Julien Supurling

Julien's Research

Theorizing the Overdose Crises

Washington D.C. has the second highest overdose death rate in the country, and these deaths are overwhelmingly racial minorities and people in poorer neighborhoods. The city is set to receive $50-100 million to address the overdose crisis from settlements with companies that were found liable for fueling it. How the money is spent will be determined in part by the narratives that are marshaled about drug use and addiction, and how we give uptake to drug user “lore” – taboo knowledge about safer use practices passed among members of user communities who keep each other safe. User experience and knowledge has historically been left out of drug policy and program development.

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Medicalized frameworks for discussing drug use and the overdose crisis are often framed as the compassionate alternative (encouraging treatment, care, support) to “criminal justice” frameworks (concerned with blame, punishment, incarceration). Adopting medical frameworks can be a strategic avenue for securing rights and protections, but can also come with costs that have been under-investigated in addiction medicine and research. The way that medical institutions cast drug users in this ostensibly compassionate approach often forecloses the possibility of taking users as having certain types of useful expertise.

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My research aims to analyze how the shift in recent years to framing the overdose crisis “as a public health issue” and addiction as a “disease” impacts drug policy and treatment programs, and how user expertise on harm reduction and safer use is integrated or disregarded in the development of these programs and policies. Some scholars and advocates have noted that harm reduction efforts can have an uneasy relationship with medical frameworks for understanding drug use and the overdose crisis. This project explores that tension, and the extent to which medicalization is an appropriate or strategic move in addressing the rising death rate.