The symbol of dreamland represents three elements in the text: the dreamland of industrial America, the dreamland of wealth and status in Xalisco for those who engaged in black tar heroin trafficking, and the fantasy state offered by opiates themselves, drugs whose “new appeal was that it kept them at the edge of a hazardous yet alluring dreamland” (195).

Quinones opens the book with a description of a private pool in Portsmouth, Ohio, called Dreamland. The site was more than just a pool; it was also a community hub. In describing this pool Quinones highlights elements that would be lost over the latter half of the 20th century, with consequences for the opiate crisis. These include a level of economic equity and opportunity for all, with both rich and poor families using Dreamland; a level of autonomy and independence among young people, who grew up going to Dreamland without the constant supervision of their parents; and, in its relation to the town beyond, a level of middle-class stability. Above all, Dreamland represented a kind of community cohesion, and as this cohesion collapsed, it exacerbated the opiate crisis in the United States.

In Xalisco the dreamland was the possibility of an easier route to wealth and status for a generation of relatively privileged young men whose fathers were sugarcane farmers.