The opioid crisis in the United States is a textbook example of free market economics. The powerful lie, manipulate, and skirt regulations to make buckets of money, while innocent people suffer. Journalist Sam Quinones joins Goldy and Paul to unpack the economics behind the opioid crisis, and the new threat of synthetic opioids like fentanyl.

Sam Quinones is a journalist best known for his reporting in Mexico and on Mexicans in the United States. He is the author of the award-winning Dreamland: The True Tale of America’s Opiate Epidemic. His new book, The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth, is out today.

Twitter: @samquinones7

The Least of Us: https://bookshop.org/books/the-least-of-us-true-tales-of-america-and-hope-in-the-time-of-fentanyl-and-meth/9781635574357

What did the Sacklers know? https://newrepublic.com/article/162148/sacklers-know-patrick-radden-keefe-purdue-opioid-crisis-review

The ‘Secret History’ Of The Sackler Family & The Opioid Crisis: https://www.npr.org/2021/04/14/987195464/the-secret-history-of-the-sackler-family-the-opioid-crisis

State-Level Economic Costs of Opioid Use Disorder and Fatal Opioid Overdose: https://www.cdc.gov/mmwr/volumes/70/wr/mm7015a1.htm

Massive Costs of the US Opioid Epidemic in Lives and Dollars: https://jamanetwork.com/journals/jama/article-abstract/2780313

Website: https://pitchforkeconomics.com/

Twitter: @PitchforkEcon

Instagram: @pitchforkeconomics

Nick’s twitter: @NickHanauer

 

David Goldstein:

I’m David Goldstein, senior fellow at Civic Ventures.

Paul Constant:

I’m Paul Constant and I’m a writer at Civic Ventures.

David Goldstein:

So Paul, we often talk about economics as the study of who gets what, and why. One good example of that is America’s opioid epidemic. You know, different people are getting different things out of it. The Sackler family has earned billions of dollars selling prescription opioids, and the rest of America has gotten this opioid epidemic. That’s economics.

Paul Constant:

So I’m a child of the 1980s. So I grew up in the middle of the war on drugs. I very clearly recall Nancy Reagan’s just say no campaign. And like many of the Reagan administration’s policies, the war on drugs was a very libertarian idea that ignores systemic truth about drug abuse and drug addiction, and instead cast it as a personal choice. And so for me, as a white kid, the war on drugs just meant I had to sit through a few embarrassing school assemblies, and then they would pass out dare to keep kids off drugs t-shirts to the end, but for black and brown communities, the war on drugs resulted in skyrocketing incarceration rates with whole generations of especially young black men sent to prison and communities basically ravaged.

David Goldstein:

There’s the cost to human lives. That’s the big cost, the pain that it causes people’s family’s the lost lives, but there’s real economic cost too. For example, it’s estimated that in 2017 alone, the cost to the US economy of opioid addiction was 1.21 trillion dollars due to overdose deaths and opioid use disorder. I mean, that number is just stunning.

Paul Constant:

It is. And even more stunning is almost half a million people have died from opioid overdoses during the last 20 years in America. That loss of life is almost impossible to keep in your brain, especially when you figure that that almost equals the amount of people who, a number of Americans, who we lost to coronavirus last year.

David Goldstein:

Right? And remember, none of this happened by accident. It wasn’t just due to people not living up to their own personal responsibility. This is a really profitable industry. The Sackler family, who own Purdue pharma is estimated to be worth 11 billion. That’s 11 billion earned creating America’s opioid crisis.

Paul Constant:

Yeah. And really because the drug trade is illegal and it’s in the black market and drug cartels, don’t often file tax returns, there is no way to know the actual amount of money involved in the drug trade, how much they are profiting from selling drugs to Americans.

David Goldstein:

But there is one person who has a sense of both the scale of the legal and illegal drug industries, Paul.

