Dreamland: The True Tale of America’s Opiate Epidemic

Sam Quinones wrote in this 2015 book:

* Yet Mexican drug traffickers avoided the town, police told me. This made Huntington rare. Mexican traffickers operated all over America—in Tennessee and Idaho and Alaska. But not in West Virginia. West Virginia was one of the seven states with no known Mexican drug-trafficking presence, according to a U.S. Department of Justice 2009 report I had seen. Police had a simple reason for this: There was no Mexican community in which to hide. Mexican immigrants followed the jobs, functioning as a sort of economic barometer: Mexicans in your community meant your area was growing. Huntington and West Virginia had no jobs, no Mexicans either.

* He [Columbus DEA agent] discoursed at some length on the frustration of arduous investigations ending with the arrest of young men who were replaced so quickly. They hide among Columbus’s large Mexican population, he said. The drivers all know each other and never talk. They’re never armed. They come, give false names, rent apartments, and are gone six months later. This was not the kind of heroin mafia Ohio and the eastern United States was used to.
“Crazy thing,” he said. “They’re all from the same town [Tepic].”

* Dealer: “They’re in many others. All over the country,” he said. Salt Lake, Charlotte, Las Vegas, Cincinnati, Nashville, Minneapolis, Columbia, Indianapolis, Honolulu. They were working full-time in seventeen states. They’d been in another seven or eight states at one time or another. He went on. The cities he mentioned all had large white middle classes that benefited hugely from the economic booms of the previous dozen years, and now had large Mexican immigrant populations as well. I hardly associated these cities with heroin. Were there heroin markets in these towns? I wondered. Yes, he assured me, they were big and getting bigger. He hadn’t even mentioned America’s traditional heroin capital, I noticed.
“No, in New York are gangs, with guns,” he said. “They’re afraid of New York City. They don’t go to New York.”
Mexican traffickers afraid of gangs and gunplay?

* A new attitude was taking hold in American medicine at the time. The patient, it held, was always right, particularly when it came to pain. The doctor was to believe a patient who said he was in pain. David Procter embodied this new attitude, and then some. He had a folksy style, with a little of the evangelist in him.
“His patients loved him because he had the ability to figure out what that person believed or needed or wanted,” said Lisa Roberts, who was a hospital nurse at the time. “He was brilliant in that way, to forensically identify vulnerable people and figure out what they needed or believed. He would tell them they had all these things wrong with them.”

* Procter was paid in cash at his South Shore clinic. In the mid-1980s, the medical world wrestled with how to use the new opiates that pharmaceutical companies were developing to treat pain. David Procter was an early and aggressive adopter. He prescribed opiates for neck, leg, and lower back pain, arthritis, and lower lumbar spine pain. He combined them with benzodiazepines—anxiety relievers, of which Valium and Xanax, Procter’s favorite, are the best known. In Portsmouth, people had anxiety and they had pain. Appalachia had a long history of using benzodiazepines—dating to the release of Valium in the early 1960s. Little old ladies used it. In this part of the country, anything that relieved pain was welcome. But opiates and benzos together also led quickly to addiction.
By the mid-1990s, Procter was also known to prescribe a lot of diet pills and stimulants, even to those who weren’t fat. A modest industry evolved in and around Portsmouth of scamming prescriptions for diet pills from willing docs like Procter, then selling the pills for a profit. His Plaza Healthcare clinic boomed.
In 1996, one who went to visit him was a man named Randy, a guard at the state prison in Lucasville ten miles north of Portsmouth. Randy suffered deep bruises to his back in a fight with an inmate. He was given a list of approved doctors to see. One was David Procter.
“Several guys from the prison went there because his office could take care of the [workers’ compensation] paperwork,” Randy remembered.
Procter took him off work for six months and sure enough, handled all the paperwork, charging him two hundred dollars cash. He also prescribed a drug called OxyContin—40 mg, twice a day, for thirty days. The drug was a new painkiller, he said, and they were having good results with it.
“Looking back on it, [the injury] was nothing that warranted that harsh of a drug,” Randy recalled. “But at the time, you’re thinking this is great because I don’t feel my back.”
Thirty days later, Randy figured he was better and didn’t return to Procter for a refill. Soon he was gripped by what he thought was the worst flu of his life. He ached, couldn’t get out of bed, had diarrhea, and was throwing up. He talked to some friends. One suggested he might be going through withdrawal.
Then it hit him: You’ve got to go back.
Procter prescribed him more of the same. Randy returned every month, paying two hundred dollars cash for a three-minute visit with Procter and an Oxy prescription. Procter’s waiting room overflowed. People fought over space in line. Only a handful of patients were there for injuries. The rest were feigning pain, scamming prescriptions, with the doctor’s connivance. Randy saw six fellow prison guards in the waiting room. He kept his head down, got his Oxy prescription, and left.

