continues. host: welcome back to "washington journal." we are joined by sam quinones, the author of "the least of us: true tales of america and hope in the time of fentanyl and meth ." welcome. guest: thank you. host: i want to put something on the screen talking about the

scale of this fentanyl problem. the sources from npr, but i lis have been claimed from acan 2022, 2023, accord the cdc, a 37% increase compared with a 12 month period ending in may 2020. the vast mory who died were adults, but drugverdoses are killing young americans and at unprecedented numbers, rising from 31 and july 2019 to 18 in may 2021. what is going on? what is causing the rise? guest: i would say the supply that has inundated the country, most of it from mexico. and fentanyl is a legal drug used effectively in surgery. i have had it in surgery myself,

but when it is in the hands of the trafficking world and mexico, who was able to get quantities of ingredients to make fentanyl, you have a combustible combination, and what has happened is over the last several years, the traffickers and mexico have been able to make it in staggering quantities. so much that fentanyl is now nationwide. it used to be illicitly in 2013- 20 14, mostly congregating in the states where the opioid epidemic began, ohio, west virginia. since then, it has really just pretty much gone all over the country. it is the deadliest drug we have ever seen on our streets. host: fentanyl is synthetic. guest: a synthetic drug made only with chemicals. host: in a lab. you don't need to grow it, and that makes it cheaper. guest: that next it cheaper,

easier to make, and easier to smuggle because it is a highly potent, so a smaller amount will make you staggering profits. that is one of several reasons -- these are among several reasons why traffickers have figured out that this is a bonanza drug. a lottery type winnings from this drug. so people are finding that traffickers and dealers across the country have been putting it into other drugs. cocaine is the main one. methamphetamine. host: why is it being next with other chemicals? guest: again, it is all about supply. there is so much of it coming in from mexico that it gets mixed in where people on the street have figured out, if you mix it into other drugs, it will boost the potency. thus, it is important to understand, you don't kill the

customer first, they will develop a tolerance have become an addict, and then will be a daily, aggressive customer, whereas, maybe a person using cocaine may use once or twice a week or month, but now they become daily users, so it is also -- as much as it does kill people, it is also a customer expansion tool on the part of local dealers. this is something that dealers all across the country have figured out. a good number of them are also selling fentanyl to maintain their fentanyl habit. it is part of the whole drug world. you sell to make the money that -- make the drugs that you do not want to spend your own money on. it is kind of an ecosystem of vendors all across the country, but fentanyl has now competed

with karen. if you are addicted to fentanyl, there is no chance that heroin will be taking care of withdrawal symptoms. host: so as far as addiction goes, fentanyl is easier to get addicted to than other illicit drugs and harder to get off of. guest: well, because the supply is so vast and relentless, it takes people's tolerances of very high. that means the withdrawals are beastly. they are just demonic. so getting off of it becomes very difficult. but, again, all of this is kind of related to the vast amounts of fentanyl coming in from mexico. host: if you would like to join the conversation with our guest sam quinones, our lines are this way. if you have been impacted by the drug crisis, call (202)-748-8000

. if you are a medical professional, (202)-748-8001. everybody else can use the line (202)-748-8002. of course, we have our social media and are texting line open, as well. speaking of supply, you wrote an opinion piece for "the washington post," with the headline -- "the fentanyl crisis is being driven by supply, not demand." this is a common belief that if there were no market in the u.s., no users, there would be no fentanyl problem. guest: yes, and i think that has been true in the past, but i think with fentanyl, i think all opioids really change our brain chemistry. they make us physically addicted to them. it is a common idea in the opioid vending world that once someone starts on it, pretty

soon, that person becomes a big customer, so that demand -- essential demand starts with supply. with fentanyl, you are seeing this in an exaggerated way. fentanyl -- again, if it does not kill you, and many die from it right off the bat -- that is another part of the story. once you have had fentanyl, and you have had it a couple of times, you get very addicted. you get addicted very quickly, and very quickly your tolerance rises. that is why we are seeing also on the street, across the country i would say, people offering services and treatment. we have a treatment bed for you. you are going to die on the street. fentanyl is going to kill you, and people still do not accept treatment because they are terrified from being away from the drug. i had a drug counselor tell me that my clients are afraid of

