notes / kortina.nyc

Quinones // The Least of Us

I loved Dreamland and Dopesick, so when I heard Sam Quinones had a new book I was eager to read it.

The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth covers much of the same material as Dreamland and Dopesick – on the opiod crisis and Sackler family – but about half of it is about the “next chapter” in American designer drug use.

After authorities cracked down on access to ephedrine home cooks used to cook meth with, some clever chemists in Mexico figured out how to import raw materials from China and cook at industrial scale. This “new meth” seems to cause much more severe psychological effects (hallucinations, paranoia, schizophrenia) and Quinones posits it has led to the recent increase in homelessness and tent cities.

Another designer drug – fentanyl – is extremely potent, also manufactured at scale, and far more deadly than the last round of legal opioids pushed pharma companies like Purdue.

There are quite a few juicy tangents, too:

If you’re at all interested in drugs in America, it’s another great read.


One of my favorite bits:

We live in a time when drug traffickers behave like multinational corporations and corporations behave like traffickers.

Both seem to understand our brains the way our neuroscientists do and have resources to prod them.

Take Wendy’s, the nation’s number-two hamburger chain. Wendy’s has a “Made to Crave” menu. Its burgers are displayed in almost pornographic close-up photos, which companies know are cues to binge. The ads’ message: pure, orgiastic pleasure. Thick burgers sweat fat as they bulge from their buns; each ooze slatherings of cheese, or bacon, or barbecue sauce. (Marijuana growers long ago began to copy this technique, as well, with their well-lit “pot porn” shots of glistening, engorged buds.)

“Let’s face it,” reads a company press release, “foodies want maximum craveability and quickly get hooked on the Deliciously Different flavors Wendy’s is known for.” To this lineup Wendy’s then added chicken sandwiches. Each sauce-dripping wonder, the company promised, is “packed with craveable, mind-blowing, unforgettable flavor.”

Taco Bell jumped into promotion using the imagery of drug addiction with its Cravings campaign in 2020, showing a young man worn out, desperate, and wandering through the night—conjuring, to me, a meth user—jonesing for the corporation’s nacho fries. The tag line: “He. Can’t. Escape. The Craving.”

Neither Wendy’s nor Taco Bell originated the marketing of fast food as crave-worthy. That title appears to belong to McDonald’s. In 1997, a McDonald’s ad campaign exploited the understanding that its name alone was by now a brain cue to binge. “Customers will connect with the advertising because it presents situations that everyone has experienced, where the mere mention of McDonald’s triggers cravings,” a company vice president of marketing told CNN at the time.

It is a sign of where we are that Wendy’s, Taco Bell, and McDonald’s use the language of drug addiction—hooked, cravings, triggers—as evidence of their products’ tastiness. Any addict, of course, knows the truth: cravings and triggers are torment, evidence of controlled brain chemistry. “Craveable, mind-blowing” is a product description the Sinaloa cartel might come up with.

A lot of this grew from the great competition of the twentieth century. Capitalism won the battle with communism, and happily so. It then lifted hundreds of millions of people from poverty. This stands as among the great achievements of justice and human realization in world history.

But capitalism lost something, too—the one thing it claimed was essential to human growth: competition. For most of its history, capitalism was like the gritty tool-and-die guy in his shop, battling to move ahead against loads of competitors. Adam Smith insisted that capitalism required a moral compass. But it didn’t take long after the Berlin Wall fell before questioning any free-market result was deemed softhearted and wrongheaded. Today, for the first time since Smith described it in 1776 in The Wealth of Nations, capitalism has no competition anywhere in the world. Even China has KFC restaurants —5,200 of them.

In the United States, unions, one brake on capitalism, weakened. Another—our tax laws—favor the wealthy. We caved to corporate conglomeration and largely gave up the antitrust battles of previous generations that allowed smaller and newer companies a chance to compete. Competition, the essence of capitalism, was stifled. When industry after industry merged into a few participants with gigantic power, we viewed that as the natural law of the market, then wondered why wages weren’t growing at the lower end of the economy. Along the way, we lauded the private sector and laughed at government. We viewed not paying taxes as some patriotic act. Around the globe, meanwhile, the rule of law in general—reining in various versions of capitalism—grew threadbare.

