Has anybody here read Dreamland: The True Tale of America's

I had heard bits and pieces about the painkiller and heroin problem, but liked seeing it all pieced together in one place. I didn't know about the shifts within the medical community regarding pain and I thought the tracing of this history was great (and definitely disconcerting given it was a one paragraph letter that led to a lot of the misleading information about opiate painkillers not being addictive). And I didn't know about the Xalisco boys and their new model of heroin distribution.  I did find the book repetitive after a bit - but overall I still thought it was great.

I had previously listened to an interview with a recovered heroin addict who just published a memoir. I was appalled that after having a c-section the dr casually gave her a 30 day prescription of a strong painkiller. She said she was lucky she had a support system and she didn't fall back into addiction, but she was shocked she was so easily given pills given her history. 

This is exactly what was discussed in the book - this won't be anything new to you or anybody else who is in the medical field - but was new to me. I found it very interesting. My impression was that most doctors were prescribing painkillers with the intention to really help people, but there were some egregious cases of bad doctors who set up "pill mills" or did other illegal/unethical things and really caused a lot of problems (one of the main "bad guys" profiled in the book subscribed pills in the millions).

The pharma companies really pushed the drugs and certainly had some shady practices- mainly denying that people could become addicted. And OxyContin was a game changer because it could more easily be crushed or liquified versus previous drugs that contained acetaminophen that made it a lot harder to extract the opiates. 

Insurance companies carried some of the blame too as they often refused to pay for more holistic treatment of pain (I mean holistic like a total approach with physical therapy, different doctors, etc, not bone broth and essential oils and crap like that, lol), but were willing to pay for pills. And doctors were/are under pressure to see more patients and with limited time with each patient, it's easiest to just prescribe some pills and move them out.  And people also want the pills and not have to deal with more than that (not saying that people don't have legitimate reasons for taking painkillers, but in the book several times it was mentioned about patients who didn't want to hear about diet, exercise, quitting bad habits, and just wanted the drugs). The Medicaid system was also a factor in how people were getting pills cheaply and then reselling them.

I knew that people often moved from painkillers to heroin (much cheaper - I was surprised at how cheap black tar heroin is), but didn't know just how linked they were. Some of the dealers specifically targeted areas with Oxy problems (mainly in the Rust Belt and Appalachia); those areas were primed for heroin. And these areas had suffered greatly when manufacturing jobs dried up and I think this is also linked to the report released last year that showed death rates going up for middle aged white Americans due to suicide, drugs, and alcohol. 

Anyway, I could ramble on for a long time. The book was really good!  There was a lot to untangle there and the author did a good job pulling in all the various pieces.

ETA: And I'm sorry you suffer from headaches and back pain.  I think the painkillers can be life changing to those who suffer and hopefully new guidelines will allow those who need the relief to get it. I'm sure there will be another shift in the medical community as the epidemic has grown. At the very least when they do prescribe medication they can be really clear about the possibility of addiction and provide resources and info for patients.