Addiction stigma and the production of impediments to take-home naloxone uptake
journal contributionposted on 05.03.2021, 05:18 by Renae Fomiatti, Adrian Farrugia, Suzanne Fraser, Robyn Dwyer, Joanne Neale, John Strang
© The Author(s) 2020. Opioid overdose deaths are a major health issue in Australia and around the world. Programmes to provide opioid consumers with ‘take-home’ naloxone to reverse overdose exist internationally, but uptake by mainstream health services and consumers remains inconsistent. Researchers have identified a range of important educational, training and logistical impediments to take-home naloxone uptake and distribution, yet they have focused less on the social dynamics that can enhance or limit access, such as stigma. In this article, we also explore impediments to uptake, drawing on qualitative interview data gathered for an Australian research project on take-home naloxone. Mobilising a performative approach to stigma, we argue that overdose and prevention are shaped by the social dynamics of stigma and, as such, responsibility for dealing with overdose, as with take-home naloxone, should also be considered social (i.e. shared among peers, the public, communities and governments). Our interview data illuminate the various ways in which addiction stigma limits the possibilities and capacities of take-home naloxone and overdose prevention. First, we focus on how stigma may impede professional information provision about take-home naloxone by limiting the extent to which it is presented as a matter of interest for all opioid consumers, not just those who consume opioids illicitly. Second, we explore how stigma may limit the scale-up and expansion of programmes and access points. From here, we focus on how stigma co-constitutes the politics of overdose and prevention, rendering take-home naloxone ill-suited to many social settings of overdose. In closing, we point out that stigma is not just a post hoc impediment to access to and use of take-home naloxone but is central to opioid overdose production itself, and to effective prevention. While take-home naloxone is an excellent life-saving initiative, uncritically valorising it may divert attention from broader goals, such as the de-stigmatisation of drug consumption through decriminalisation, and other ambitious attempts to reduce overdose.
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was supported by an Australian Research Council Discovery Project grant (DP170101669) and conducted at the Australian Research Centre in Sex, Health and Society, La Trobe University and the National Drug Research Institute, Curtin University. The National Drug Research Institute is supported by core funding from the Australian Government under the Drug and Alcohol Programme and also receives significant funding from Curtin University.
JournalHealth: an interdisciplinary journal for the social study of health, illness and medicine
Article NumberARTN 1363459320925863
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Science & TechnologySocial SciencesLife Sciences & BiomedicinePublic, Environmental & Occupational HealthSocial Sciences, BiomedicalBiomedical Social SciencesJudith Butleroverdosequalitative researchstigmatake-home naloxoneOPIOID OVERDOSECHRONIC PAINDRUG-USERSHEROIN OVERDOSEBARRIERSDEATHSPREVENTIONAUSTRALIAIMPLEMENTATIONAVAILABILITYPublic Health