Paul Constant:

That’s right. His name is Sam Quinones. He is a journalist best known for his reporting on Mexico and on Mexicans in the United States and for his chronicling of the opioid crisis in America, through his amazing 2015 book Dreamland, which really introduced a lot of comfortable middle class Americans to this opioid epidemic that, that they had no idea about that was ravaging middle America and his new book, which is out today, is The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth. And it’s a really incredible book and I’m are very excited to talk to him.

Sam Quinones:

My name is Sam Quinones. I’m a freelance journalist and author of four books of narrative nonfiction. The last of which is, The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth.

Paul Constant:

Well, thank you so much for joining us. I really love the book. I almost said I enjoyed the book, but given the subject matter, it’s a little tricky. I really was moved by it and informed by it and it was really, really beautifully written.

Sam Quinones:

Thank you so much. Appreciate it.

Paul Constant:

I mean, Dreamland, I think had a huge part in raising public awareness of the opioid epidemic. And I was wondering if we could sort of start this conversation by talking about how you think public awareness of the opioid epidemic has developed in the last decade or so and maybe how that developing awareness or lack of developing awareness has affected families and individuals who are impacted by the epidemic.

Sam Quinones:

My experience was when writing Dreamland that there was almost no awareness, except for in certain areas that you kind of know West Virginia and Southern Ohio and Eastern Kentucky and so on. I could say that I tried mightily to find families that would talk to me about this problem. They had addicted loved ones, a son, a brother, a mom, a grandmother, whatever. And nobody really wanted to talk to me about this. It was almost like the early days of the aids epidemic when nobody wanted talk about it, the obituaries were fabrications and all that. And that is really why it’s spread. People say, well, it’s only now because the middle class people are being involved that we’re paying attention to this. And I would say, I think that the opposite is true.

It was because middle class people were involved that we did not recognize this. They didn’t want it to be recognized. Their obituaries were always fabrications and nobody ever said publicly. Yeah, my son didn’t die of a heart attack. He died of a of years, long pain pill/heroin addiction. It just didn’t happen until though, and I would say the awareness really was nil when I was writing the book and there were three lawsuits by counties and those were on hold. There was very little, the book, I have to say, thank you. I believe the book had an enormous role in creating that awareness. And so what you’re seeing now is little by little people after Dreamland came out, people came out of the shadows where they always were. They always were there, but they just kind of felt like it was okay a little bit, not as many people as should come out, but nevertheless much more than had been the case.

And this began to prompt politicians to action, because they had never really had any exposure to it before in many, many areas. And so that’s when you begin to see new priorities, budgetary priorities, that’s when you begin to see last few years, a lot of investment in neuroscience research and addiction treatment. And that’s when you also begin to see the great, one of the great things to come out of this was this kind of feeling among politicians, particularly attorneys general, that they now needed to sue these companies. And that’s what you’ve been seeing. Those lawsuits now number, I think, close to 3000 or something like that. And in 2015 there were three. There were three, right? And that is because I think people are, politicians are feeling this movement from below, it’s really one of the great grassroots movements of our time. If you ask me. It’s not organized, it’s not recognized as such, but there would be none of these lawsuits and money being pried away from these drug companies who behaved so reprehensibly in helping create all this, were it not for all those people coming out of the shadows, getting on Facebook, going to a council meetings, meeting their state legislator in the grocery store or at church or wherever. That kind of thing has happened all across the country.

David Goldstein:

I’m curious, Sam, how has the opioid epidemic progressed throughout the pandemic? What influence has the-

Sam Quinones:

Well, of course, here’s the thing, it got much worse. And the reason it got much worse was because the pandemic collided with what the opioid epidemic had become. The opioid epidemic started, as I said in Dreamland with pharmaceutical companies and pain specialists promoting this idea that pain pills and narcotic pain killers could now be prescribed to pain patients without any risk of them getting addicted at all. And that became an idea that became accepted in American medicine, taught in med schools, pushed by a variety of large medical institutions. And I created an enormous new supply of pain pills from coast to coast, right. Maine to California. But then that changed as the underworld began to figure out what we had created through all that. And they began to provide first heroin and which is what I wrote about Dreamland.