So, in a sense, capitalism today is a monopoly. Without competition, capitalism has bent toward the agglomeration of profit and power in the hands of relatively few families, corporations, industries, and governments. The coercion of twentieth-century dictatorships as methods of individual persuasion and control has been replaced by marketing, far more benign and effective. Meanwhile, vast rafts of people—entire regions even—sit becalmed in seas of poverty and resentment.

We live in a time of concentrated economic power. Big Tech. Big Oil. Big Pharma. Amazon. Facebook. Apple. Google. Walmart. In a remarkable book called The Myth of Capitalism: Monopolies and the Death of Competition, authors Jonathan Tepper and Denise Hearn insist that these concentrations of power behave like monopolies. They live to limit competition, to make markets, to rewrite rules, to increase prices and hold back wages, all in favor of the continued expansion of their economic power. “The average worker feels screwed,” Tepper and Hearn write. “They are bargaining against monopolists and oligopolists when it comes to getting paid.” Rural areas are where this is felt most acutely, they write, and this helps explain the urban-rural divide.

The effect of quasi-monopolies on our economy reminds me of what happens in our brains on drugs. Drugs limit or skew competition of natural chemicals within the brain to ensure their survival at the expense of our well-being.

Marketing deploys great energy to convince us of the pleasures of buying this or consuming that, no matter how unhealthy. Drugs do something similar to our brains. Both marketing and dope invite us to confuse pleasure with happiness or fulfillment. I came upon a YouTube video of a speech in which Dr. Robert Lustig contrasts pleasure and happiness. Pleasure, Lustig said, is fleeting; happiness is long-lived. Pleasure comes from taking or getting; happiness comes from giving. Pleasure is achieved alone; happiness with others. Pleasure comes from substances or things; happiness does not. Pleasure releases dopamine in our brains, the constant search for more; happiness releases serotonin, producing feelings of contentment, an end to consumption. All of which means, Lustig said, that pleasure can prod our reward pathways into addiction; happiness cannot.

“America has devolved,” Lustig once wrote, “from the aspirational, achievement-oriented ‘city on a hill’ we once were, into the addicted and depressed society that we’ve now become. Because we abdicated happiness for pleasure. Because pleasure got cheap.” The supply of it was everywhere. Like street dope.

Capitalism has been a titanic force for human advancement and innovation; opiates miraculously calm our pain. Yet unbound, both act to exterminate us. Opiates can train our brains to ignore our approaching demise. Capitalism markets products that poison us, and narcotizes us with such comfort and convenience that we scoff at signs of our approaching end.

When I met Nicole Avena, she told me this about sugar: “Potency is a big player. It’s one reason why we’re seeing these addictive responses. Products from thirty years ago didn’t have concentrations of sugar like we see today. The [processed food and drink] people consume these days are dominated by sugar, and potency of sugar is so much greater than it was.”

Unprecedented potency combined with unrelenting supply. That describes the illegal drug stream on American streets. Today, one drug primes a user for others.

In the United States, all this is etching and twisting our brain reward pathways in ways unknown even a few decades ago. The United States is the world’s leading per capita consumer of both opioids and sugar.

As in a drug-controlled brain, what was intended to keep us alive now threatens us. Food is made addictive; animals sold for our consumption spawn new viruses; plastic, a boon to humanity when employed for long-term uses, turns nightmarish when immediately thrown away; social media designed to connect us has us at each other’s throats; and fossil fuels disrupt the climate.

As I traveled the country, it occurred to me that our epidemic of addiction is an extreme expression of so much of this. We turned healthy self-reliance into a grim isolation. Then pain pills were marketed grotesquely and supplied beyond reason. They were overlaid on the mass marketing of legal, addictive substances. Beneath that lay reservoirs of childhood trauma, stress, depression, community destruction, and PTSD from fighting two wars using the same small minority of people while the rest of us got a tax cut.

So opioids that perform great miracles of pain relief now kill us. And from industrial chemicals indispensable to our modern prosperity, traffickers stir potions that send us out of our minds.