Episode #61

Restoring Dreamland

Featured Guest: Sam Quinones

Sam Quinones image

As shifting cultural priorities and values leave America vulnerable to the opioid crisis, how can we do more to rebuild community and fight the preeminent health issue of our time?

We’ll answer this with former LA Times reporter and author of the best-selling book Dreamland, Sam Quinones, on this episode of Recovery Unscripted.

Podcast Transcript

David Condos: It’s my pleasure to welcome Sam Quinones to our 52nd national conference here at Innovations in Recovery. It’s such an honor to have you this morning, closing out of conference with your keynote on the opioid epidemic. Thank you for sharing with us today.

Sam Quinones: It’s great to be here. Thanks very much for having me.

David: Yes, you talked this morning much like in your book Dreamland. You took us through kind of the journey of how this epidemic began but for your journey, you were in journalism covering crime stories you said. Why did you want to begin covering this story?

Sam: I started this because I was interested in how or why heroin traffickers from Mexico were doing such big business. I learned that those seizures were up at the border and there was a lot of evidence that they were doing much bigger business. I didn’t understand why that would be because I thought heroin was per se a kind of drug and that’s what got me into it. I had lived in Mexico for 10 years I was by then working with the L.A. Times and began to really think like, “This doesn’t make any sense. Why would anybody be using more heroin now?” Most people come to this story through pain pills and that leads them then to, “There’s more heroin now because of the pain pills”. I didn’t know anything about the pain pills. I wanted to follow the heroin and I backed into the story and that led me to the bigger story again of pain management and all that. The revolution and pain management that we had in our 80s’ and 90s’.

David: Yes, and getting into that, one of the story arcs that you cover in the book is about the mass distribution of opioids through prescription but really it seems that was a mass failure across many levels.

Sam: Well, I mean it was a lot of people doing what they thought was the right thing and it didn’t work well. Believing in easy answers, motivated by profit but also a lot of people believing that they were doing the right thing. A lot of doctors and pain specialists believe that these pills were really important for patients to use and that this would help patients. There was people tend to believe that there’s these avaricious motives and there’s some of that for sure. The incentives to do the wrong thing but a lot of people believe that they were doing the right thing. Doctors, pharmacies, pharmaceutical companies, nurses everybody and, of course, patients wanted their pain dealt with. It all combined to create this juggernaut of feeling, “We need to use these pills for more often than we do”.

David: Now and that kind of gets into our cultural ideas of what is health what is pain.

Sam: Yes exactly. There was an incentive to get away from wellness as an approach to health. You need to take your whole body into consideration and what kind of exercise you get, what kind of food you eat or don’t eat. All these kinds of things; where do you live, how much human connection do you have where you live? All that kind of stuff got pushed to the side. If you do good or soft-headed stuff for people who live in Santa Cruz and stuff and in fact, it’s fundamental. It’s not that at all, it’s fundamental to our health and our ability to function as human beings that we accept that that is part. Part of the story is I got into it realized that was part of the story. I changed my own diet. I don’t drink sugary drinks anymore. Sodas I used to drink Coca-Cola fairly routinely. I stopped all that sugary teas and all that stuff just my sugar consumption has dropped way off. Through that, you know you kind of come to a different idea about how to cure yourself and you don’t need pills as much. You don’t need pharmaceutical companies telling you what you need. Now some of those pills that they make are great and they’re life-saving and they’re wonderful but I think it’s a better approach to look at yourself first and change yourself first.

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David: You said you’ll talk this morning that as you got deeper into this story writing Dreamland you realized that this was bigger than you thought it was. It was bigger than trafficker’s, pharmaceuticals.

Sam: It got into cultural questions that I had not considered beforehand and it got into economic questions and questions of urban development. Like how far do we live from a store? Do we have to drive three miles for every loaf of bread we need? That kind of thing where we just built into our life lack of exercise and driving constantly and that’s a big part of it too. Once you begin to understand the ramifications it becomes very very big and that’s why I think that one of the true solutions is for all of us to begin to look more personal. We can’t change everything about urban development and the economics of our country and that kind of thing but we can every time we go out look at what we’re eating. Make sure that we’re getting a lot of exercises. Obviously, quit smoking don’t drink nearly as much et cetera and all these kinds of things are– It all gets back to personal responsibility.