two things. one, we are afraid of dying from fentanyl because they know the longer you stay on the street, you are going to die. nobody survives long term. the other thing they are afraid of is being away from fentanyl. it is a terrible, terrible thing. because fentanyl, like all opioids, changes the brain chemistry so dramatic and squelch is the basic instinct for survival that we all possess. every animal has it. but on opioids in particular, particularly no one fentanyl, you find that people are just terrified of being away from fentanyl, even though they know it is going to kill them. host: since fentanyl is so different from other drugs, does the drug policy in the u.s. need to be evolved in response, or are the same policies we have used for crack/cocaine and others be used? guest: i think fentanyl changes

things, and it changes how we need to approach this. the reporting i have done across the country the last 10, 12 years, i believe we need policies that take people off the street where they cannot leave. frequently, you see people say, i don't want treatment, or maybe i do, and then three days later they are leaving because they are terrified and neither drug. i believe there -- and they need their drug. i believe that they are calling on us so we understand that we need to take people off the street to places where they cannot leave where the drug tells them they must because otherwise, they will die on the street. so you are seeing in some parts of the country a very interesting experiment in how to do jail differently, so rethinking jail becomes an especially important part of how to address this because jail is

a place where people cannot leave. they get arrested, they cannot leave because they're waiting for trial or whatever. in the past, we have thrown people in jail, and they vegetated to the throw away the key idea. i think we need another way, and we are seeing in certain counties where they are experimenting with dale as a place for recovery. essentially, the same services in a treatment center are now available in some jails. host: with the caveat you cannot leave. guest: which turns out to be lifesaving when you are talking about fentanyl and methamphetamine that are now on the streets and really nationwide. host: talk about meth and how it is different. guest: meth is a stimulant, an amazing idea. in the past, we had cycles of drug use. we would go from stimulants to the presence back to stimulants -- to depressants to stimulants.

now we are seeing no cycles. it changes the supplies of these drugs. both synthetic area they have changed history, so you are getting no cycles. it is just straight up fentanyl and meth together all across the country, nationwide, and unprecedented event. and methamphetamine is so potent now, the key to what has happened with meth is its potency. it is made very potent in mexico because it is so prevalent. it is everywhere. and does not need to be cut or diluted by the local dealers. who would only cut it and lead it if they wanted to extend the life, but now it is so prevalent that they can buy it anywhere, so you are finding this extraordinary -- extraordinarily potent with amphetamine is being used by people all across the country. the most potent that has been used by a population ever in the

history of that drug. and the effect of that is to quickly push people into symptoms of mental illness, schizophrenia, psychosis, and i believe a strong driver of our mental illness problem and our homelessness problem is the spread of methamphetamine. it is so potent coming out of mexico for the last 10 years or so. host: we will take calls, but i would like to ask you about the flow of fentanyl into the country, being made in mexico. how is it getting into the united states exactly? specifically. and why can't that be stopped? guest: well, we have a free-trade agreement with the country of mexico, 2000 mile border, numerous border crossings all along the border. we have trucks going back and forth, most of the fentanyl is carried, and methamphetamine for that matter, and most of that traffic is coming through ports of the border crossings. it is just that we don't have the ability -- we don't have the

manpower to check each of those trucks or even a significant percentage of those trucks. and what is more, my understanding speaking with border economists, it is likely that even if we did, it would not be in our interest to check all of them because it would cripple the economy. so much of what comes back and forth is essential to our economic structure, making products, delivering products, food, etc. host: is it being carried by american citizens? guest: i am sure some, of course. there are not only mexicans crossing the border. in fact, i know several people in the book that i interviewed were american citizens who went down to mexico. one woman was the first woman in san diego to be caught smuggling counterfeit fentanyl pills in 2018. you know, she moved to mexico to be closer to the drugs, and then was caught smuggling these.

yeah, anybody who is available, and truck drivers, too, of course, are part of this. any of the mexican, of course. -- many of the mexican, of course. it is a robust ecosystem of potential transporters and participants on the border that play a role in all of this. host: ron is first, michigan. good morning. caller: yeah, i talked about drugs for 32 years in public education, and i understand exactly what you are talking about. the question i going to ask is unusual, and i might get an unusual answer. let's assume and say i walked through a store and buy a hershey candy bar, or i buy a product with a lot of keynotes

in it, can distributors of fentanyl, in order to get it is treated throughout the entire country for people who do not take drugs, and i never took drugs in my entire life, to distribute those drugs through argument it states to individuals who might buy the product, eat it, and then find out, i am getting into fentanyl or getting into some kind of use of drugs, can they distribute that to the people in the country as a whole? host: by what, ron? you are talking about np butter and things like that -- in peanut butter and things like that? caller: the kind of products that the u.s. distribute some people by across the counter. guest: i would say that that has not happened yet, but it is happening in mexico. what you are finding in mexico with reporting from the "l.a. times" that they are finding