* In 1951, an adman named Arthur Sackler from a little-known marketing firm met with the sales director of a small hundred-year-old chemical concern named Charles Pfizer and Company in New York City.
Arthur Mitchell Sackler was thirty-nine and already had a career of achievement as a psychiatrist behind him.
He and his brothers, Raymond and Mortimer, had grown up in New York, the sons of eastern European Jewish immigrants. They attended college during the Depression and all three passed briefly through the Communist Party…

* Finishing his medical studies, [Arthur] Sackler became a psychiatrist at Creedmoor, a New York mental hospital. There, he wrote more than 150 papers on psychiatry and experimental medicine, and identified some of the chemical causes in schizophrenia and manic depression. He was an antismoking crusader long before it was popular, and prohibited smoking at the companies he would later own. At Long Island University, he started Laboratories for Therapeutic Research, which he later directed and supported with large donations. Meanwhile, he established the first racially integrated blood bank in New York City.

* Sackler’s campaign marked the emergence of modern pharmaceutical advertising, a field that up to then, in the words of one executive, “existed but it didn’t.”

* Part of the campaign aimed to convince doctors to prescribe Valium, which the public saw as dangerous. Ads urged doctors to view a patient’s physical pain as connected to stress—with Valium the destresser. If a child was sick, maybe her mother was tense. Valium was marketed above all to women, pitched as way of bearing the stress of lives as wives and mothers.

* Arthur Sackler never retired. In 1987, at age seventy-three, he had a heart attack and died. He left behind a wife and two ex-wives, a spectacular fortune, and an industry so indebted that it referred to him by his first name. Today, his name is on galleries or wings of the Smithsonian Institution, the Metropolitan Museum of Art in New York City, the Royal Academy in London, as well as at Princeton, Harvard, and Beijing universities. Medical facilities bear his name at Tel Aviv, Tufts, and New York Universities. In 1996, he was one of the five first inductees into the Medical Advertising Hall of Fame.
But Arthur Sackler is important to this story because he founded modern pharmaceutical advertising and, in the words of John Kallir, showed the industry “that amazing things can be achieved with direct selling and intensive direct advertising.”
Years later, Purdue would put those strategies to use marketing its new opiate painkiller OxyContin.

* Chavez learned early on that most crime is connected to illegal drugs

* All these guys running around Denver selling black tar heroin are from this town of Xalisco, or a few small villages near there, the informant told Chavez. Their success is based on a system they’ve learned. It’s a system for selling heroin retail. Their system is a simple thing, really, and relies on cheap, illegal Mexican labor, just the way any fast-food joint does.

* Moreover, the Xalisco cells never deal with African Americans. They don’t sell to black people; nor do they buy from blacks, who they fear will rob them. They sell almost exclusively to whites.

* The Xalisco traffickers’ innovation was literally a delivery mechanism as well. Guys from Xalisco had figured out that what white people—especially middle-class white kids—want most is service, convenience. They didn’t want to go to skid row or some seedy dope house to buy their drugs. Now they didn’t need to. The guys from Xalisco would deliver it to them.

* Jamaicans, Russians, Italians, even other Mexican traffickers, all bought property and broadcasted their wealth in the United States. The Xalisco traffickers were the only immigrant narcotics mafia Chavez knew of that aimed to just go home…

* For years after it emerged from citrus groves in the 1950s, Canoga Park and the Valley had been famously white, with only small islands of Mexican American barrios. But the mass migration of Mexicans to Southern California and the end of the Cold War changed the area. Defense contractors departed; so did many white people. Soon, districts of Los Angeles such as Van Nuys, Reseda, North Hollywood, and Canoga Park were largely Mexican.

