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The social logic of naloxone: Peer administration, harm reduction, and the transformation of social policy

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  • Faulkner-Gurstein, Rachel

Abstract

This paper examines overdose prevention programs based on peer administration of the opioid antagonist naloxone. The data for this study consist of 40 interviews and participant observation of 10 overdose prevention training sessions at harm reduction agencies in the Bronx, New York, conducted between 2010 and 2012. This paper contends that the social logic of peer administration is as central to the success of overdose prevention as is naloxone's pharmacological potency. Whereas prohibitionist drug policies seek to isolate drug users from the spaces and cultures of drug use, harm reduction strategies like peer-administered naloxone treat the social contexts of drug use as crucial resources for intervention. Such programs utilize the expertise, experience, and social connections gained by users in their careers as users. In revaluing the experience of drug users, naloxone facilitates a number of harm reduction goals. But it also raises complex questions about responsibility and risk. This paper concludes with a discussion of how naloxone's social logic illustrates the contradictions within broader neoliberal trends in social policy.

Suggested Citation

  • Faulkner-Gurstein, Rachel, 2017. "The social logic of naloxone: Peer administration, harm reduction, and the transformation of social policy," Social Science & Medicine, Elsevier, vol. 180(C), pages 20-27.
  • Handle: RePEc:eee:socmed:v:180:y:2017:i:c:p:20-27
    DOI: 10.1016/j.socscimed.2017.03.013
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    References listed on IDEAS

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    1. Des Jarlais, D.C., 1995. "Harm reduction--a framework for incorporating science into drug policy," American Journal of Public Health, American Public Health Association, vol. 85(1), pages 10-12.
    2. Moore, David, 2004. "Governing street-based injecting drug users: a critique of heroin overdose prevention in Australia," Social Science & Medicine, Elsevier, vol. 59(7), pages 1547-1557, October.
    3. Gowan, Teresa & Whetstone, Sarah & Andic, Tanja, 2012. "Addiction, agency, and the politics of self-control: Doing harm reduction in a heroin users’ group," Social Science & Medicine, Elsevier, vol. 74(8), pages 1251-1260.
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    Cited by:

    1. Collins, Alexandra B. & Boyd, Jade & Cooper, Hannah L.F. & McNeil, Ryan, 2019. "The intersectional risk environment of people who use drugs," Social Science & Medicine, Elsevier, vol. 234(C), pages 1-1.
    2. Zhang, Chaoxiong, 2022. "Building care amid navigating liability risks: The possibility of policy-driven care in China's drug-control arena," Social Science & Medicine, Elsevier, vol. 314(C).
    3. Brothers, Sarah, 2019. "A good “doctor” is hard to find: Assessing uncredentialed expertise in assisted injection," Social Science & Medicine, Elsevier, vol. 237(C), pages 1-1.
    4. Fiona Mercer & Joanna Astrid Miler & Bernie Pauly & Hannah Carver & Kristina Hnízdilová & Rebecca Foster & Tessa Parkes, 2021. "Peer Support and Overdose Prevention Responses: A Systematic ‘State-of-the-Art’ Review," IJERPH, MDPI, vol. 18(22), pages 1-24, November.
    5. Olding, Michelle & Boyd, Jade & Kerr, Thomas & McNeil, Ryan, 2021. "“And we just have to keep going”: Task shifting and the production of burnout among overdose response workers with lived experience," Social Science & Medicine, Elsevier, vol. 270(C).

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