that some of the pharmaceuticals in the so-called legitimate pharmacies on the border in mexico, and further into the country, ordinary drugs are now containing fentanyl, and some of the methamphetamine. i would say that in the u.s., i have not heard of this happening. this is still fairly illicit. it is being sold, important to understand, it is being sold by the tens of millions in counterfeit pills, made in mexico, looking like a percocet or a xanax bar, or one of these common, ordinary pharmaceutical prescriptions. they are now coming in containing only fentanyl. again, i believe this is just a symptom of the enormous supply that they are producing in mexico, always looking for new ways of delivering the drug.

kilos of fentanyl. the other way that has become extraordinarily popular down in mexico is by making these pills, and i believe that those pills are not coming into the country in the tens of millions. it started out with a woman i interviewed in san diego, bringing in thousands at a time, and now that feels quite. host: when you say counterfeit, are you saying i could take an advil -- guest: no, no. well, it varies. but the pills that usually are being made with fentanyl and it looked like opioids, percocet, generic oxycodone, little blue pills, xanax bars. you are finding other pills occasionally. it is not so much common, ordinary headache relief. but, you know, the trafficking

in mexico is nothing if not ingenious and constantly changing. host: do you think if you have to take an opioid for a legitimate medical reason you should test your pills first? guest: i think you should get it from a doctor and pharmacist. but these are being sold on the street, on social media sites like snapchat and that kind of thing. it is not something you would get in a pharmacy. i would like to be clear on that, just so nobody misunderstands. this is like the underworld kind of version. and we know they are fake because they are selling for 50 cents to two dollars. host: lydia is on the line for those impacted by the drug crisis. new york. good morning. caller: good morning. i had one of my relatives passed away years ago, overdosed on pain medication that i am sure

was probably laced with fentanyl. the one thing that we currently have, i know of someone personally who is actually in an injury grade rehab center. the one thing i wanted to mention, it is not talked about a lot, but there are the people who do not die when they overdosed. they are brought back. they are on a ventilator, and then etc. and so on. ultimately, they can land with a lot of disabilities, problems, and issues on drugs. guest: thank you for bringing that point up. that is extraordinarily important and i appreciate the question. that has become one of the side effects of leaving people on the street and simply providing them with naloxone, a miracle drug, and reviving people is important, naloxone is very

important, it is as common as fire extinguishers after years of reporting on this. however, if all we are doing is reviving people after an overdose -- an overdose is a deprivation of oxygen to the brain, it could be one minute to five minutes, but whatever it is, it is not good for the human brain. you are finding that people have overdosed and then revived, paramedics, friends, whatever, and they are slowly developing significant brain impairment because they are damaging their brains through repeated deprivation of oxygen. i wrote about this in a story in "the atlantic" in june of last year. this is one of the results. if we are going to leave people on the street, we need to understand that they will not be the same after they have been

revived. it is good to revive them and have naloxone as a tool out there, but do not think that they go back to normal. frequently, they are out long enough to be impaired. i set up on my instagram account an interview with a woman who had 26 overdoses in 15 months. now, she is really unable to help her kids with their homework, unable to participate in conversations that are fast-moving. it is very clear to her that her brain has been damaged by repeated overdoses. this is what i fear is also happening by people saying, we are going to let people use the drugs on the street until they become ready for treatment. readiness is not happening. people are dying before they ever get a chance to develop the readiness. meanwhile, as you say, a lot of

folks are developing brain impairment. it is now very widespread. host: in arkansas, diane is a medical professional. caller: good morning. thank you for taking my call. i am retired now, but i did work for the hospital in arkansas for 15 years. i was in physical operations, but it is ridiculous what is happening in this country, and i don't think the leaders of this country care. there has been over 70,000 people that this year alone have fentanyl overdosed. 106,000 from opioids. we have all these millions of people coming over the border, bringing this stuff, and they do

not care. we have homeless of 70,000 in the state of los angeles, california. philadelphia now is missing tranquilizer with fentanyl that is causing ulcers and rotting peoples flesh off. there is trash in the streets, abandoned buildings. millions and billions of dollars that we are getting to other countries, we could clean up this mess -- we are giving other countries, we could clean up this mess," or, and stop importing all merchandise from these countries if they don't cut it down. host: let's get a response, diane. guest: that was a lot there. a lot of what this lady has to

