OD : Naloxone and the Politics of Overdose

Description

The history of an unnatural disaster--drug overdose--and the emergence of naloxone as a social and technological solution. For years, drug overdose was unmentionable in polite society. OD was understood to be something that took place in dark alleys--an ugly death awaiting social deviants--neither scientifically nor clinically interesting. But over the last several years, overdose prevention has become the unlikely object of a social movement, powered by the miracle drug naloxone. In OD, Nancy Campbell charts the emergence of naloxone as a technological fix for overdose and describes the remaking of overdose into an experience recognized as common, predictable, patterned--and, above all, preventable. Naloxone, which made resuscitation, rescue, and "reversal" after an overdose possible, became a tool for shifting law, policy, clinical medicine, and science toward harm reduction. Liberated from emergency room protocols and distributed in take-home kits to non-medical professionals, it also became a tool of empowerment. After recounting the prehistory of naloxone--the early treatment of OD as a problem of poisoning, the development of nalorphine (naloxone's predecessor), the idea of "reanimatology"--Campbell describes how naloxone emerged as a tool of harm reduction. She reports on naloxone use in far-flung locations that include post-Thatcherite Britain, rural New Mexico, and cities and towns in Massachusetts. Drawing on interviews with approximately sixty advocates, drug users, former users, friends, families, witnesses, clinicians, and scientists--whom she calls the "protagonists" of her story--Campbell tells a story of saving lives amid the complex, difficult conditions of an unfolding unnatural disaster. CONTENTS ACKNOWLEDGMENTS INTRODUCTION: MAKING OVERDOSE MATTER—PROTAGONISTS AND ANTAGONISTS IN THE SOCIAL LIVES OF NALOXONE Moving Overdose from Margin to Mainstream How Did Philip Seymour Hoffman Die? Place Matters: The Undone Science of Place People Matter: Protagonists in an Unnatural Disaster Things Matter: Naloxone as a Technology 1. POISON MURDERS AND NATURAL ACCIDENTS: ANTIDOTES AND ANTAGONISTS Apothecaries’ Blunders and Lamentable Accidents: A Century of Unfortunate Events, 1850–1950 Toxic Events Involving Morphine or Heroin An Impure Antagonist: N-allylnormorphine/Nalorphine/Nalline Magical Mixtures: The Work of Nalorphine in the Clinic Mixed Performances: Nalorphine’s Role in the Hunt for Multiple Opiate Receptors 2. THE “CHEMICAL SUPEREGO”: POLICE SCIENCE, SOCIAL ANTAGONISM, AND ARTIFICIAL WILL Detecting “Addiction”: The Nalline Test in the Police Precinct Proof Positive: The Frye Test and the Forensics of Nalorphine Boon and Bane: Expanding Spatial Control over Addicted Persons “Even One Day in Prison Would Be a Cruel and Unusual Punishment” Self-Appointed Apothecaries, Guinea Pigs, and the Surveillant City 3. DEATHS FROM “NARCOTISM” IN THE MID-TWENTIETH-CENTURY UNITED STATES The Haunting Iconography of “Narcotism” The “Heroin Overdose” Mystery: “Myths,” “Facts,” and Amnesias The Lethal Synergies of Polydrug Problems 4. BRINGING OUT THE DEAD: NALOXONE’S NINE LIVES BEGIN The Inglorious Synthesis of Naloxone Epicenter of Overdose: The New York City Office of Chief Medical Examiner Approving Naloxone: The Pure Narcotic Antagonist 5. UNNATURAL ACCIDENTS: THE SCIENCE AND POLITICS OF “REANIMATOLOGY” The Historical ABCs of Cardiopulmonary Resuscitation Narcan: That ’70s Thing Approximating Reality: Overdose, Data, and Nation in the 1970s An Early DAWN in Overdose Epidemiology Witnessing the Raising of the Dead 6. ADOPTING HARM REDUCTION: EARLY DEMOCRATIZATIONS OF NALOXONE A Protohistory of Harm Reduction: “Done but Not Mentioned” in Italy Another Protohistory: Rural New Mexico “Mentioned but Not Done”: Revolution, Respectability, and Harm Reduction Unmentionable: Harm Reduction and Needle Exchange in the United States 7. “ANY POSITIVE CHANGE”: NALOXONE AS A TOOL OF HARM REDUCTION IN THE UNITED STATES Santa Cruz Needle Exchange and the Visual Politics of junkphood Parallel Worlds: San Francisco Naloxone Research Communities Chicago Recovery Alliance and the Politics of Recovery as “Any Positive Change” Naloxone at the Turn of the Twenty-First Century 8. HARM REDUCTION RESEARCH AND SOCIAL JUSTICE: WORKING NALOXONE INTO PUBLIC HEALTH USA “Death in the Nation’s Garden” “Doing the Work”: Overcoming Social, Structural, and Regulatory Divides Why? The Race for Proof in an Era of Evidence-Based Activism Protagonists Unite! Partisan Professionals, Engaged Research, and Undone Science 9. RESUSCITATING SOCIETY: OVERDOSE IN POST-THATCHERITE BRITAIN Paving the Way for Take-Home Naloxone: Up Close and Arm’s Length From Throwaway Line to Direct Provision: THN in UK Drugs Policy Official Numbers: DRDs and Resuscitative Response in the Early 2000s Tipping Points: Importing Recovery into British Harm Reduction Just Do It! Hands-on at South London at Maudsley (SLAM) Naloxone as “Wonder Drug” in Wales and Northern Ireland 10. “GROWING ARMS AND LEGS”: THE SCOTTISH NATIONAL NALOXONE PROGRAM Metrics of Recovery: Mortality and Morbidity in Scotland The Social Conditions of Scottish Exceptionalism SCARE ME: A Scottish Field Trip to the CRA Pilots and Protocols: Fitting Practice to Policy and Policy to Practice Restructuring the Landscape of Scotland’s National Naloxone Program Beyond a Cup of Tea and a Biscuit: Peer Education and Engaged Research 11. EVIDENCE FROM PILLAR TO POST: RESEARCHING THE VARIETIES OF OVERDOSE EXPERIENCE Disturbing Numbers: In Whose Data Do We Trust? “Gate-Happy”: Staying Alive after Prison Release Restructuring in The House of the Dead: N-ALIVE and Heroin Maintenance in England Lived Experience and Naloxone Research: Peer Education in Scotland “Service Users” and “Experts by Experience” in England 12. OVERDOSE AND THE CULTURAL POLITICS OF REDEMPTION “Breaking Out the Narcan” Denaturalizing Excess Deaths: Age, Class, Gender, Race, and Place Matter Warm Hands: Harm Reduction Recovery Support Services Technologies of Solidarity: Should Naloxone Be “Wild” or “Tame”? Backlash: Epidemics of Ignorance CONCLUSION: HARM REDUCTION INFRASTRUCTURE—WE HAVE HARDLY BEGUN TO BE HUMAN NOTES Introduction 1. Poison Murders and Natural Accidents 2. The “Chemical Superego” 3. Deaths from “Narcotism” in the Mid-Twentieth-Century United States 4. Bringing Out the Dead 5. Unnatural Accidents 6. Adopting Harm Reduction 7. “Any Positive Change” 8. Harm Reduction Research and Social Justice 9. Resuscitating Society 10. “Growing Arms and Legs” 11. Evidence from Pillar to Post 12. Overdose and the Cultural Politics of Redemption Conclusion INDEX