Author Sam Quinones discusses opioid epidemic at 2017 Heroin and Opioid Mississippi Drug Summit

More than 700 people registered for the 2017 Heroin and Opioid Mississippi Drug Summit, a partnership between multiple health and public safety agencies and organizations with one single goal – to educate about the growing opioid epidemic that is affecting communities throughout the country, including right here in Mississippi.

Journalist and author Sam Quinones was the keynote speaker for the conference. The author of “Dreamland: The True Tale of America’s Opiate Epidemic,” Quinones shared what he had seen in his years of covering the opioid epidemic and watching it grow to affect people from all walks of life. Before he spoke though, conference attendees heard from Mississippi Commissioner of Public Safety Marshall Fisher, Bureau of Narcotics Director John Dowdy, Secretary of State Delbert Hosemann, and Attorney General Jim Hood about the crisis posed by opioids. The partnerships, coming from different agencies and even from different political backgrounds, underscore the messages everyone had to share.

“Opioid addiction is an epidemic in our state,” Secretary of State Hosemann said. “It doesn’t have any boundary or political parties, or economics, or age. In Mississippi, you used to say you were born on the wrong side of the tracks or the right side of the tracks. This addiction has both sides of the tracks.”

He noted that even though there are extensive financial costs associated with opioid abuse, the true cost is in how it affects people.

“It’s not just the dollars. It’s what happens to our communities, and to individuals, to our moms and dads, to our children and grandchildren,” he said.

Attorney General Hood spoke about how vital it is for the treatment and mental health community to aid in fighting addiction. Working to prevent addiction, he said, is the best way to prevent deaths from opioids. He noted that many people get trapped by addiction after receiving opioid prescriptions following surgery or another kind of injury.

“We’re talking about a substance that’s supposed to help you,” Hood said. “It’s given to you by a medical professional, so it’s more acceptable to people.”

Sam Quinones’s presentation closely mirrored those comments as he discussed what he had seen in his years researching and reporting on the opioid epidemic across the country.

In his book “Dreamland,” Quinones takes a look at the city of Portsmouth, Ohio and its transformation from a thriving, blue-collar community to a town devastated by addiction. The culprits were not only illicit drugs and the dealers who pushed them on the community, but the rising count of opioid medications prescribed during the 1990s. Though he ultimately finds hope, his book describes the threats opiates pose for communities throughout the country.

Quinones first realized how large this problem had become when he read about a series of deaths by drug overdose in West Virginia. The drugs in question were heroin, which was interesting enough, but it was also in the form of “black tar” heroin. He found it extremely strange that kind of drug, which normally would have come up through Mexico, would end up that far east of the Mississippi River.

In talking with local law enforcement, he found them angry about the quantities of heroin they had been finding in their community.

Quinones learned from a local officer that there was a whole crew who were selling heroin like they were delivering pizza – they were driving around town waiting for calls to come in, making deliveries, and then waiting for their next customer. They dressed casually to avoid drawing attention to themselves, and they carried the drugs in balloons they held in their mouths. That way, if they found themselves pulled over or in some kind of trouble, they could take a swig from the big bottle of water beside them and swallow the evidence.

“Then he told me something that changed my life,” Quinones said. “He said ‘And the craziest thing is, they’re all from the same town.’”

Quinones had also covered immigration for years, and he’d lived in Mexico for 10 years. He knew there were small towns in Mexico where basically the whole population learned the same job and had the same career. They had to, since they were so limited in their training and education opportunities and their job prospects. He figured that there was a small town where hordes of young people saw the drug trade as their shot at making it in the world, and they’d figured out a system for just that.

And he was right.

The Xalisco Boys, as they came to be known, came from the town of Xalisco, not far from the Pacific Ocean and in an area where opium poppies grew particularly well. Quinones learned all about their methods, interviewing former Xalisco residents who were now in U.S. prisons. He learned all about how they were savvy marketers who spread their product throughout the country. Strangely enough, he learned about how many of them were in it to make money so they could buy huge stacks of Levi 501 jeans, which they would take back home, to both sell for money and wear as status symbols.

“But I still didn’t have an answer to a major question I had when I first stumbled onto this thing in Huntington, West Virginia. Why West Virginia? Why Huntington, West Virginia would have an appetite for heroin made no sense to me,” Quinones said.

He got his answer soon enough, as he began to realize the revolution that took place in medicine during the 1990s, as opioid painkillers became heavily marketed and promoted as not only incredibly effective at treating pain, but virtually non-addictive as well.

“And in time, marketing worked,” he said.

In 1990, the entire world supply of hydrocodone was three tons. By 2010, the entire world supply of hydrocodone was 42 tons, and 99 percent of it was used right here in America.

“That is a revolution,” Quinones said. “A quiet one, and it wasn’t really noticed much outside the halls of hospitals.”

It was that revolution that led to the devastation of towns like Portsmouth, Ohio. A working class town, Portsmouth had a football-sized swimming pool that was a social hub for decades. Dubbed “Dreamland,” the pool and all of its surrounding areas were a place that provided real human connection for children and parents throughout the town, bringing the whole community together.

But eventually, the local factories closed. The mom and pop stores closed. The economy faltered. Local doctors left. Dreamland was razed to make way for a strip mall. Doctors left, and pain clinics, little more than pill mills, came in. Illicit entrepreneurs like the Xalisco Boys realized the market that was created by people becoming addicted to these pills, and they seized the opportunity.

“And they’ve got more customers than they know what to do with,” Quinones said. “They were the first guys to recognize and systematically exploit the coming market for heroin that massive prescribing of pain pills represents.”

This epidemic spread because there wasn’t much violence associated with it. It made its way through poor areas like Appalachia, but eventually began to spread to more wealthy areas. It was the first drug epidemic, Quinones said, to spread not because of the criminals and drug dealers, but because people believed they could take opioid pills and not worry about addiction.

“I realized as I was really writing about a book about us, about who we’ve become as Americans and what America had become,” Quinones said. “I’m just a reporter, but I couldn’t avoid certain conclusions as I got into this.”

He said that during the same time frame prescription opioids were taking off and the Xalisco Boys were spreading throughout the country, he saw government work become more and more vilified, but it was government institutions – police, public hospitals, coroners, mental health professionals, courts, and more – who were facing the opioid epidemic. When he was a child, he was outside playing until dusk. If he drives through his old neighborhood, he doesn’t see a single person outside. While people used to embrace new ideas at college, now he sees many complaining about ideas that make them uncomfortable.

“It seems to me we’ve spent 35 years in this country destroying community in America,” Quinones said.

As he has ultimately concluded, heroin use is a final expression of attitudes that have been sweeping America for decades now – an embrace of the personal and private and self-gratification over an embrace of community.

“I believe more strongly than ever that the antidote to heroin is not naloxone or Narcan,” he said. “It is community. If you want to get kids off heroin, make sure people in your neighborhood do things outside, often, together.”

Let kids ride their bikes. Don’t be scared of them skinning their knees.

“Create your own Dreamland on your block,” Quinones said.


The 2017 Heroin and Opioid Mississippi Drug Summit was a partnership between the Mississippi Department of Mental Health, the Bureau of Narcotics, the Board of Pharmacy, the Department of Public Safety, the Attorney General’s Office, the Mississippi State Medical Association, the Department of Health, and Capstone Treatment Center. 

Thanks to Sam Quinones and everyone else who participated in the summit.