After Dreamland was published, what you really began to see is the, I’m sorry, the underworld, primarily the Mexican trafficking world switch and understand and come to the realization that growing drugs doesn’t make any sense. It’s not a very profitable thing. It’s very risky. A far, far less risky, far more profitable thing is to make synthetic drugs with no plants involved made in a lab. You don’t need land. You don’t need sunlight. You don’t need seasons, infrastructure. You don’t need farmers or any of that kind of stuff. And if you get access to shipping ports, which is what they have, very controlled those shipping down in Mexico, on the Western Pacific, on the Pacific coast, you can get the access to all the world’s chemicals, enough to make your drugs year round, not just every few months and in quantities that are only limited by how many chemicals you get.

And that’s really what has happened. We’re now fully in the era of synthetic drugs. We’ve had synthetic drugs around for a while, but never to this massive degree, with this kind of extraordinarily dangerous, catastrophic really, drug supply with fentanyl. Fentanyl is a wonderful drug actually, when used medically. I’ve had it myself, when I had a heart attack a few years ago. It’s revolutionized surgery, made surgery possible when it was not in many cases, but used illicitly, of course, it becomes a curse, a scourge, and that’s what it’s becoming now. It kills people very easily. And even when it doesn’t people get addicted to fentanyl, they’re at very high tolerance. So there’s almost, there’s really no true heroin in America anymore. That’s been crowded out. What is called heroin is usually fentanyl, probably other stuff mixed in. Meanwhile, of course, they’ve been also able to produce, and this is connected to that.

Produce ungodly quantities of methamphetamine and methamphetamine is in such supply now, that the price has collapsed. Places that never had methamphetamine like New England, now have it. It’s all coming out of Mexico. It’s gotten rid of all those smalltime little cooks that used to make it in the Midwest and so on. And at the same time, fentanyl is killing people, this new meth, and it’s a very new kind of meth that they’ve been making in the last eight, 10 years has been really creating symptoms in people of severe schizophrenia, mental illness in a very severe way, paranoia and extraordinary paranoia and hallucinations and that kind of thing. So at the same time, all this collided, the pandemic collided with all this and isolated people brought people, made people alone, recovering addicts relapsed. There was no one around to help them. And so what you’ve seen, is an enormous leap in overdose deaths in the last year. And I’m sure 2021 is going to show somewhat similar numbers.

Paul Constant:

We like to say that this podcast is about who gets what and why. So I had a pair of questions for you. I wanted to ask you how profitable is drug trafficking and who is it profitable for?

Sam Quinones:

Well, certainly there’s an enormous population of people in Mexico that are profiting from it. Again, though, it’s very similar to the opioid. There are certain people near the top, I think that are benefiting, have always benefited more. At the bottom, what I think you’re seeing in Mexico is a proliferation of producers, both fentanyl and methamphetamine because they’re making fentanyl now in Mexico. At first, they got it from China, but China curtailed all that. And so now they’re getting just the chemicals from China and they’re making it there. It’s very much kind of a wild west. We think of these groups as cartels, we call them cartels. They’re not cartels. OPEC was a cartel, right? It reduced supply to force prices up. And you remember, or maybe you don’t, but the 1970s, when they did that and the prices went skyrocketing and there were lines at the gas station.

Well that is not what’s happening in Mexico. There is a proliferation of producers, the cartels, act as cartels, really when it comes to violence and enforcing their will. But when it comes to production, it’s really every man for himself and all these new people can enter and all that. And it’s really made, I think, just that the gold rush people got wealthy in the gold rush, where the folks who are selling the shovels to the people mining the gold, I think nowadays the people are getting really wealthy down in Mexico or the people who are selling the chemicals to the people who are making this stuff. And the response at the lower at the lower end, the levels of Mexican drug production has been to as prices drop, as they have say with meth to make more of it. It’s like a kind of constant glut economy down there right now.