David: Yes, and you talked about some of how it relates to the culture that we’ve created over the last few decades. Comfort driven individualistic privatized and all of that.

Sam: I believe a lot of that is the case that we just became a culture that believed that it could not stand the least little amount of pain. When you endure pain you find out that you can endure some. Obviously, we’re not talking about the kind of life mangling, horrifying pain that some people do feel and that needs to be dealt with but that’s not the cultural norm. More likely it’s people either thinking or doctors thinking that that person cannot handle any pain at all from a wisdom tooth extraction. None, and so what do you do? You’ve 60 Percocets to take home. Well, that is a mystery that dawned on me at one time. Is about the agony we create in our search for a pain-free life.

David: That’s a pain in itself if you’re constantly striving and seeking that.

Sam: Then, of course, the consequences can be catastrophic. They can be kids dying and lives ruined and families destroyed and life savings wiped out.

David: As you said a lot of this crisis can be traced back to a manifestation of a culture individualism, consumerism stuff like that but that the antidote is community.

Sam: I believe and that sounds I am aware very kind of sweet and maybe naive and pollyannish and people come me, “Well, how do we change the culture?” I’m like, “I don’t know I’m a reporter.” I think everybody’s neighborhood is where you work and so get outside and get to know the people across–

David: We all have an effect on our immediate neighborhood.

Sam: Exactly. I don’t know what to call. I wouldn’t suspect that may be in your Culdesac or your street you could probably do a whole lot of things outdoors and foster that and vote for funding for public amenities. Hey, let’s try that too. Why not? Support your library and support your PTA and do those kinds of things that increasingly when you get down into– My wife’s a former PTA president. 5% of the parents participate in PTA, it’s really a small number. Well, how about getting out and working on that kind of stuff? There’s a lot of ways that people view it as this huge cultural force that you know one individual has no effect on. The truth is that’s true but the other truth is that you can have a lot of effect if you just work at your own local street level or school or church level. It’s not as daunting as it seems when you reduce it down to its elements.

David: Yes, and we all have a way to change that little by little.

Sam: I believe we do, sure. When people do that they kind of remind themselves that “Actually yes, that was the way to do it. I just never tried” or it’s so difficult to think that you will have an effect. As I said in the talk you so much about what we believe today is it’s wise to be cynical and endless skepticism. “Oh my God that will never work. No”. Maybe not but it’s worth a try and you never know what you might find.

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David: In your travels as you’re writing this book, where were some of the rays of hope that you saw related to community?

Sam: I think the main one really is that you’re finding now these towns and counties forming up. It’s interesting because these towns and counties do have serious problems. It’s not like all of a sudden everything’s solved, that’s not it at all. Quite the contrary, they have a difficult time dealing with it, but that they’re moving forward in that way, together. Leveraging those talents and that expertise and that budget and really the energy. More than anything it’s just the energy. Leverage all that energy and find ways to use an energy that wasn’t being used before and doing it at the local level, at the church level, at the park level, on your street.
To me, that’s what’s great about this topic even as I said, as catastrophic as it’s been, it offers us this chance to do something very new and different for America. Different than we’ve done in the last 30-40 years or so.

David: Yes. Like you said in your talk there’s no one solution. We have to try all the solutions.

Sam: Yes. Exactly. I think that’s what got us into this. We wanted one solution to all pain. All human pain, no matter who you are, where you’re from, what your background is, we have one pill to take care of it all. That’s insane. We’re going to look back in 50 years and think the entire country was on drugs, deluded, living in a fantasy to think that that would work.

David: What do you hope that people take away, specifically people in the treatment field,? What do you hope they take away from Dreamland and some of the lessons that you learned writing it?

Sam: I think what we’ve just been talking about but also that they’re enormously important in all of this. We need a whole far more treatment in this country, pretty much every state, every county probably needs more. I do believe as I said also, that they need to take lessons from this. That there is this big rush now to try to find treatment and in that, there’s lots of marketing, there’s lots of money and there’s a real scary potential for abuse.

David: This is some of the problems you saw with pharmaceuticals back in the ’90s.

Sam: Very much so. I think you got to be very careful about this stuff. I think you need to invite scrutiny. You need to hold yourself to the highest standard because people are skeptical about this. There’s a stigma surrounding treatment. They certainly don’t want it at their own backyard. You have to open up to people, you have to very aware of where the bad actors are and report them and make sure they get out of the business. If you don’t, nobody really knows the difference between your treatment that may be doing things very well and that other treatment. All they know is that they’re both called treatment. Most times, that will jeopardize the building constituency for treatment that is happening in the country.

