In his 2015 book Dreamland, author Sam Quiñones presents a study of the US opioid crisis, especially as it expanded from the late 1990s onward. Quiñones addresses multiple dimensions of a complex situation that has affected millions of people in all walks of life. One of the key points he raises is that the crisis is highly complex; this complexity stems in part from the multiple causes and long historical development. Quiñones clearly advocates for ending the crisis, but his primary focus is not on solutions. While he addresses numerous possible routes that can contribute to ending the opioid crisis, he does not advocate for any single approach. The very complexity ensures that no single way out could be the best way.
Throughout the book, Quiñones explains how the situation got so far out of hand and demonstrates the impact on a wide-ranging set of people. Most of them live in the United States, but he also addresses the issues as they affect Mexico. Interwoven in the stories of human vulnerability, desperation, and greed are analyses of legal and public policy issues that either failed to prevent problems or contributed to their growth.
Especially in the Afterword, the author provides information about programs and policy changes and the views of people who have been involved in effecting change. These include considering the problem from medical and public health perspectives, focusing on treatment. Another important aspect is the legal system, with focus on arrest, conviction, and incarceration. Quiñones also offers his personal view that rebuilding community is an essential component of strengthening the bonds that hold together American society.