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
In 2007, Jeremy Wilder, the “gaunt” addict from Aberdeen, returns from prison, where he’d been since 2003 for robbing pharmacies to fund his drug habit. When Wilder was first locked up, Aberdeen’s addicts were a small group of people; when he returns, that number has skyrocketed. Countless people now drive to Florida to procure pills easily, and countless more are on heroin. Of particular influence on Southern Ohio’s drug market are rich kids, which is something that Ed Socie, an epidemiologist with Ohio’s department of health, notices in the data he analyzes. Despite decades of stability, Ohio’s “accidental poisoning” deaths, and more specifically, drug overdose deaths, have tripled in recent years.
Wilder also sold drugs before his imprisonment. He recalls that before, he sold to a certain type of drug user. After he was released from prison, he discovered that there no longer was a particular type of drug user: addiction now affected all classes and groups of people. Socie’s observation that Southern Ohio’s drug market now catered to rich kids further dispels the idea that addiction affects only a certain type of group of person.
Themes
Christy Beeghly becomes supervisor of the Department of Health’s Violence and Injury Prevention Unit in 2007. Socie shows her his drug overdose data, and the two also notice that the amount of OxyContin prescribed in Ohio has increased in recent years; in fact, “in 2005, Ohio’s overdose deaths exceeded those at the height of the state’s HIV/AIDS epidemic in the mid-1990s.” Portsmouth doctor and Scioto County coroner Terry Johnson isn’t surprised: Portsmouth is full of pill mills and SSI and Medicaid abusers. Autopsying overdoses has become the norm for him. Despite this, lawmakers in Columbus (Ohio’s capital) stay silent. Christy Beeghly assembles a presentation to display southern Ohio’s troubling overdose data. After several town hall meetings with medical professionals and the DEA, Ohio’s then-governor declares a state of emergency.
Comparing the opiate epidemic to the HIV/AIDS epidemic reinforces the idea that addiction is an illness, not a character flaw. Beeghly and Socie present ample, alarming evidence that Ohio’s drug problem should be considered an epidemic. At the time, however, the state had an active law that protected doctors who prescribed opiates from prosecution, so Ohio lawmakers were at first limited in how they could respond to the disturbing statistics contained in the report. This is another instance in which a well-intentioned aspect of the pain revolution (destigmatizing opiates and protecting doctors who prescribed them) resulted in unintended, negative consequences.
Themes
