Dreamland

Dreamland

by

Sam Quinones

Teachers and parents! Our Teacher Edition on Dreamland makes teaching easy.

Dreamland: Part 2: Fifty, Hundred Cases a Month Summary & Analysis

Summary
Analysis
Washington State holds a monopoly on insuring workers. Labor and Industries (L&I) employee Jaymie Mai, thus, is in a unique situation. Since 2000, Mai, a pharmacist, has been in charge of overseeing workers comp cases. She begins to notice a disturbing trend: painkillers are being inappropriately prescribed to workers in alarming numbers. More disturbing than this, workers who are prescribed the painkillers begin dying, including those whose initial complaints were simple ailments like a sprained knee. In the past, most deaths could be accounted for by accidents like electrocutions or from cancer.
Mai’s discovery underscores how widespread opiate use has become since OxyContin was released in 1996. Her findings also show the extent to which the pain revolution’s initial goals (patient welfare and dignity) were corrupted by greed: patients with minor injuries are literally dying because Purdue, wanting to make more sales, erroneously advertised OxyContin as a safe treatment for non-life-threatening conditions.  
Themes
Pain Management and the Normalization of Narcotics Theme Icon
The Drug Business Theme Icon
Stigma, Shame, and the Opiate Epidemic  Theme Icon
Mai immerses herself in research. In 2005, Mai and her boss Gary Franklin publish a paper in the American Journal of Industrial Medicine attesting to the increased number of workers who have died from prescription painkillers between 1995 and 2002. Most of these workers initially entered into the worker’s comp system with non-life-threatening conditions. The paper is met with backlash from people who don’t want their meds taken away. Mai and Franklin contact Jennifer Sabel, an epidemiologist with the Washington state department of health, to see whether the trend in rising opiate deaths in worker’s comp data is mirrored across the state’s entire population.
Mai and Franklin’s paper shows that OxyContin is anything but a Holy Grail: the “heaven” of convenient pain relief it affords is overshadowed by the decidedly hellish downside of death. Despite its alarming findings, the paper is met with backlash by a market of people conditioned by the pain revolution to believe it is their right to have accessible, convenient pain relief.
Themes
Pain Management and the Normalization of Narcotics Theme Icon