Denaturalizing Excess Overdose Deaths

We don’t have to accept all opioid overdoses as a fact of life.

| March 2020

 opioids
Photo by Adobe Stock/Antonio Rodriguez.

Excerpted from OD: Naloxone and the Politics of Overdose by Nancy Campbell. Reprinted with Permission from The MIT PRESS. Copyright 2020.

When beginning this research, I never anticipated that overdose death rates would continue to spiral upward throughout, never seeming to peak, plateau, or decline. The most recent figures suggest that 70,237 people in the United States died from overdose in 2017, more than two-thirds from opioids; between 2000 and 2017 close to 300,000 have died, according to the Centers for Disease Control and Prevention (CDC).

Despite less ignorance, more prevention, more naloxone, and more integration between recovery, treatment, and harm reduction, “excess” death has become naturalized. The very notion of “excess” death implies that these deaths are preventable or premature. But they are far from evenly distributed, and their patterns reveal much about what a society values or devalues. As David Sudnow showed in Passing On, “social death” is reflected in the rationing of resuscitative care according to accountings of social value and moral worth.

Some such deaths are discounted—those in lower-income brackets, those who lived in darker skin, those who used drugs. A common, if morally repugnant, interpretation is that those who die “excess deaths” were already leading “excess” lives.



Cultural anthropologies of excess death suggest that people who do not feel needed die early. For instance, Michelle A. Parsons’s work on premature mortality, titled Dying Unneeded, concluded that in post-Glasnost Russia, men perceived themselves as useless whereas women experienced themselves as having something to offer others. “Being unneeded is a distal driver of the mortality crisis. Being unneeded translates social collapse to bodily death from cardiovascular-and alcohol-related causes. Being unneeded is related to the death of the body, but it is also related to the life of the soul.”

OD-naloxone-and-the-politics-of-overdose

Michelle Parsons
3/21/2020 5:33:03 PM

This account of the politics of overdose is an important contribution to understanding how biotechnological interventions and social movements can reframe 'excess' deaths and social responsibility around these deaths. Especially in these days of the coronavirus pandemic, we see how mortality is not an individual matter, but a social one that is influenced by how our lives intersect (or not) with others. This is not only the case for infectious diseases. In my own work on post-Soviet Russian mortality, 'being unneeded' was a common expression related to the transformation of informal Soviet exchange practices. As more of us practice social distancing we may also be realizing the importance of seemingly trivial social practices and interactions in our own lives that give us a sense of neededness, belonging, or social integration. Campbell makes us consider what other technological, social, economic and political interventions might build our sense of social responsibility for others.


Michelle Parsons
3/21/2020 5:22:34 PM

This account of the politics of overdose is an important contribution to understanding how biotechnological interventions and social movements can reframe 'excess' deaths and social responsibility around these deaths. Especially in these days of the coronavirus pandemic, we see how mortality is not an individual matter, but a social one that is influenced by how our lives intersect (or not) with others. This is not only the case for infectious diseases. In my own work on post-Soviet Russian mortality, 'being unneeded' was a common expression related to the transformation of informal Soviet exchange practices. As more of us practice social distancing we may also be realizing the importance of seemingly trivial social practices and interactions in our own lives that give us a sense of neededness, belonging, or social integration. Campbell makes us consider what other technological, social, economic and political interventions might build our sense of social responsibility for others.


rzangari
3/21/2020 4:58:34 PM

The thought that society's social bonds are being reduced which can lead to overdose is such an important issue especially in this new time of social distancing. Do you think there will be an increase in overdose deaths due to the current pandemic? I also wonder if the 45% higher rate of overdose in rural areas as opposed to urban is in part due to the reduced numbers of people and lower social capital than in places with higher densities?





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