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Quinones' book 'The Least of Us' sheds light on the dangers of fentanyl and meth

RACHEL MARTIN, HOST:

Journalist Sam Quinones never got over what happened to him after he wrote a book called "Dreamland" about the opioid crisis. People came up to him at book signings with their own stories of addiction, including an elderly man in Ohio. His daughter was imprisoned for drugs, and he and his wife were raising their young grandchild.

SAM QUINONES: I held his hand. We shook, and I didn't know what to say, and he just said to me, you know, it's just so hard. And we held each other's hands for longer than two men in Portsmouth, Ohio, normally shake each other's hand. And I looked into his eyes, and then he just moved away. It was one of those moments I just never, ever forgot.

MARTIN: Quinones has a new book that is as much about the new drugs wreaking havoc in America as it is about the people trying to make a difference - a sheriff in Ohio who hired a man recovering from drug addiction as a dispatcher, a town in Kentucky that created a recovery unit in a jail to help people accused of drug-related crimes. The book is called "The Least Of Us: True Tales Of America And Hope In The Time Of Fentanyl And Meth."

QUINONES: As I was writing this book and searching for what I thought it was about, I began to read the Bible, and I came upon this idea that perhaps what this epidemic was teaching us was something that perhaps as a society or a culture we'd gotten away from, which was that we need to attend to the most vulnerable, that we are only as strong as the least of us. You know, we're only as strong as that addict eating from the trash. And that seemed a powerful idea because I believe the root of the opioid epidemic and this - really, it's an addiction epidemic - is really our own isolation.

MARTIN: The new book picks up where your last one, "Dreamland," left off - "Dreamland," again, about America's opioid epidemic. Why did you feel like that story was not over and that you had more to say?

QUINONES: Well, you know, initially, I thought I would never write again about this topic. I thought I'd go onto something else because I'm an old crime reporter - for many years, covered the stuff. And what is worse than heroin, you know? But then as I traveled, I began to realize that clearly fentanyl was now replacing, crowding out heroin. Heroin likely in a few years won't even exist on our streets anymore, I think. And I began to realize that the trafficking world in Mexico had moved away from plant-based drugs and had moved into synthetics. As synthetics, they could be made year-round in quantities that just were staggering coming out of Mexico in synthetic form, from fentanyl and methamphetamine, so long as they had access to shipping ports, which they do, and therefore world chemical markets so they can get all the ingredients they want.

MARTIN: Explain how much more dangerous these synthetic drugs are, especially fentanyl.

QUINONES: Yeah. Fentanyl is a magnificent drug when used medicinally. I've had a heart attack; they gave me fentanyl. It revolutionized surgery in our country. It's a fantastic drug when used medically. The problem is when it's mixed, it's extraordinarily potent. It reaches the brain very, very quickly, dominates the brain, creates overdose very, very quickly with just the most minute amounts. It's an opioid, so it's very, very addictive, like heroin. But in the hands of the underworld, it's extraordinarily difficult to mix because it's so potent, because so little of it will kill you. There's a saying - a guy told me this - you know, there's no such thing as a long-term street fentanyl user. Heroin, you could last for years and years, and people did. Well, on fentanyl, people die, and they die very quickly.

MARTIN: I mean, you say a lot of this has to do with the fact that people didn't know how to mix it correctly because just access to fentanyl transformed who could be a drug dealer, who could be a drug manufacturer. I mean, it could be anyone. They go online, and they can find out how to buy fentanyl on the black market from China, right?

QUINONES: Exactly. And there's a saying also on the street that fentanyl changes everything. One of the things it changes is that - who can be a kingpin. Some guy in his mom's basement in his boxer shorts now can sell quantities that we - before were considered kingpin-sized quantities of dope. More and more people saw that they'd almost - fentanyl was like a lottery ticket winning, you know? They were going to make huge amounts of money. And the problem is they make all kinds of stupid mistakes, and a lot of them also get arrested very quickly. So it's changed almost everything about the drug world.

MARTIN: And the new synthetic drugs destroyed so many lives. Quinones tells the story of a lot of victims, including that of a woman named Starla Hoss. She went looking for help at a women's shelter in Tennessee run by Angie Odom. But Starla didn't stay long, and Angie lost track of her - until one day Starla's mom showed up at Angie's Clinic with a baby. Quinones picks up the story from there.

QUINONES: This is Starla's baby. She said you would help. So it turns out Starla was in Florida working as a prostitute, had an overdose, wasn't taken to the ER in time and lived but couldn't talk, couldn't move, really couldn't eat. However, she was pregnant with this girl. And so eventually, the hospital tended to her for several months until she gave birth. And Angie, this woman who had had only cursory connection with Starla, adopted Starla's infant girl, naming her Bella (ph). It was the most powerful, powerful story that I'd heard in quite a long time.

MARTIN: That was the thing that really struck me, and honestly, it's what kept me reading. I don't mean to dismiss the book, but it's tough, right? It's tough stuff.

QUINONES: Yep.

MARTIN: But these stories, not just of the victims and the devastation that the epidemic wrought in their own individual lives, but how people who you profile were looking at their corner of the world and saying, you know, the big epidemic, I can't fix that; I can fix what's right here in front of me. And that was really powerful to read.

QUINONES: And that is why, amid all this very sinister stuff that I'm writing about, fentanyl and methamphetamine, I believe that the book I was trying to write was a hopeful one, in fact. The stories that most inspired me and excited me, even, were these stories about people doing small stuff, you know? It's just daily work - not caring if they're not, you know, saving the world. They're saving one person's world. They're helping out in one small way. They're figuring out how to make the community a little bit easier to live in. And it really was a hopeful thing to see amid all the other junk that's going on.

MARTIN: The book is called "The Least Of Us: True Tales Of America And Hope In The Time Of Fentanyl And Meth." Sam Quinones, thank you so much for talking with us.

QUINONES: It's my pleasure. Thank you very much.

(SOUNDBITE OF AARKTICA'S "INSTILL") Transcript provided by NPR, Copyright NPR.

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