The relationship between intoxicants and the law has long been debated. Indeed, it was a key theme in Euripides’s The Bacchae. Herodotus, the father of history, records that the ancient Persians would decide important matters only after they had discussed it while drunk, and then again when sober. Yet with recent reports of Britain’s knife crime scourge spreading out from cities into the countryside, and with drugs the apparent catalyst, it is worth investigating a similar phenomenon in the United States.
Sam Quinones’s Dreamland illuminates America’s opioid epidemic. An LA Times journalist, Quinones traverses the decades to tell how the ‘pain revolution’ in the medical establishment collided with an innovation in heroin trafficking to devastate the American heartlands. He shows how a small clan from a tiny district in one of Mexico’s poorest states were able to revolutionise the supply of heroin to meet a new demand in middle-class America – a demand largely created by the medical world itself.
The narrative moves effortlessly amongst a galaxy of perspectives. Quinones introduces ‘Enrique’, the archetypal Mexican boy escaping the drudgery of an agricultural world to make something of his life in ‘El Norte’. This account is spliced with those of the families and isolated law officers dealing with the problem. The reader is treated to a junkie’s-eye view of the history of heroin interwoven with pharmaceutical archives. Quinones examines how a short letter to the editor of the New England Journal of Medicine snowballed into the erroneous belief that pain cancelled out addiction. The results are charted as even star college football players, prescribed opioid pills for injuries, become addicted and eventually die, tragically young, from overdoses of the potent, yet dangerously impure, Mexican ‘black tar’ heroin.
As Quinones pieces the puzzle together, the story of the Xalisco Boys emerges. Learning that gang warfare engendered police action, and mindful of the ‘big bust’ model of drug enforcement, the Xalisco Boys operated in small cells and used modern ‘just in time’ supply chain techniques reminiscent of corporate franchises. The cells competed, but their warfare was limited to price competition as clean-cut young Mexicans, with little English and driving unremarkable cars, serviced a new and growing market. Pagers and then cell phones allowed middle-class kids to avoid going to skid row or a seedy dope house and have their fix delivered like pizza instead.
Ultimately, the sheer quantity of cases caught the Drug Enforcement Administration’s attention and an operation stretching from coast to coast was mounted, to little effect. The ‘internet of dope’ could not be switched off like a traditional Mexican cartel. There was no single kingpin to take down, the cells were just too independent and networked beyond the reach of the authorities.
Quinones surveys the history and efficacy of morphine, tracing it back, past Herodotus, to the Sumerians. Consulting Andy Coop, a British specialist at the University of Maryland, he describes how it fits like a key in a lock to create an intense euphoria beyond anything the body can naturally create, yet exacts the ‘mighty vengeance of a cruel lover’ on any who dare free themselves from it. Unlike other drugs that the body processes and expels, morphine refuses to follow the rules. Coop concludes: ‘It really is almost like someone designed it that way – diabolically so.’
Yet the ‘pain revolution’ de-stigmatised what had been the pastime of jazz musicians and sanctioned its use for the middle classes. As society was progressively liberalised, doctors lost their authority and were pressured by patients to become mere mechanics. Quinones points out that after the World Health Organisation claimed freedom from pain to be a universal human right, morphine use increased thirty-fold between 1980 and 2011, 90 per cent of that use being in the West.
Comparing the drive of Mexicans with the complacency of Americans, Quinones muses on ‘a country turning on this legacy in pursuit of comfort, living on credit, attempting to achieve happiness through more stuff. And I saw no coincidence that this was also when great new numbers of these same kids – most of them well-off and white – began consuming huge quantities of the morphine molecule, doping up and tuning out’.
That civilisations rot from within has almost become a cliche. Yet one cannot read Dreamland, a paradox of capitalism and the rule of law, and not reflect on Kipling’s verse of almost a century ago:
In the Carboniferous Epoch we were promised abundance for all,
By robbing selected Peter to pay for collective Paul;
But, though we had plenty of money, there was nothing our money could buy,
And the Gods of the Copybook Headings said: ‘If you don’t work you die.’
Man has always used intoxicants to banish what Euripides termed ‘the sufferings of our unhappy race’. Nevertheless, ‘proper prostrations to the Gods of the Market Place’ will reduce us to mindless Maenads, as warnings from The Bacchae to Dreamland illustrate.