Hacker News Books

One of the root causes is supply. The book Dreamland is a pretty thorough explainer.

If you're looking for a go-to book on America's opioid crisis- Dreamland by Sam Quinones.

http://www.goodreads.com/book/show/22529381-dreamland

The devil is absolutely in the details and it seems like it's gonna get a lot worse before it gets better.

I highly recommend the book Dreamland for more on this topic: https://www.amazon.com/Dreamland-True-Americas-Opiate-Epidem...

I just finished reading Dreamland which I also thought was good.

https://www.amazon.co.uk/Dreamland-True-Americas-Opiate-Epid...

This book has more of a focus on American pharma industry but still has lots of interesting insider insights.

The book to read about the opioid crisis is Dreamland by Sam Quinones.

It is really well written and researched and lays out the several separate events and trends that converged to make this perfect storm happen when and where it did:

https://www.amazon.com/Dreamland-True-Americas-Opiate-Epidem...

“Dealers of Lightning” by Michael Hiltzik - on Xerox PARC and its highly inventive cast of characters

“Man’s Search for Meaning” by Viktor Frankl - on choosing your own attitude

“Dreamland” by Sam Quinones - on America’s opioid epidemic

“Technics and Civilization” by Lewis Mumford - on technological progress (and machines) from the perspective of someone in the 1930s

“The Color of Law” by Richard Rothstein - on the myth of de facto segregation (vs de jure segregation)

Purdue is definitely the creator of the American opioid epidemic by lying about OxyContin's addictiveness and heavily pushing it for situations which didn't need it (wisdom teeth) and got people addicted. Read any of the ~10 mainstream books on this like Dreamland or Dopesick.

The book Dreamland covers this quite a bit, and is a good read on the subject:

https://www.amazon.com/Dreamland-True-Americas-Opiate-Epidem...

My takeaway was that opiates were incorrectly classified as a non-addictive way to treat pain, so doctors started dolling them out far too liberally. Hospitals also started employing pain specialists who's sole job was to treat pain in patients. It's pretty easy to find people in any sort of "pain" if that's all you're looking for.

1. Everyone should read Dreamland. Even if you think you know the Opioid story, you don't know half of it. And completely aside from that, it's really well written.

2. One thing I took away from Dreamland was that there wasn't one factor to blame. Instead it was 4-6 separate factors that came together in a nightmarish perfect storm vortex to create this crisis.

Which means the pharmaceutical companies have plenty of blame here, but still only 20-30% of the total.

The first time I heard of this kind of system it was for black tar heroin distribution in the US from a specific Mexican town that basically franchised the drug trade. [1]

Super interesting stuff. Google Xalisco or pick up the book Dreamland for more.

[1] https://www.latimes.com/archives/la-xpm-2010-feb-16-la-me-bl...

I've been reading Dreamland by Sam Quinones, which goes into detail and background of the past ~50 years or so about how we got into this situation. A large part of the WHY you're referring to I'll summarize as

1. Pain being identified as a vital sign and hospitals/institutions new-found focus on tracking and treating pain

2. Deceptive pharmaceutical marketing that painkillers are a be-all solution to pain and also non-addictive (Purdue/Sackler seem to be worst offenders here)

This lead to doctors prescribing opioid painkillers to many of middle-class americans who would likely have otherwise not come in contact with drug addiction. The book so far has been a really good read and also goes into detail around how heroin started spreading through the rust belt as well (feeding on the existing prescription addiction). I highly recommend it (about 65% through it right now).

I think what you're saying makes sense. I just want to pull out the idea a bit more.

Mexico is a country with a massive informal economy. For every McDonalds that operates in the formal sector, there are millions of small business operators who are totally off the radar.

The cartel is the McDonalds. The narco-technocrats are the thousands of taco carts off the metro crammed into every corner of Mexico City.

Two technocrats, sure, they wouldn't break the bank. But it's not tremendously difficult to get a package across the Guatemalan border, drive it up to Tijuana, and have your cousin with a drone fly it across the border where your other cousin picks it up on the other side.

There's no overhead. There's no need to pay protection money. There's no need to pay off police. There's no psychos in your organization calling attention to you.

This is the same thing that happened with black tar heroin distribution in the United States. A low-key family operation run by guys from the same small town in Mexico. They were revolutionary because they flew completely under the radar. No guns, no violence. Just earning a buck to send home to mom and dad.

Ref: Dreamland by Sam Quinones

Recommended reading if this interests you: Dreamland tells the story of intersecting prescription pill and heroin use in America.

http://www.samquinones.com/books/dreamland/

I grew up in the same part of the country around the same time as the author. While I agree not everything in the book is a fully realistic depiction, it is honestly highly accurate in many regards. It goes in depth with the type of inconsistent, moralistic and tribal decision making and thought process in Appalachia in a more detailed and accurate way than I’ve seen in almost any other account.

I’d suggest to also read the book Dreamland about the opioid and prescription drug epidemic in Appalachia.

Between base knowledge of how tribal morals work there, how skills gap unemployment had hit that area, and how the addiction crisis has hit them, it helps dramatically to understand why it creates a conservative-leaning voting bloc that feels scared of modern progressive politics and would generally vote modern Republican despite having deep historical roots in voting Democrat as a worker solidarity signal.

For those interested in this topic and how the opiate epidemic has stretched across the US, read Dreamland by Sam Quinones (https://www.amazon.com/Dreamland-True-Americas-Opiate-Epidem...)

There are a multitude of reasons to explain how this happened but to quickly sum up an excellent book:

- Purdue created the whole "sell-direct-to-doctor" phenomena that is now the norm in the US medical profession

- One bad study that showed opiates for pain relief are NOT addictive and this study kept being cited by sales people

- Mexican drug dealers from a very tiny area in Mexico importing black tar heroin

- A prevailing idea in the US that people should never be in pain and managing it through lifestyle changes is not acceptable; a quick fix is needed

- economic depression in the Midwest and Appalachia regions

But really, read the book. It's eye opening and well written.

I have no life outside of reading and consume nearly 200 books/year, so I'd love to offer up a few 2018 favorites!

Doctor Dealer: The Rise and Fall of an All-American Boy and His Multimillion-Dollar Cocaine Empire (by Marc Bowden).

Trust Me, I'm Lying: Confessions of a Media Manipulator (Ryan Holiday).

Dreamland: The True Tale of America's Opiate Epidemic (Sam Quinones).

American Pain: How a Young Felon and His Ring of Doctors Unleashed America’s Deadliest Drug Epidemic (John Temple).

Rosemary's Baby (Ira Levin).

The Fall of the Dynasties: The Collapse of the Old Order: 1905-1922 (Edmond Taylor).

American Heiress: The Wild Saga of the Kidnapping, Crimes and Trial of Patty Hearst (Jeffrey Toobin).

The Way of Kings: The Stormlight Archive, Book 1 (Brandon Sanderson). This year was my fourth read. Don't get me started :/