And so, because these are folks for whom drug trafficking has been a ticket out of poverty into, or out of rural work into something akin to the middle class, or maybe even the upper middle class. And there’s no way they’re going back to the ranch. If one lab was making me this, and now the price is half that well, I’ll make two or three to make up for that. And that’s where you’re getting this glut. That’s why you’re seeing prices so low over the last few years and meth come to areas that never ever had it all across the country.

David Goldstein:

I don’t mean to make light of this Sam, but what you’ve been describing here sounds to me like free market capitalism.

Sam Quinones:

Yeah, though, that’s absolutely what it is. And it’s just kind of, the underworld is the most, it’s the most imitative and it times can be the most innovative, a fast moving part of our economy. It’s extraordinarily imitative. Once I did one of the chapters in the book, as you know, is about how everybody decided that the great way to mix fentanyl was with a magic bullet blender. Pretty soon everybody is mixing these powders and one of which is extraordinarily deadly to human beings in a magic bullet blender that you buy for $29.95 at Target. Right. And that was that was where example of everybody just kind of hearing that and going, oh, okay, sure. I’ll do that. You know and extraordinary imitation and coffee grinders and all that kind of stuff.

These things are uniformly bad at mixing powders. Right. And that’s why we got a lot of those cluster deaths early on. If you remember fentanyl in Cincinnati and West Virginia had like 40 or 70 overdoses in a three day period, that’s why. On the other hand, there’s enormous innovation and people are constantly finding new little ways, some of them are kind of more visionary types. I would say that when it comes to methamphetamine. Nacho Coronel, who was a Mexican Sinaloa drug capo kind of was like the visionary, what we can do with methamphetamine, we can make our drugs now, we don’t need to rely on growing them. And that was long, long time ago. He was killed by the military in 2010, and then everybody imitated what he did. So it’s extraordinarily fast moving though. Whatever it is, it’s imitative or it’s innovative, it’s very fast moving. And absolutely, it’s all part of unfettered, free market capitalism. As long as you can get those chemicals and you know a little bit about what you’re doing, or you have a guy who’s worked on a few labs and can help you. Then you can make meth too. You can make fentanyl too.

David Goldstein:

And they’ve done a fantastic job of reducing the price of a highly sought after commodity.

Sam Quinones:

That’s right. And that’s what those have become. Now they have become commodities. That’s right. And that is why it’s a good point you bring up. That is why my feeling is the, natural tendency, and again, I don’t know how articulate this is down there, I’m not sure there’s somebody with the kind of the vision of all this, but it’s a natural tendency towards trying to move away from commodification of what you’re making. And that is why they’re making counterfeit pills now filled with fentanyl. Probably the underworld has always understood our American love affair with pills, dating back to really like Valium, in the sixties, right. Since then, we’ve always been just kind of accepting of pills. Doctor says use it, okay, I’ll use it. You pull a pill out at a party.

Nobody’s going to be horrified, as they would if you pulled out a little baggy of heroin or whatever. So I think the trafficking world long realized this, but never had access to, as only pharmaceutical companies, they had access to this. Our love affair of pills and our belief that they kind of solved all our problems. Everything’s fine now. One guy I talked to a couple days ago at a methadone clinic in Eastern Tennessee, it was out there and he said, it was like the holy grail. It’s the holy grail, it’s a pill. But instead of taking five Percocets a day, all I need to take is one of these fentanyl pills that look like a Percocet, and I’ll be good for 12 hours. So it’s like he called it the holy grail, like you could get all your sickness taking care of, and it’s dirt cheap. Of course, if it’s badly mixed, you’ll die.

Paul Constant:

One of the things that I thought made such a huge difference in Dreamland was talking about the way that American companies were implicated, perfectly legal companies that were admired in the corporate community. I was wondering if you could talk about the implication of companies in your new book?

