Themes
Key
LitCharts assigns a color and icon to each theme in Dreamland, which you can use to track the themes throughout the work.
Pain Management and the Normalization of Narcotics
The Drug Business
Stigma, Shame, and the Opiate Epidemic
Community as a Remedy to Addiction
Summary
Analysis
It is late 1997 when Ed Hughes, who runs the Counseling Center, (Portsmouth’s only treatment center) receives a phone call from the Portsmouth Daily Times. A reporter wants to interview staff members about tips for staying sober during the holidays. The journalist asks Hughes if he knows what OxyContin is. Hughes doesn’t, but his staff reveals that addicts are abusing the oxycodone-based drug. The resultant article published by the Portsmouth Daily Times reports on “a new trend in addiction in southern Ohio.” Only a week after the story’s publication, Hughes is contacted by Purdue’s lawyer, who threaten legal action if Hughes claims OxyContin is addictive.
The fact that Hughes, who runs a drug treatment center, hasn’t even heard of OxyContin speaks to the silence that is characteristic of the opiate epidemic. Throughout Dreamland, Quinones emphasizes how the shame and stigma attached to drugs among the new class of opiate addicts allows the epidemic to gather strength largely unnoticed. Purdue’s swift threat of legal action against such a seemingly inconsequential local paper shows how important small-America is to the OxyContin campaign: it makes sense for Purdue to want to conceal OxyContin’s addictive quality because the addicts and pill mills of places like Portsmouth fuel their business.
Themes
Hughes founded the Counseling Center two decades earlier in response to his belief that community support is essential to an addict’s recovery. He remembers the OxyContin epidemic as distinct in its origins; unlike other drugs, OxyContin addiction started and expanded from pill mills, “a business model invented in town.”
