Book Review: ‘The Least of Us,’ by Sam Quinones

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“The Least of Us,” by Sam Quinones, tracks the emergence  of drugs similar  methamphetamine crossed  America.
Credit...Jim Wilson/The New York Times

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  • Nov. 2, 2021, 5:00 a.m. ET

THE LEAST OF US
True Tales of America and Hope successful the Time of Fentanyl and Meth
By Sam Quinones

American pain. This is the territory of Sam Quinones, a masterly newsman and vivid, lyrical writer, whose past book, “Dreamland” (2015), won a National Book Critics Circle Award and awakened readers to the occupation of opiate addiction successful the United States. In it, Quinones traced connections betwixt pill-pushing doctors successful Portsmouth, Ohio, and heroin dealers from a municipality successful Mexico. It was Quinones who showed america that doctors had laid the groundwork for the influx of black-tar heroin by getting patients truthful hooked connected OxyContin that they were hopeless capable to crook to cheaper dope, immoderate dope, erstwhile those pills ran out.

In “The Least of Us,” Quinones applies a likewise kaleidoscopic attack to “designer drugs” similar fentanyl and methamphetamine. But his caller enactment lacks the cohesion of “Dreamland,” a occupation 1 senses aboriginal on. This, helium tells us, is simply a publication astir fentanyl and methamphetamine and besides astir assemblage efforts to combat addiction. Then why, 1 wonders, are we speechmaking truthful overmuch — 5 chapters — astir OxyContin and the Sackler family, whose company, Purdue Pharma, produced it, worldly that would person been astatine location successful his past book? (The reply seems to beryllium that since Quinones published “Dreamland,” lawsuits against Purdue person revealed the tactics by which the Sacklers made their billions.)

When Quinones tackles the newer occupation of decorator drugs, helium does truthful with his accustomed depth, describing successful 1 lawsuit the shipments of fentanyl from a father-and-son squad successful Shanghai to American customers who placed their orders connected the internet. “An immensely profitable drug, casual to smuggle, inexpensive and highly addictive,” helium writes. “Anybody could beryllium a fentanyl kingpin.” Over the past decade, fentanyl has shown up everyplace successful the United States, sold connected its own, but besides sprinkled into different thoroughfare drugs similar cocaine, heroin and meth. “Fetty” is specified an enticement that to support up with competition, “dealers didn’t dare not premix it in.” Overdose fatalities support rising, overtaking car crashes arsenic the starring origin of accidental death.

In the 12 months ending successful September 2020, that fig deed an all-time precocious of 87,000 deaths by overdose, according to the Centers for Disease Control and Prevention. Fentanyl tin beryllium truthful deadly that it astir makes heroin look mild. Micrograms tin kill. A dart afloat of fentanyl tin rather virtually “stop an elephant,” according to the Belgian chemist who invented it successful 1959. Meth, though little deadly, is present being churned retired successful wide quantities done a manufacturing process that often includes toxic chemicals. “Meth users dragged themselves done the nighttime streets, howling, hysterical, starving,” Quinones writes. While the opiate situation raged, giving mode to a surging request for fentanyl, meth crept successful and took clasp successful communities wherever it had ne'er been seen before.

Though helium understands increasing calls for decriminalizing drugs, Quinones is yet successful favour of policies that trim the disposable cause proviso successful the United States. After all, helium points out, the opioid epidemic followed an outpouring of ineligible drugs prescribed by doctors opening successful the 1990s. As synthetic drugs present proliferate similar variants of a virus, Quinones calls for cracking down, not easing up.

Quinones depicts his subjects affectingly, but on with his affluent reporting is the occupation of excess. A earthy storyteller, helium applies those skills to specified an array of characters that it is hard to registry their existent value to his larger narrative. There is Lou Ortenzio, a practicing doc who became addicted to his ain escaped samples of Vicodin, mislaid his aesculapian licence and coiled up delivering pizzas to his erstwhile patients, until helium reinvented himself arsenic an organizer helping addicts successful his community. But determination is besides the communicative of “Bird,” a vicinity fixture successful Muncie, Ind., whose vices are junk nutrient and soda, whose decease is owed to crab and whose lengthy inclusion here, portion poignant, is little casual to explain.

The slightest of us, Quinones is speedy to emphasize, is successful each of us. What helium means is our searing vulnerability, simply by dint of being human. And that’s the constituent and the powerfulness of his work: to radiance a agleam airy not lone connected the pathways by which drugs traverse this country, but besides connected the hopeless symptom that truthful galore among america are in.

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