Sam Quinones:

What I began to, what I should have done, frankly, in Dreamland had my brain had any capacity for this at that time, which it did not, was to along with studying all this other stuff, was really try to understand the neuroscience of all this, of addiction and how the brain works when it’s hijacked by drugs, but then also how the brain works when it’s affected by legal substances that are highly addictive. And that’s really what I’m seeing in this new book is that we live in a time when certain corporations at least behave like drug traffickers and drug traffickers behave like corporations, with the counterfeit pills and all that kind of stuff. And that is really where I began to, there was some real learning on my part that went on, talking with neuroscientists and how this all works.

But the understanding was the same, that sugar, for example, processed sugar, hits the same receptors as does the opioid molecule, as does heroin. And they did an experiment at Princeton years ago, in which they give sugar dependent rats the drug Naloxone. Naloxone is when it’s used with overdose victims, it revives them, brings them out, sends them into withdrawals usually. And, but it’s a way of reviving someone who’s going to die of an overdose. That’s exactly what happened to the rats that were on sugar, they give them Naloxone and all of a sudden they go into withdrawal and they’re twitching and all that. But it’s a remarkable thing to think that what we have in our economy today, particularly given all the stuff that’s legal and produced for our consumption and fine tuned also, right?

So litter bottles of Pepsi, fast food, a variety of ways, all kinds of processed foods that you find in the middle of the supermarket, but not just that, of course, social media, video games, really, you’re not going to convince me that that’s almost like heroin, honest to God. These companies understand neuroscience. It’s one of the most important things we can learn today, is how our brains actually work. And there’s such a neuroscience golden age of research going on right now. It’s really amazing, exciting, fascinating stuff. And these companies know it and probably knew it have known it for a long time. And so they are constantly prodding these products that they produce and whatever it is, it could be a service like social media, like Facebook or TikTok or whatever, or it could be a, something that we literally consume like Pepsi or whatever, but they know or casinos where they’ve totally kind of engineered those things.

And to me, that’s where we are now. We are bombarded on one hand, more far more commonly by legal addictive products, by a whole array of corporations. We can all probably name and then on the underworld we’re of course, bombarded by the stuff coming out of Sinaloa. And so the Sinaloan drug cartel takes its place, as I wrote in the book alongside the Facebook and TikTok engineer, the casino designer, the porno maker, the alcohol and cigarette manufacturers and all that kind of stuff. So to me, that was really, I took it from, in Dreamland I focused really mostly on Purdue pharma and the Sackler family. And I began to say, no, there’s a bigger thing going on out there. Purdue and the Sackler’s are kind of small potatoes, almost, in this larger story. And the larger story is all these ways in which companies have made, that they know will attack our brands and prod our brands to use them, to buy them constantly. That kind of thing.

Paul Constant:

I was wondering if you could talk about any lessons that you’ve taken, from writing this book that you want readers to take from this book. And also if there are any policy solutions that you think would be especially meaningful for leaders to take in?

Sam Quinones:

Well, I’ll talk about some policy that I think, there’s three chapters in my book about one county that has been experimenting with a new way of doing jail. I believe the opioid epidemic is really calling on us to understand what a damaging thing jail, the way we do it, traditionally has been. It’s not that you’ll get a way, get a rid of jail. The drug brings most people to jail is legal, it’s alcohol so we’re always going to have jail. It’s just how you do it. And up to now, it’s been a vegetative place where you just park for nine months, you watch Judge Judy, you sleep a lot. Maybe you get into some tiffs. Maybe you start comparing notes on how to do your crime better. There’s nothing good about the time spent in jail. And that’s what of people have come to realize during this whole opioid epidemic, I think.