* News of the shootings mainly served to remind Enrique of why he was in Canoga Park selling drugs. Back home, drug users were the moral equivalents of pedophiles. But drug sales were his pathway out of problemas. He saw dayworkers on Sherman Way, exploited, sometimes not paid—yet that wasn’t treated as a crime. They tried to work the right way and look what happened. He wasn’t forcing anyone to buy his dope. With that thought, and the problemas he was escaping, he felt peace.

* Most Mexican traffickers naturally followed the immigrants from their home states. This was astute and common sense, for no immigrant group has settled in such numbers in so many parts of America as Mexicans had by the end of the 1990s. Mexican immigrants were in rural areas where local police were often monolingual and understaffed. Those areas had cash-only businesses—Mexican restaurants and money-wiring services—that could be used to launder cash. By the 1990s, small towns and communities in rural Colorado, Georgia, and Arkansas, where Mexicans worked in meat plants, became major hubs for traffickers, places where they divided the dope loads they’d brought in and with which they supplied much larger towns. Mexican traffickers did this by following the immigrants. Thus by the 1990s, for example, it was possible for Sinaloan traffickers to find drug markets in many parts of America using Sinaloan immigrant communities as their point of contact and place to blend in. Michoacan traffickers did the same in the many U.S. regions where Michoacan immigrants became essential parts of the local economy.

* WHO went further. It claimed freedom from pain as a universal human right.

* The relentless Xalisco retail delivery system evolved evolved as it fed on this ever-growing base of customers addicted to OxyContin in America and on the deep frustration of young, landless working-class men in Mexico. These men did not form a cartel. They could not. The envidia—small-town jealousy—and the wild-bronco attitudes that rule Mexican ranchos prevented grand organizations from forming. “Families cannot work together,” the Man told me. “We’re real envious of each other.”
But precisely because they could not, their heroin system became pernicious and successful. It aroused the entrepreneurial spirit of rancheros, young and driven, as it harnessed a cheap and addictive product to the power of small-scale free-market capitalism. The system marked a radical departure in the way Mexican traffickers sold and profited from dope, and it challenged U.S. law enforcement.

* Through the 1990s, the Xalisco system had refined through trial and error. The Boys compared notes at barbecues back in Xalisco and slowly a set of rules evolved that was passed along like folklore. One rule: no violence. At the time, the best-known drug gangs, the Bloods and Crips, shot it out over crack cocaine on street corners in towns far from Los Angeles, garnering police attention wherever they went. Watching all this, the Xalisco Boys quietly began to expand nationwide by doing exactly the opposite. Polla was part of that 1990s expansion and one place he showed up was Boise.

* Dr. Gary Oxman never forgot what he learned from the Bloods and Crips.
In the 1980s, Blood and Crip gangs moved out of Los Angeles in search of new markets for crack cocaine. Their turf war over L.A.’s crack market had turned parts of the city into war zones. Heading north up Interstate 5, one place they landed was Portland, Oregon. By the mid-1980s, the City of Roses was awash in crack and crack houses. Drive-by shootings and murders soared. So did rates of syphilis.
Oxman was hired at the Multnomah County Health Department in 1984. One day, he spoke to a teacher in a black neighborhood, who explained what was taking place: Bloods, Crips, crack, crack houses, sex for drugs. Hence the syphilis epidemic he was seeing.

* Sell to whites; that’s where the money is, he told them. Steer clear of blacks. He didn’t have to insist too strongly on this point, either. His runners came with their own ideas forged by the negative view of black people common in Mexican culture that was, in turn, reinforced by the stories of returning immigrants who lived in Compton, Watts, and South Central Los Angeles, where powerful black gangs terrorized vulnerable Mexicans. So the Xalisco Boys stayed away from black neighborhoods, and this was one reason why, as their system expanded, Nayarit black tar was primarily sold to, and used by, whites.

