Found in 9 comments on Hacker News
jmalicki · 2018-11-16 · Original thread
The book Dreamland[1] chronicles a lot of this history... but a belief in science means that if scientific studies challenge some of your preexisting beliefs, you accept that evidence.


base698 · 2018-08-16 · Original thread
"Dreamland" is a pretty amazing summary of the responsibility.

In short: pharma companies for misrepresenting an editorial in the 80s about addiction rates, medical industry calling pain the fifth vital sign, and enterprising drug dealers setting up Domino's like delivery services for heroin.

BurningFrog · 2018-05-31 · Original thread
40 of 2700 is 1.5% of deaths. If those are people decades younger than normal deaths, it will bring the numbers down. Not by several years, but by a decimal or two.

> Opioids do not generally cause a person to transition from healthy to unhealthy (they are prescribed to treat a preexisting condition).

This is a very naive view.

People start taking opioids in many different paths, legal and illegal. Some lie to get the prescription, no one can prove you don't have back pain. Some get a prescription after surgery and get addicted that week.

The super informative and well written book to read is Dreamland:

BurningFrog · 2017-09-07 · Original thread
The book to read about the opioid crisis is Dreamland by Sam Quinones.

It is really well written and researched and lays out the several separate events and trends that converged to make this perfect storm happen when and where it did:

sien · 2017-06-01 · Original thread
One of the big drivers in this has been the quadrupling in opioid prescriptions in the US since 1999.

Opioid pain prescriptions used to be very limited and carefully monitored because of the perceived risk of addiction. The prevailing wisdom on this danger was changed because of some low quality papers on the risk that were pushed by drug companies.

Another big driver has been a more effective opioid selling due to some Mexican drug sellers. Interestingly, these sellers are much less violent than previous opioid sellers.

These reasons are outlined in the excellent book 'Dreamland'

Long interview podcast (~1hr) with the author to listen to or read the transcript of here:

waterside81 · 2017-05-19 · Original thread
For those interested in this topic and how the opiate epidemic has stretched across the US, read Dreamland by Sam Quinones (

There are a multitude of reasons to explain how this happened but to quickly sum up an excellent book:

- Purdue created the whole "sell-direct-to-doctor" phenomena that is now the norm in the US medical profession

- One bad study that showed opiates for pain relief are NOT addictive and this study kept being cited by sales people

- Mexican drug dealers from a very tiny area in Mexico importing black tar heroin

- A prevailing idea in the US that people should never be in pain and managing it through lifestyle changes is not acceptable; a quick fix is needed

- economic depression in the Midwest and Appalachia regions

But really, read the book. It's eye opening and well written.

test1235 · 2017-04-10 · Original thread
I just finished reading Dreamland which I also thought was good.

This book has more of a focus on American pharma industry but still has lots of interesting insider insights.

soneca · 2017-01-27 · Original thread
Interesting, but I just listened to Econtalk podcast[1] where the guest, author of the book Dreamland about opioid epidemic[2], claims that all this epidemy only started at first place because researchers at the time claimed that opioid based pain relief medicine was disassociated from addiction (and pharma companies gladly played along).

Except it wasnt.

Very worthy your time listening to this guy if you are interested in the topic.



Donzo · 2015-11-13 · Original thread
For those interested in learning more about the erosion of the American heartland by the widespread use of prescription narcotics, particularly Oxycontin, I strongly recommend the book "Dreamland," a nonfiction text weaving together the narratives of the opiode boom in American medicine and the spread of Xalisco black tar herion cells throughout American cities that had seldom seen heroin:

Very readable and educational. I couldn't put it down, and it tied together a lot of disparate threads that I have noticed over the past two decades but which I was unable to connect myself.

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