Big Pharma
This story is a specific example of the rise of what has been popularly referred to as "Big Pharma." The competition of major drug creators has been responsible for many imbalances in America, including the opiate addiction, says the author of this book. He explains a case study which is also a key example for the rest of the industry. The company in question is Purdue Pharma, the creators and distributors of the highly addictive pain-killer OxyContin which is an opiate.
The typical case
The book explains a case which happened to thousands and thousands of Americans in the 1990's. The pattern is as follows: a patient goes to the doctor complaining of a painful ailment that either does or does not have a remedy. In many cases, doctors, under the influence of pharmaceutical misinformation (or in some cases perhaps even downright corruption) would prescribe opiates for the conditions, specifically OxyContin. The patients were made aware of the potential for addiction, but by the time the addiction occurred, it was too late. This coincided with the rise of heroin.
The cartels as businesses
On the legal side of the equation, there are the Big Pharma companies who sway law and public opinion about which drugs are good and which are bad. By giving the greenlight to OxyContin, these companies set up the nation for an epidemic of addiction. At the same time, Quinones explains that cartels were manufacturing heroin with unprecedented efficiency, which paved the way for underground criminal operations that were basically illegal providers of opiates. When doctors stopped letting addicted patients renew their pain medications, the cartels were ready with a cheap alternative.
The narrative of addiction
This book shows that, although there are certainly criminal folks and heavy drug-abusers, the majority of people affected by the opiate epidemic in the 1990's were well-meaning patients without nefarious motives. The narrative that surrounds opiate addiction is false, he shows, because the majority of opiate and heroin addicts are not evil troublemakers, as some people have believed, but rather, they are the victims of big business and chronic misinformation among the public about which drugs should be avoided and which are acceptable.
The opiate experience
To the people who became addicted to opiates, the experience of opiates was often described as a spiritual experience of bliss and pleasure far past the imagination. That is the center of the addiction of the epidemic; patients who became users of opiates for pain relief were often given experiences that were way better than they had hoped. Not only would the drug kill pain, but if more is taken, the drug would send the user into absolute bliss and ecstasy. Then, when the drug wore off, the pain would return, along with a strong desire for that experience of that opiate pleasure which felt infinite.
