Former Los Angeles Times reporter advocates a balanced approach in tackling the opioid epidemic

While writing “Dreamland,” Los Angeles author and journalist Sam Quinones traveled to Columbus to interview the parents and brother of 21-year-old Matt Schoonover, who died in 2012 from a heroin overdose.

In the book, Schoonover's father voices an essential but confounding question to Quinones: How could this have happened?

“Dreamland,” published in 2015, is now regarded as one of the most thorough, disturbing and riveting answers to that crucial question. Quinones traces the origin of America's opiate epidemic from Mexico (where he lived for 10 years as a reporter) to Ohio, West Virginia, Western Pennsylvania, Kentucky and other nearby states, where, at the same time that black tar heroin from Mexico was flooding the streets, many doctors were also indiscriminately prescribing addictive painkillers such as OxyContin.

“It started with an innocuous thing, like pain. We all want to have our pain cured and assuaged,” Quinones said in a recent phone interview. “The problem did not arise because people wanted to abuse drugs. It arose because I think we had an unrealistic idea of how well doctors should be able to treat pain, and how much we should be asked to endure.”

On Thursday, Aug. 17 at 5:30 p.m., Quinones will speak about “Dreamland” and the opioid crisis at Celebration of Hope, an annual fundraiser for House of Hope, a Victorian Village addiction treatment facility in operation since 1959. Ohio has been hit particularly hard by heroin and other opiates; a Columbus Dispatch investigation found that more than 4,100 Ohioans died of drug overdoses in 2016, and 2017's total will almost certainly be even higher.

In the two years since “Dreamland” hit bookshelves, Quinones said more people seem to be familiar with the crisis and how it unfolded. “More people understand this pain revolution that took place in the '90s, and that this new way of using opiate painkillers was central to it, and that this is an epidemic that didn't start with drug traffickers,” he said. “But on the other hand, I still encounter a lot of people who don't understand this yet, or for whom it's a surprise. I think we're farther along in that than when I started my research, but not far enough along.”

In early August, Attorney General Jeff Sessions held a press conference in Columbus to discuss the opioid epidemic, and in addition to creating an Opioid Fraud Abuse Detection Unit, Sessions also advocated creating “a culture that is hostile to drug abuse.” Quinones opted to keep an open mind on the attorney general's approach.

“Let's see what he means and go from there. There could be some good to come from that,” he said. “I think the federal government has an extraordinarily important role to play in going after outrageous doctors, but also in dealing with major traffickers.”

Quinones said there's a danger in trying to solve the epidemic with a singular approach. Treatment is essential, he said, but so is a law-enforcement crackdown. “If you want treatment to work, you have got to reduce the supply on the street, because addicts right now are getting out of treatment and [relapsing],” he said. “You cannot expect people to go into recovery, come back to the same communities that they just left, which are awash in pills or heroin or fentanyl, and expect those people to live.”

“A lot of people have been saying, ‘We can't arrest our way out of this.' I don't think that's true. I think we need to arrest our way out of it if we want to treat our way out of it,” he continued. “We want law enforcement but also investment in treatment and investment in prevention. All three of those things need to happen simultaneously. … For years we'd throw every addict in jail. It doesn't work! It doesn't help anybody — certainly not the addict. So we need to expand dramatically the amount of treatment. But that doesn't mean there's no place for prison in this story.”

While researching “Dreamland,” Quinones said he had trouble tracking down people who were willing to talk about a family member's struggle with opiates. “They were embarrassed and hid it, much like the AIDS epidemic,” said Quinones. “That has changed. You see a lot of obituaries now that mention [opiate overdoses]. That's the most encouraging part.”

The obituaries, he said, are written by “parents who probably, before they were affected personally, believed that you needed to throw all addicts in prison and throw away the key. But addiction has a way of changing minds pretty quickly.”