say is what i hear frequently. i travel a lot to speak around the country, and i hear this commonly. yes, the supplies coming in are huge. i would say that it is not really coming in on people's person. that would not be able to account for the vast expansion. it is coming on a truck and in cars. you are talking major loads of this stuff. not to say people do not import it, they do, but this is really coming in because we do not have the ability for the interest in checking because it would crush our economy. i would say, just to say something about what this woman expresses, not getting too far into the details of what she said, this is absolutely a feeling out there, and it is

people who cannot understand what is going on and can see all around them the effects on the street, as she mentioned. trash, people out of their minds , why can't we do more about this? there is this feeling among so many americans that this is kind of an example of the inability to do something, and there are a lot of reasons why that is the case, and there are new ones to reasons sometimes, but i have been struck by that feeling over and over as i go cross-country. host: if we go farther upstream in the stream from the precursor materials coming in from china, can't that be stopped so that dries up? guest: i don't see why not. i mean, the chemicals that are used to make fentanyl are almost used only to make fentanyl. there are not a lot of

wide-ranging use is you have for some of this stuff, so i cannot understand why china would allow for the sale of some of that stuff. host: it weakens the united states, doesn't it? guest: it does that, without a doubt. so, yeah, with china to do about this is a big question that needs response. host: let's talk to sheila in new jersey. good morning. caller: hi. i am on disability, and i have been on xanax for 40 years. and i recently moved back to new jersey, and i got a new doctor, and they will not prescribe xanax to me. i said to my doctor, well, i guess i will get it off the street.

she said, do what you have to do. so i blame doctors. i am on disability for it and cannot get help. they have prescribed me non-narcotics. come on. guest: this is common. i am afraid that one response to the opioid epidemic, it began when drug companies began pushing for the expanded prescribing of opioid -- prescription opioid painkillers, except when they are prescribed wantonly, and that happened in the mid-1990's, that was my first book. it was all about that. and then the reaction has been from a lot of doctors to kind of cut back and say i will not prescribe it at all, it is not my business and so on, and then you are finding people like the caller who are having trouble.

host: rockville, maryland. is it acuno? caller: yes, it is. host: go ahead. caller: i appreciate you taking my call, first time caller. did want to address a couple of points and a question i had. it was mentioned that supply and not demand is the cause. the u.s. is a capitalist country, and no business runs without the demand for its products. that is one thing to take a look at. secondly, what demographic are mostly affected by the use of fentanyl? third, the u.s. has always been the leading user when it comes to drugs from marijuana, cocaine, and now dealing with this. there is obviously a huge problem within the country

itself with drug use in general, particularly with the youth who are not being educated on the impacts of the drugs on the street. so it has a harsher consequences when it comes to fentanyl, obviously, but, still, i believe we need to bring back drug educational programs in the school and community. guest: thank you. good questions. yet, with the last one, i would say that we need greater prevention efforts. really, it is a focus on prevention. i would say that my book has been used recently as something i wanted to encourage, used in the high school class in washington, and there was a class on neuroscience and the study of the brain, and i

believe that is essential. we need to bring neuroscience studies into the high school. it is not hard to get that information out there, and it helps you understand the effects of drugs. i think that fentanyl is calling on us for these prevention efforts that are essential. i would say that capitalism is prodded as much by supply as demand. nobody knew they wanted a tablet until apple invented one, right? with fentanyl in particular, especially people who are already addicted to opioids, which itself as the opioid epidemic creates supply and the demand which started with doctors inundating the country with those pills, i think this is clearly a situation of when supply is creating demand and also exacerbating event, meaning

keeping people using when they are clearly in the process of killing themselves. all of this is part of the story . it is complicated and takes a lot more explanation than we have time for here. i would say that there is, as you say, a real cultural isolation in this country that breeds using substances to alleviate the worry and the depression and so on. and that reservation and feeling of being disconnected, even though we have social media that acts as a connection. and all of this is of a culture of fast food that plays apart, sugar, creating this malaise that people look to add drugs to calm. host: are there other countries dealing with the fentanyl problem or is this an american issue? guest: this is an american issue. we created the first market for

