Idean Roohani
Addiction Medicine Tele-Learning Elective
5-24-2022
The Least of Us Summary
“The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth”
by Sam Quinones sheds light on the opioid epidemic that is currently happening in the United
States. Previously recognized for his award-winning book “Dreamland” that originally drew
connections between OxyContin-pushing doctors and the current opiate crisis. Quinones applies
a similar scope on fentanyl and methamphetamine in this book. Sam Quinones is a former LA
Times reporter and he uses his skill in investigative journalism to describe compelling
storytelling narratives in both works. Quinones explores two major shifts towards synthetically
produced drugs in the current dark market: heroin to fentanyl and methamphetamine to P2P.
Fentanyl has been the new hot topic of among opiates. Its depressive effects of are so fatal that
they make look heroin seem weak in comparison. However, due to its effects, fentanyl has
become popularized among the drug market because its immensely profitable drug, easy to
smuggle, cheap and highly addictive. Fentanyl has become so popular that it has been mixed in
with virtually every street drug (cocaine, heroin, meth, etc.). The superior effects of fentanyl has
been so enticing to dealers to help their product stay on top of the competition. Consequently,
overdose deaths continued to rise with the number hitting an all-time high of 87,000 deaths in
2020 according to the Centers for Disease Control and Prevention. In the realm of
methamphetamine, meth was originally produced from ephedrine, now is being massively
produced using the new synthetic chemical “P2P”, which is highly addictive, toxic, and
corrosive. Methamphetamine used to previously be used as a party drug that would all the user to
feel euphoria and remain socialable while taking the drug. Now, being produced by P2P, there
have been more cases of methamphetamine causing hallucinations, extreme paranoia, and
psychosis. Many addicts resulted in brain damage that caused permanent personality and
behavior changes from their baseline. Quinones describes an interesting shift in the drug markets
using the cases of fentanyl and P2P as examples. Drug dealing no longer requires a cartel to mass
produce these drugs. Now, anyone can access large quantities of fentanyl and P2P simply
through their laptop and internet connection. Drugs that used to require farming poppy-seeds can
now be produced in laboratories in larger-quantities than ever. The traditional drug dealer has
evolved, allow you to run the business in the basement of your home in your pajamas. Quinones
calls for us as a community to crack down on these proliferating new lethal drugs. Quinones
describes the story of ex-physician Lou Ortenzio, who became addicted to his own Vicodin
samples and lost his medical license. He eventually reinvented himself as an public organizer
helping addicts in his community. Quinones believes community efforts similar to Ortenzio’s
will help shed light of the evolving drug market and help us fight this new drug epidemic.