Heroin & The Gift

Gabriel Rossman reviews Dreamland by Sam Quinones:

"As more and more dealer-migrants return to Xalisco flush with cash this creates a new standard of living in the village and transforms being an impoverished sugar cane farmer from just how life goes to a status that can be rejected. But relative deprivation is too weak to explain Xalisco life, which is better characterized as competitive feasting straight out of Mauss’s The Gift.  … while dealers often planned to save enough wages to capitalize a small business, they tended to dissipate their wealth in gifts to family and “the rest on beer, strip clubs, and cocaine, and walked the streets of Xalisco for a week or two the object of other men’s envy” (261). This envy is something Quinones emphasizes repeatedly and the way it is formed by public feasting and is sublimated into a need to reciprocate so as to restore honor, which in turn creates the labor supply for black tar heroin retailing ...

people cited this tiny publication because they wanted to believe it as it created a permission structure for prescribing effective but dangerous drugs and pharmaceutical detailing exploited this …

• pharmaceutical detailing in opiates, as in all drugs, follows my model of obfuscated transactionalism and Quinones has a lot of material on the history of detailing ...
  
• Xalisco boys engage in statistical discrimination by only selling to white customers who they see as less likely to rob them than black customers ...
  
• doctors prescribed opiates in part to get patients out of their offices quickly and prescribed 30 day packs of pills rather than 3 day packs of pills to avoid return visits. Proper pain management is extremely labor intensive, but hard to get insurance reimbursement. This follows logically from Baumol’s disease in that as high-skilled medical labor grows more expensive, insurance companies will substitute capital (drugs)
  
• reactivity is everywhere. Pain is part of doctor and hospital ratings, but iatrogenic addiction is not, so doctors prescribe dope. Sentencing is based on large quantities of dope and carrying a gun, so Xalisco boys carry only small quantities of dope and go unarmed.”