And it’s a remarkable thing to see. And so these small counties at very, very conservative counties, by the way, most of these places are now experimenting with recovery pods, so that you can begin recovery. Instead of watching Judge Judy all day long, you can actually begin to take 12 step meetings, education classes, get your GED, these kinds of things. So jail is no longer this burden that we’ve had to bear, this cost that we’ve had to bear. It becomes more likely to be an investment. It does require a complete change of mind, right? You have to have the right jailer. You have to have the right sheriff or county commissioners, and you have to have the right people to run it. And that’s not always possible. That talent pool isn’t always there.

But when it is there, you can start doing a lot of very exciting things. And then once you do, as they did in Kenton County, that I wrote about in The Least of Us, in Kentucky, what they begin to figure out is, oh, it’s not just here. We need to provide services on the outside too, because people were spending nine months doing really well in this pod. And then they get out and on in three hours they’d be on the bus, into town, they’d meet an old buddy and pretty soon they’re getting high. And the whole nine months is wasted. They began to understand that this is a much more… That we need to have a community of recovery. So service is designed to help those folks getting out of jail, now that we are doing jail a bit better than we used to.

And provide ways for them to, if you have, if you’re arrested in August, you have certain kinds of clothes, you’ve been on the street, By the time January runs around those clothes won’t work. And also, you probably gained a lot of weight because you been eating all those carbohydrates. And so you’re going to need new clothes. That kind of stuff is, is what a community begins to think of this stuff. And pretty soon it begins to think begins to advance in that way. And I think that’s, what’s going on in some of these counties. I think that’s absolutely a big deal. But I would say that overall, just in answering the first part of your question, that what the process of writing Dreamland and now, made me, really clued me into this. That really, what this is about is that we have been on a 40 year March of destroying community in this country. And it happened with lots of jobs that went overseas.

It wasn’t just that they went overseas. It was that, well, we just said, oh, well, it’s kind of the will of the market. So what are we going to do? There wasn’t really much done about it. There wasn’t much done to help people who lost those jobs, and those communities that lost all their downtown businesses and were then replaced by Walmart. We didn’t do much about that. Right. And I would say that there’s a lot of other ways we have not built infrastructure. The reason I called the last book Dreamland was because it was about this swimming pool. That was really the heart and soul of the town. And then once the de-industrialization process begins, people leave, everybody leaves and they have to destroy the pool. And what comes in its place is Wal-Mart is the one place where everybody now sees each other, which they used to see them each other all the time at the pool.

And of course, you’re very, very exposed because you only have those community bull works that really existed, or 10 years earlier to prevent this kind of drug problem from spreading. We’ve left ourselves in many areas, not just in economically devastated areas, but also in wealthy suburbs, I think very, very exposed. And it’s really about community rebuilding, which sounds just a lot of people like it’s just too big. And so the point of the book, half of the book really is really taken up with stories, as I said, of people doing small, unnoticed, unsexy Americans involved in community repair, stories of Americans involved in some small way in community repair. Not that this is a prescription, not that they should follow what’s in the book, but rather the message is small steps. Just like those people coming out of the shadows for so long where they, they resided for so long and all of those small steps out of the shadows.

Now, five years later leads to all these people, all these companies having to actually be accountable for what they’ve done. And it’s now actually I believe a kind of a cautionary tale to lots of business in America. You better watch this kind of stuff, make sure you’re not doing the opioid, making the opioid mistake. It’s this, it’s the idea is if we, small stuff is the in daily stuff, just like an addict in recovery, not saving the world, you’re not changing the world. You’re just making these small steps. Maybe it’s at a very local level in your church, in your neighborhood, at your school, whatever it’s that kind of stuff. And so I found those kinds of stories only by way of saying that’s what we got. We’ve gotten away from. We’re looking for big splashy answers to all our problems, when really the best political change, the best cultural and economic change, i my opinion comes in these small, small ways.

