Sam Quinones takes a hard look at synthetic drugs in 'The Least of Us'

The bestselling author of “Dreamland” returns with a frightening examination of the meth and fentanyl crisis

By Seth Combs

San Diego Union-Tribune

Dec. 14, 2021 5:19 AM PT

Sam Quinones has had a busy morning. Fresh off an appearance to promote his new book, “The Least of Us,” he’s spent his time poring over a Centers for Disease Control report about how the U.S. had surpassed 100,000 overdose deaths in a 12-month period, the largest amount ever recorded. One of the main culprits? Synthetic opioids like fentanyl and psychostimulants like methamphetamine.

“The truth is that you just don’t survive on the street anymore,” Quinones says. “You could survive when heroin or cocaine was the drug, even when crack was the drug, but that is no longer the case. The problem now is that the drugs that are out there now are so potent and prevalent that they are almost anchoring people to the street just as they kill them.”

The CDC report is indicative of the types of studies and stats that Quinones loves to immerse himself in. It’s not light reading, but, then again, neither is “The Least of Us,” a highly detailed and often heart-wrenching account of the methamphetamine and fentanyl epidemic in the U.S. But even as Quinones loves to talk numbers, his journalistic heart is really in the streets, talking to people who are on the frontlines of what he describes as an “unprecedented crisis.”

“You pretty much have the same offerings all across the country and increasingly those two offerings are synthetic,” says Quinones, who found in his research that the same types of meth and fentanyl are being found all over the U.S. “Heroin is quickly not going to be part of the mix. It’s fading from the streets.”

The subtitle of “The Least of Us,” recently released by Bloomsbury Publishing, says it all: “True Tales of America and Hope in the Time of Fentanyl and Meth.” It’s not a direct sequel to “Dreamland: The True Tale of America’s Opiate Epidemic,” Quinones’ 2015 bestseller that largely focused on pharmaceutical painkillers, but the subject matter is related in that many people who become addicted to prescription drugs like OxyContin and oxycodone sometimes resort to buying illegal narcotics such as heroin, fentanyl and even meth.

“I thought there was some urgency in continuing that conversation I started in ‘Dreamland,’ because it was clear to me that this was getting worse and worse,” Quinones says. “What’s more, because the trafficking world had shifted to synthetic drugs, they could now produce drugs in quantities only comparable to the amount of prescription pain pills unleashed on the country by Big Pharma and doctors.”

Line between dread and optimism

Quinones has been around long enough to see just how rapidly and profoundly the U.S.’s relationship has changed when it comes to drugs, both legal and illegal. Fresh out of UC Berkeley and after a stint at The Orange County Register, he moved to Mexico in the ’90s to work as a freelance writer, an experience that ultimately helped prepare him for what he’s doing today.

“It taught me long-form journalism,” Quinones recalls. “It also taught me that if you’re going to write about America, you have to know a lot about Mexico.”

This experience eventually led him back to the U.S. and to write “Dreamland: The True Tale of America’s Opiate Epidemic,” a book that Quinones says he thought was going to fail miserably, but ended up becoming a bestseller. The fact that the public so widely consumed a book about such a dire subject is a testament to both Quinones’ skills as a journalist and the public’s concern about the epidemic.

“‘Dreamland’ came out and all of a sudden you could feel a shift, and it kept growing through the next several years. You could see more people coming out. More people on Facebook, more people giving speeches and talking to politicians about this stuff,” Quinones says. “That was an important thing, because you don’t get change without people being heard and from folks who can tell that story better than anyone else; family members, parents, siblings.”

Still, Quinones balances a thin line between dread and optimism in “The Least of Us.” The chapters within the book, while interconnected, sees the author jumping between places such as Bakersfield, California and Chicago, Illinois; Hardin County, Ohio and Toluca, Mexico. He also visits both the labs in which they’re cooking these drugs, as well as the ones studying the neurochemistry behind addiction.

The most visceral chapters, however, are the ones where Quinones speaks directly with addicts, many of them homeless or unsheltered, and could provide San Diego readers a window into just how interconnected addiction is with issues such as homelessness. Quinones clearly lays out in the book that cities cannot address the issue of homelessness without addressing the easily available supply of illegal drugs.

“When I started, I didn’t understand the homelessness crisis, the mental health side of it, when it came to meth,” Quinones says. “I knew it was bad for the brain and had some psychological effects but not to the degree that my reporting ended up showing.”

The book ends on a slightly optimistic tone when Quinones travels to Kenton County, Ky., a deep-red area of a deep-red state, but one that is rethinking its law enforcement approach to drugs, homelessness and addiction. The author argues that other towns and cities, especially border and port cities like San Diego, need to begin to embrace the concept of “community repair” even when it comes to law enforcement.

“Jail is something that needs to be rethought. And there needs to be ample room, space and possibility for people to begin their recovery,” Quinones says, adding that people still need to be arrested, but not with the sole intent of sending them to prison. “There needs to be programs set up in jail, because sometimes you can spend months in jail just sitting around doing nothing. It’s a horrible waste of opportunity socially, societally and individually. We need to be in the business of getting people off the streets and getting them into treatment.”

Quinones says the approach isn’t perfect and that it will likely take years of experimenting before cities find a suitable balance and the numbers begin to go down. Until then, he says, the drugs will continue to come and statistics like the ones from the CDC will continue to climb.

“We have to be in the position of pushing people or, otherwise, they will die,” Quinones says. “And the statistics are proving that.”