LitCharts assigns a color and icon to each theme in Dreamland, which you can use to track the themes throughout the work.
Pain Management and the Normalization of Narcotics
The Drug Business
Stigma, Shame, and the Opiate Epidemic
Community as a Remedy to Addiction
Summary
Analysis
Dr. Phillip Prior died of liver cancer in 2013. When he died, hundreds attended his funeral. Dr. Orman Hall remembers Prior as “the guy who painted the bigger picture of the complicity of Purdue Pharma in starting this epidemic.” Ironically, Hall notes, Prior became dependent on opiates in the last weeks of his life, overwhelmed by the pain of his cancer. Hall believes this illustrates that there is a place for opiates in health care.
In Dreamland, Dr. Phillip Prior sticks out as one of the few doctors who refused to be corrupted by the pain revolution. He maintained his sense of moral ethics despite Purdue’s aggressive marketing of OxyContin. The addiction to opiates Prior suffered at the end of his life is the medical situation that prompted pain crusaders’ call for expanded access to opiates in the first place: terminally ill patients for whom death should be dignified.
Active
Themes
In Marion, Ohio, Brad Belcher’s “guerrilla” signs inspire Jennifer Miller, Marion County’s chief probation officer, to adopt a more understanding, educated approach toward addiction. In Columbus, it’s nearing the second anniversary of Matt Schoonover’s death. The Schoonovers have started to collect the pieces of their shattered lives. Since speaking openly about Matt’s death, they’ve found many other parents who were dealing with the same tragedy.
Belcher’s “guerilla” signs helped dismantle the stigma and shame associated with drug abuse, brought addiction into the public conversation, and inspired a public figure to respond more compassionately to addicts. Dismantling the stigma attached to their son’s overdose death allowed the Schoonovers seek solace in community.
Active
Themes
In Ohio, opiate prescriptions are down, and bills are being proposed that would provide more services to recovering addicts. Nationally, the opiate epidemic has caused a shift in the way Americans regard addiction: there is now a greater emphasis on compassion and treatment. More parents are coming forward. In the larger culture, addiction has been transformed from a perceived moral failure to a legitimate disease.
Overcoming the shame and stigma associated with drug use has created more public services for addicts and transformed America’s attitude toward addicts and addiction.
Active
Themes
Residents of Central Ohio, “ground zero in the opiate scourge,” are taking the time to self-reflect. Paul Schoonover has become involved with the “nascent college recovery movement” at Ohio State, which addresses college alcohol and weed culture on campus.
The “nascent college recovery movement” is an example of a community effort to combat addiction and substance abuse.
Ohio Governer Tim Kasich responded to the epidemic, too, by expanding Medicaid and forming “Start Talking!” a program aimed at making the epidemic a public issue. All of these gestures work to counteract the “selfish” quality of opiates by bringing “atomized” communities back together and back into the public sphere.
As of 2018, over 90 percent of opiate addicts enrolled in Ohio’s expanded Medicaid program received treatment. “Start Talking!” reflects both the national trend of destigmatizing addiction, as well as power of community to combat drug abuse.