And so that’s why I called it The Least of Us, it’s the least, smallest, little effort or it’s, we’re only as vulnerable, whereas only as strong as the least of us, we me as strong as those that grocery store clerk who may or may not have health insurance who comes to work anyway, in the middle of a pandemic or that meat packing worker, all of a sudden we discover as an essential worker, but doesn’t have any safety net to speak of at all. This kind of stuff is where I think we need to be focused and far less on Twitter with all that anger and all that crap, just get rid of that crap, get rid of cable news. It’s just like heroin and focus on our neighborhoods, on our schools, our houses of worship, that kind of thing. And that is really where I come down on all this.

David Goldstein:

So one final question for you, Sam, why do you do this work?

Sam Quinones:

I love it. I’m trying to figure out anything I could possibly do that I’ve been high for 34 years, man. Every day I get up, I get to be a journalist man. I get to… I get to go… I don’t, and what’s more, I get to hear the most amazing damn stories, every day or week or so. It’s just incredible to me, the profundity of the stuff that I encounter and what kills me most of all is that I don’t have time to write about it all because there’s just too much of it. I was in in a methadone clinic in Eastern Tennessee a couple of days ago, and I was listening to these amazing stories of people, resilience, deeply broken folks, sometimes. And before that, the week before that I was talking with a neuroscientist about this minute little experiment that he was doing at Vanderbilt University.

I don’t think I’ll ever be rich, but I’ve been more fulfilled than any human being actually ever has a right to feel, I think sometimes. And it allows me to, I’ve always made my focus, folks who are really not famous. That’s where the beauty of the profession lies, the stories there are so profound and so beautiful. And my mom told me when I was in ninth grade, she said, most important thing you can do as you get into adulthood is focus on finding a job that you love, because it’s going to infect, if you have a bad job, you hate, it’s going to infect how much you sleep, your romantic, really every other part of your life. And I never forgot that.

And when I found journalism several years after college, frankly, I stand in awe of it sometimes. It’s so exciting and fun and fulfilling and challenging, and I’m always I’m are going to be a good writer. I’m always going to be trying to reach another level. And I find that to be just a wonderful way to live. I don’t think of it as work. I think of it as the most beautiful thing I could be involved in. And with dreamland, my two previous books, by the way, the first two books I’m very, very proud of them, but nobody read them. And they were stories about Mexico, very much like Dreamland and that kind of thing, stories about Mexico and about Mexican immigration, nobody read them. And so with Dreamland, it finally kind of many years into my career, 30 plus, almost 30 years into my career, all of a sudden it was actually having a fairly, not fairly, a really profound impact on people’s lives and on policy and on political races and all that kind of stuff.

People were bringing it up. And I was hugging mothers, almost every speech I gave and on the book. And it was wonderful, wonderful, and moving, and again, profound to be a part of that. And that’s wonderful but it was also just I’d be doing it anyway. I mean, it’s such an exciting thing to do. And I feel sorry, frankly, I really feel sorry for journalists coming up today because I don’t believe that they are getting the same training or experience. It’s all, everything is, you come at it with a political point of view and the best stories you don’t find when you find only when you leave your politics at the door, far away, and you just go with most… I would say I’m fairly independent politically. I’m fairly, I guess, liberal leaning, on a lot of things.

And I spent most of the last six years with, with people who ended up voting for Donald Trump, whom I love, and I think they’re wonderful, wonderful people. And it’s a process of you saying, I want to focus on the person and not on what Twitter and Fox and CNN says, is important that I should focus on. And so all of that is also part of the job description, in my opinion. You got to let go where the facts and the immersion take you and not battle against it, I guess. So that’s long answer, probably. All my answers are long, I guess.

Paul Constant:

No, that was wonderful. And I think the love really shows through in your work. And I just think they’re really-

Sam Quinones:

Thanks, Paul. I appreciate it.

Paul Constant:

They’re really impressive work. And we went long and I’m sorry about that, but thank you so much for giving me so much of your time.

Sam Quinones:

Oh, my pleasure. I’ll talk about this for another two hours. It was really nice to you guys. I appreciate the interest and good luck with what is actually a fantastic podcast already.

