. His appearances were made possible through the efforts of the Summit County Opiate Task Force; the Summit County Alcohol, Drug Addiction and Mental Health Services Board; Summit Educational Service Center; Akron-Summit County Public Library; Cover2 Resources; Breaking Barriers; Akron Roundtable; Summit County; Community Partnership of Summit County; and Summa Health.

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