cover image The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth

The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth

Sam Quinones. Bloomsbury, $28 (432p) ISBN 978-1-63557-435-7

Journalist Quinones follows Dreamland with a sweeping portrait of the destruction wrought by pharmaceutical companies, Mexican cartels, and other drug profiteers, and an inspirational call for a renewed sense of community to combat the isolation of addiction. Quinones reports from Mexican meth labs, Ohio treatment centers, federal prosecutors’ offices, and the Stamford, Conn., headquarters of OxyContin makers Purdue Pharma, where sculptor Domenic Esposito displayed an 800-pound “Opioid Spoon” in 2018. Quinones also delves into the history of fentanyl, a synthetic opioid first manufactured in the 1950s that began to appear in significant quantities in the U.S. in the mid-2010s. More addictive and profitable than previous opioids—and also far more likely to result in a fatal overdose—fentanyl has largely displaced heroin in the street trade, according to Quinones, who lucidly explains how opioid usage rewires the brain’s dopamine receptors, making it impossible to achieve a feeling of happiness without the aid of the drug. Vivid character profiles of drug runners and abusers, their family members, and social workers and addiction treatment counselors make the scale of the tragedy clear, while providing persuasive evidence that the battle against the opioid crisis can be won by “breaking down silos,” fostering interpersonal connections, and believing “that the least of us lies within us all.” This is a richly rewarding report from the front lines of an ongoing emergency. (Oct.)