it by opioid obit of nick -- opioid epidemic, which was an inundation of supply, creating a larger population of opioid addicted americans. they were the first to switch to fentanyl when it began to come in, and since then, it has been added to a number of other drugs. the caller mentioned which demographic groups have been affected. i would say all. what is new is that in the african-american community, this is a problem because when i wrote "dreamland," there was very little involvement of the black community. it just did not affect that part of america. now, cocaine dealers in african-american communities have figured out that adding fentanyl to the cocaine -- and this is a story in "the washington post" or they talk all about this -- very high

rates of opioid overdose and death do to fentanyl among the black immunity. that is a new thing. i talked about it in my book at the place where it first started in cleveland, ohio, and you are seeing it all across the country now. host: let's go to detroit, michigan. loraina is a medical professional. caller: yes, and i have dealt with substance abuse, and i am a recovering alcoholic. the first thing is, when people do complete treatment, even long-term treatment, such as here at salvation army, they still have fentanyl down the street area at the situation in the community is abysmal in terms of housing, transportation , in terms of all kinds of things. and we need to deal with that

because a lot of folks, even people who get out of jail, and are clean, it is the same situation. the other thing that is balancing it is why they are not usingdogs. guest: i think dogs are being used. i think dogs have been trained. my understanding, anyway. i could be corrected on that. i would say that what you are pointing out, too, is another thing that fentanyl is highlighting. i think the opioid epidemic highlighted it, as well. that is that we still don't have a continuum of care for drug addiction. we have it for cancer, heart attacks -- i had a heart attack six years ago and gave me fentanyl, but they did not put a stent in me and say you are on your way. there was a continuum of care that i am still on, frankly. i think maybe that model needs to be adopted for addiction, which means that if somebody goes through a detox or a

recovery system in jail, as they do now in some jails, but then after that, you have two or three years of continual care that involves talking about some of the things you refer to, jobs, housing, expunging criminal records, tattoo removal, etc., so there are a lot of things tried in certain counties. i just think they need to be more widespread, and it is that continuum of care, i think, that offers the best hope for long-term recovery, but is probably as much as a society can do to help folks with two or three years of that. host: columbia, south carolina, julio. good morning. caller: good morning, yo. i was listening to the guest, and he associated black people and cocaine with this drug. i did not think that was proper

because every time everything goes bad in the country, even with white people doing opioids and all of that, he is trying to associate that with black people now. since day one in this country, he associates black people with opioids. and you are trying to put us in it now. guest: i am afraid, sir, that is what is going on nationwide. i think the statistics are pretty clear. "the washington post" in the paper, d.c., baltimore, you know, the problem of drug use in the black immunity historically has revolved around cocaine. the cocaine dealers in the black community have figured out if the ad fentanyl to the cocaine, they will get a more aggressive and regular customer.

so now you are finding african-americans dying from opioid overdoses and that those opioids are really just fentanyl. that is mainly the thing. this has been going on since 2015-2016, when they first saw this. and this is something happening across the country. it is not me trying to associate black people with opioids. these are the facts reported all across america because of the way fentanyl is being used by local drug dealers, which is simply to mix it into cocaine, methamphetamine, marijuana, and sometimes these counterfeit bills coming out of mexico -- pills coming out of mexico. host: next, out of california, a medical professional. caller: good morning. i appreciate the caller's expertise and the study he has done. i have heard hyperbole, and you

have mentioned a few times that if we were to stop the supply by closing the border, for example, it would cripple our economy. do we really think it is true that we could not shut the border down, stop all import/export and not make it through in terms of our economy? that we could not pull together as a country and keep moving? guest: this is a great question. what i am telling you is what i have been told by border economists, who say that so much of our economy now -- so much of the back-and-forth is mexico, so much that the free trade agreements of mexico have essentially created this north american production unit that if we were to slow down the inspection and inspect more trucks coming across so it would maybe take a week or two, perhaps three or four, hard to

say, giving us time to check more and more trucks coming across, that this would devastate the economy. it would certainly have an effect on fruits, vegetables, what have you. these economists are making the point that a lot of the manufacturing that both countries do now depends on the back-and-forth. i am not an economist, and i don't study the border economy as well as i should, but that seemed like a credible perspective. it is possible that if you just shut down the entire border and maybe nothing moved across, the u.s. would find other ways of functioning. host: we talked a little bit earlier about china, there was news two days ago, nbc news said u.s. and china hold high-level

talks on the fentanyl crisis, and they said that it was productive. guest: good. host: frank william in pennsylvania. go ahead. william, are you there? nope. caller: i am here, sorry, i had it on mute. thank you for being there and doing everything you do. guest: you are welcome, thank you. caller: first, i apologize for my breaking down a little bit. i think this will go away in a short period. i would like to tell you that i am an orthopedic surgeon, retired. i lost my son daniel about eight years ago --yeah, i know. wow. anyway, he bought, you know, he was a big internet surfer i guess you would say. he was 27 when he died, and he found a website called mr.chemis