* The bust reflected the spread of Mexican immigration. Mexican immigrants were now coast-to-coast, too. They formed the working classes in North Carolina, Alaska, Idaho, Minnesota, and Nevada. Mexicans were the largest influx of foreign-born labor to the American South since slavery. They were in the biggest cities and were revitalizing parts of heartland America. The only locally owned new businesses in many rural towns were those that Mexicans started, and it was common by 2000 to find Mexican restaurants in Mississippi or an out-of-the-way burg in Tennessee.
This also meant Mexican traffickers had more places to blend in. That wasn’t true even five years before. But by the late 1990s, as Mexican immigration was now virtually nationwide, Mexican drug networks national in scope were now possible, too. Such a thing was unprecedented in the history of U.S. organized crime. Not even the Italian Mafia had done it, but Operation Tar Pit showed that the Xalisco Boys had.

* Peter Rogers watched the new opiate epidemic emerge out of nowhere and file through his clinic. Hundreds of kids. They were all white, suburban kids from well-to-do homes. Most were girls. One was a tennis champ. Another was the
daughter of a Columbus cop. One was the daughter of a thoracic surgeon; there were several children of doctors, in fact.

All had started with pills. Many said they’d seen friends die. They had no idea where else to go. “The first kid showed up and word got out. I noticed that we got a lot of kids during that first six months from a place called Lancaster [a Columbus suburb]. It turns out these kids were coming to Columbus, buying heroin, going back to Lancaster.”

Rogers was an early witness to heroin’s new mainstreaming. The drug had for years appealed to rebellious kids from a seedy urban corner of America’s counterculture. “I remember at eleven and twelve years old seeing pictures of [Sex Pistols bass player] Sid Vicious and thinking he’s the coolest,” one twenty-six-year-old recovering addict, a musician, told me. “Sid Vicious, [New York Dolls’ guitarist] Johnny Thunders, Lou Reed, and William Burroughs, but also Charlie Parker. It was punk and jazz that made heroin so sexy and appealing, exciting and dangerous and subversive and not the norm. Then I saw the football players and the cheerleaders getting into it. These are people I turned to heroin to get away from.”

To the suburban kids hooked first on pills, heroin fulfilled the dream of the adventures they’d never had in their quiet towns. Part of heroin’s new appeal was that it kept them at the edge of a hazardous yet alluring dreamland. Finding dope every day could take them on a wild ride through worlds they hadn’t known existed, which, however scuzzy or harrowing, left them with fantastical stories that awed their peers.

* Forget you have children.

This advice was given to Mario, an illegal immigrant, by his new boss from Xalisco, Nayarit. Mario was preparing for what turned out to be a short career as a dispatcher for a black tar heroin cell in Columbus, Ohio, a few years after the Man brought the drug there.

“Forget that people may do to your kids what you’re doing to the children of others,” his new boss told him in a restaurant one day. “Otherwise you won’t sleep.

“And,” he added, “don’t let the clients die. Care for them. They’re giving you money.”

* He was given certain rules. No blacks. His boss feared African Americans. Once a customer brought a black customer along. The boss pulled a gun and told them both to get out and never come back. The kids Pedro sold to were all white…

* Many new athlete-addicts were not from poor towns where sports might be a ticket out for a lucky few. The places where opiate addiction settled hard were often middle- and upper-middle-class. Parents were surgeons and developers and lawyers and provided their kids with everything. Yet sports were as much a narcotic for these communities as they were to any ghetto. Love of learning seemed absent, while their school weight rooms were palatial things, and in many of them pain pills were quietly commonplace. Just as opiates provided doctors with a solution to chronic-pain patients, Vicodin and Percocet provided coaches with the ultimate tool to get kids playing again.

* Philip Seymour Hoffman, forty-six, was found that morning in his Greenwich Village apartment, a syringe in his arm and powder heroin in packets branded with the Ace of Spades near his corpse. Blood tests showed he had heroin in his system, combined with cocaine, amphetamine, and benzodiazepine. The Oscar-winning actor—a father of three—had checked into rehab the previous May for ten days, and then, pronouncing himself sober again, left to resume a hectic film schedule.

About Luke Ford

I've written five books (see Amazon.com). My work has been followed by the New York Times, the Los Angeles Times, and 60 Minutes. I teach Alexander Technique in Beverly Hills (Alexander90210.com).
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