It’s been common upon the industry to do that. They need to invite regulation, they need to invite scrutiny, hold themselves to standard, and remember that this came because a whole bunch of salespeople didn’t really care what the evidence was. They didn’t even read the evidence. They don’t want to know. That’s got to change too in every– You need to have evidence-based practices and you need to know what it is so you have something to point to. All of that is part of what I think this whole episode can teach people in the treatment field.

David: Sam, I appreciate you joining us today. Before you go, what’s next for you? You have another book you’re working on

[crosstalk]

Sam: Right now, I’ve been just speaking like a maniac. It’s been crazy the amount of speeches that I’ve been giving and places I’ve been going. The last two weeks, I was in South Carolina, North Carolina, DC, Boston, Ohio, and Chicago, and now San Diego. What it means is, of course, that this is all over the place. That’s what it means.
For the moment, that’s what I’m doing. I hope at some point to get back to writing soon. We’ll see.

David: All right. Thank you for your time, Sam. It’s been a pleasure.

Sam: The pleasure’s mine. Thanks very much. Really nice of you.

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David: Thanks again to Sam for joining us. Now I get to welcome back Stephanie Spann, National Race Director for the 6K run/walk series put on by Heroes in Recovery. A grass-roots movement that brings together communities across the country to celebrate life and recovery. Welcome, Stephanie.

Stephanie Spann: Thank you, David. How are you?

David: Hi. I’m doing great. How are you?

Stephanie: I’m good. Thank you so much for having me.

David: Absolutely. Yes. Good to be back here again talking about Heroes. For anyone who hasn’t heard any of the previous segments, could you give us a quick intro to the mission of Heroes and why you do the 6Ks?

Stephanie: Our mission at Heroes in Recovery is to break the stigma associated with drug and alcohol addiction, mental health disorders and our races are a way to celebrate those that have come through recovery and also give hope to those that need to seek treatment.

David: Yes. We’re here this week talking about the Memphis Race coming up this Saturday, May 19th at 8:00 AM. What else can you tell us about it?

Stephanie: This is the 7th Annual Memphis Heroes in Recovery Race at Overton Park. For anybody that’s familiar with Memphis, it’s the park right next to the Memphis Zoo. Beautiful scenery and a great paved part of the course. Also, part of the course is on a limestone trail. You have a little bit different scenery out there but absolutely gorgeous run or walk for anybody to come up and participate in.

David: Very nice. Some paved, some trails are kind of gets a little bit into both worlds.

Stephanie: Definitely, yes.

David: You guys are involved in foundations and foundations has the local presence in Memphis as well with The Oaks and foundations Memphis. How are they involved with this particular event there in their hometown?

Stephanie: The Oaks at La Paloma is actually our presenting sponsor for the Memphis Race. We are super excited because they had such a great art therapy program at The Oaks and they will be the ones that will be actually making and providing us with the awards on race day. We are so excited to see what they come up with. I know are past participants that have received some of these awards have been so thrilled with what they get. It’ll definitely be a nice touch and a local presentation from The Oaks.

David: Yes. Those will be painted rocks?

Stephanie: Yes.

David: Yes. Very cool. I’ve seem some of those. Those are really neat. I know you have a charity beneficiary as you do for all the races. What can you tell us about that?

Stephanie: The Grace House of Memphis is our charity beneficiary for the Memphis Race and look forward to having them out on race day and seeing their involvement their residents out there.

David: Absolutely. Yes. Where can listeners go to find out more information, whether they are in Memphis or not, you have the virtual runner option as well. Where can people find out more about that?

Stephanie: If you got heroesinrecovery.com, you’ll see the 6K button that you can click on. It will show you our seven live races for the year, one of them being Memphis. There’s also the listing for the virtual race so people can participate anywhere they live all over the country.

David: Awesome. Thank you again, Stephanie.

Stephanie: Thank you, David.

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David: This has been the Recovery Unscripted podcast. Today, we’ve heard from Sam Quinones, author of the best selling book, Dreamland. For more and work, visit samquinones.com. Thank you for listening. Please take a few seconds to leave us a rating on your podcast app and subscribe so you won’t miss any of our new episodes. See you next time.