try, and he was able to buy u47- 700's which was legal in many states. there had already been several states in the country, a couple of 13-year-olds i know about in utah i believe, anyway, he got that. and he did suffer from some depression, but he was well on his way to being a very productive and successful college student. and he died. guest: i'm sorry. caller: when that happened, i found out from investigators that he got the u47's legally on the internet, and the possession of it was legal. i went on the website, and it said you can buy this stuff. there was no criteria or credentials that had to be provided. i actually went to myself on the website and said i would like to

get some of this stuff, how do i do it? they said, how much do you want? i said, a couple grams, how much is that? he said $105, how do i get it to you? go to the grocery store, or wherever you go to spend money overseas. i did that, four days later, i had a box -- i had a pink slip in my mailbox. my wife said, don't go down to the post office and get that, they will arrest you. i did not care, i was trying to make a point to see what was going on. i get this box that says electronic accessories, i opened it up, and there are three little bags, about the size of a sucrose container with white powder in it. anyway, i went to the governor of pennsylvania, and he changed the law immediately. guest: good. host: provide ahead. guest: -- go right ahead. guest: all i can say is that is a period in our history when it

was essentially pre-fentanyl, were people were selling all kinds of drugs, designer drugs that they got from chemistry, literature, and i would say that fentanyl has changed all of that significantly because it is so parliament -- parliament. you are seeing -- prevalent. you are seeing that people are not buying those things as much. it seems like now fentanyl is the main story, where designer drugs were maybe the issue 10 years ago, maybe 10 years ago. host: conway, south carolina, kurt. go right ahead. go to cheryl in north carolina, good morning. caller: yes, good morning. . host: the right ahead. caller: thank you for taking my call.

i just wanted to say, i keep hearing all this stuff about china, china, china. there is a book called "the art of war." it 2500 years old. any country can use this book, but it is a blueprint to take over whatever it is you wish to take over. and to do that, you create chaos. guest: yeah. caller: and then, hopefully, the goal is to walk in basically without ever firing a shot, and the people want you to come in because everything is so chaotic. and, so, you do not destroy the infrastructure. you take over the people, you tell the people what to do. but i look at what has happened in this country, they started out by destroying our

educational system. host: we are running out of time, so let's get a response. guest: i have not done any reporting on the motives of the chinese government. i don't know china well enough to do that. i would say that on the surface, you know, people who understand what is going on from that perspective, i can understand how they understand it that way. these are debilitating products that are being made in quantities that simply boggles the mind by mexican traffickers who get the ingredients for those products from china. all three governments have a role in this. china has a role to stop that from happening. mexico has a role with their imports and deal with the traffickers.

i would say that in the united states, arms those traffickers by our 110, sale of very easy sale of assault weapons, many are continually smuggled onto mexico, who they arm the people who are making the drugs you are killing americans, so we are arming the people who are killing us, maybe along the lines of what this woman was talking about. host: the title of your book has the word "hope." why? guest: because i believe that the fentanyl/meth problem is highlighting many things we need to do as a country. we talk about some of the drug related things, but my feeling is very strongly that we need to understand the importance of community rebuilding. and through that, i think it is very interesting to watch now what is happening in some rural

small towns. i have a story coming out in "the free press" soon that will talk about this. areas that work massively hit by that opioid epidemic who are now rebounding, a very exciting american resilient way. matt through economically expecting a new walmart or big-box store, but rather in the smallest ways helping to nurture local economic development through micro-entrepreneurial business formation. and this is a remarkable thing. small town rural and small-town america is where you solve the problem mightily hit. i think this epidemic is calling on us to understand that it is a symptom of how not to live,

isolated, eating crazed food that we allow to be marketed to us on every tv station, a separation at the local level, and allowing jobs to just disappear from towns and telling them they are on their own because we believe in the free market, and it dictates that you should no longer have these jobs. to me, the fentanyl of adamic and methamphetamine is really showing us -- epidemic and methamphetamine is really showing us how we need to rethink how we are living. and i love the stories that i am finding about small towns doing it themselves, like getting up off the mat. a beautiful thing. host: sam quinones, the author of the book "the least of us: true tales of america and hope in the time of fentanyl and meth ." th