Two steps:

Step 1. All students respond to this prompt in one short paragraph:

This book covers and returns to differing stories throughout, as Quinones is a journalist that tells peoples stories. There is so much engaging information, however, not everyone likes the style…

·      Share your first impressions of the book- content, style, stories

·     Share the information or story that you have found most impactful so far.

Step 2. Choose one topic out of 6 choices for  discussion, as listed below below and respond in 2-3 short paragraphs:

1.     In reading the introduction, what did you learn about the author’s previous best selling book Dreamland as it relates to the evolution of the opioid crisis in our country? As you read this introduction, what class themes do you see being at the heart of Quinone’s mission in collecting the stories that together created The Least of Us? Give examples.

2.     The Project I, Chicago (pg. 15), captures the initial surfacing of fentanyl in trafficking efforts. Meth 1, “Streets of Bakersfield” (pg.24) explores the history of trafficking prior to fentanyl. Both are shared through the narratives of DEA officers. Share what you, as the reader, gained in understanding of the evolution of trafficking, as it relates to Mexico, the US, and the supply/demands of illegal substances.

3.     The Project II (pg. 51) explores how the cartels, in this example, the Sinaloa Cartel, came to see fentanyl as a money maker. The real-life characters of El Cerebro -The Brain-, El Chapo, and the “Narco’s”, mirror fictional and non-fiction portrayals familiar to many of us from cinematic tales of trafficking world. What complexities in this story can you identify that made it so difficult to address “outbreaks”  of fentanyl poisonings when they initially began to occur in the U.S.?

4.     Janssen (pg. 33) introduces us to the scientist who developed Fentanyl. Henderson (pg. 47) follows a later researcher, who developed tests for fentanyl in humans. How does this section, and the course content so far, help you understand the science of opioids? How well are you able to explain, in layperson’s language, the mechanisms of opioids and the Mu receptor? The effects of euphoria and analgesia from opioids? The mechanism of Naloxone, on reverting poisonings?

5.     Building on the Janssen and Henderson sections, what evidence of cautionary tales do we see emerging? Explore the examples of global profiteering, the development of carfentanil, and the underworld of synthetics Henderson shares.

6.      In the last section of Part One, we are introduced to Doc O in Clarksburg I (pg. 57). A lot of the stories we will read about in this book are set in small-town America, where industry has declined. Discuss how this decline and economic depression can affect how people react to large amounts of opiates flooding the market. Provide specific examples of changes within the community, the role of the physician and the role of pharma reps as they relate to economic depression and opioids.



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