Paul Constant:

Thank you.

Wow. I’ve met a lot of journalists in my life, but he has to be just like one of the most talented sort of passionate journalists, I think I’ve ever talked to. That was a great conversation with somebody who absolutely understands like every level of this crisis.

David Goldstein:

Yeah. And one of the things Paul that stood out for me is that this is an economics the podcast, we’re doing an episode about opioid addiction. And I understand all the ways that that is fed by the extreme inequality in our economy, in our unwillingness to invest in the types of services, we need to deal with mental health and addiction and homelessness and so forth. And we’ve talked about a lot of that on other episodes, but what struck me from our conversation was how much Sam was describing really textbook free market economics. Both, on one side, you’ve got the Sackler family and Purdue pharma, this regulated pharmaceutical industry. And the way, this wasn’t an unintended consequence of these new prescription opioid drugs. This was the intent. They marketed these, they were trying to create a market for their drugs.

And they had to know, as he, as he pointed out, they know the science of addiction, just like the fast food companies and the casinos, and everybody else. They’re trying to create compulsion. So you buy their products and what better way to do that than with an addictive substance, but also the way he described the synthetic drug industry coming out of Mexico. This is like this classic example of you take this largely agricultural based industry where you’re growing cacao and marijuana and opium poppies, and so forth. And now it’s modernizing and industrializing, and you’re branching out into processing and distribution and shipping, and eventually it totally industrializes into this synthetic drug industry. And it’s very high value and deficient, and they’ve increased productivity and they’re dramatically reducing prices. And you take what was, when I was a kid, these were expensive drugs and people would bankrupt themselves buying them, now into this really cheap, widely available uniform commodity. And that is what unfettered market capitalism does. And sometimes it does it to the benefit of all, because it takes a product that we, that we all need and makes our lives better and makes it more cheaply available. And sometimes it does it with the fentanyl and methamphetamine.

Paul Constant:

Yeah. If you were to strip out the context of what he was saying, he could have been describing almost any Silicon valley company or something like that. It would’ve been framed as a success story in Forbes or something like that. Yeah.

David Goldstein:

And here’s the sad irony for many, many years, the Sacklers were promoted as a success story. They were celebrated. They had their names on museums and they were known for their philanthropy because they were the legal drug dealers, but really in the end, they weren’t much different and any more innovative than the Mexican synthetic drug industry leaders.

Paul Constant:

The work he’s doing, providing context and everything, makes it clear how ridiculous that old, just say no idea of approaching drug use is these are, these are systems that are put in place to addict people and to profit off of addicting people. Until we understand that these systems are in place and that they’re very good at what they do, we can’t really make a change. We can’t really fix the problems that are caused by these situations. If we keep pretending that this is an individual problem and not a systemic one, we’re really just sort of trying to fight back a flood by bailing ourselves out with the Dixie cup. For somebody who’s spent as many years as he has, observing human misery. I was very impressed by what he had to say about community and about solving the problem on the community level and taking little steps to build your way out of it. It seemed like that’s a lesson that doesn’t just apply to the opioid epidemic, but it’s what good politicians do, is they start in communities and build out. And so the fact that after three decades of observing all this stuff, he still thinks that there is hope, and he has examples of how to do this was I thought really inspirational given the heavy topic of his book.

David Goldstein:

And just so you know, Sam’s latest book is out today, so please get it from an indie bookstore where or your local library, and as always, we’ll put a link in the show notes.

Speaker 4:

Pitchfork Economics is produced by Civic Ventures. If you like the show, make sure to subscribe, rate and review us wherever you get your podcasts. Find us on Twitter and Facebook at Civic Action and Nick Hanauer, follow our writing on medium at Civic, Skunkworks, and peak behind the podcast scenes on Instagram at Pitchfork economics. As always from our team at Civic Ventures, thanks for listening. See you next week.