| Title: |
“Generally, you get 86′ed because you're a liability”: An application of Integrated Threat Theory to frequently witnessed overdoses and social distancing responses |
| Authors: |
Bowles, JM; Smith, LR; Verdugo, SR; Wagner, KD; Davidson, PJ |
| Source: |
Social Science & Medicine, vol 260 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2020 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
4402 Criminology (for-2020); 44 Human Society (for-2020); Opioids (rcdc); Substance Misuse (rcdc); Opioid Misuse and Addiction (rcdc); Behavioral and Social Science (rcdc); Physical Injury - Accidents and Adverse Effects (rcdc); Infectious Diseases (rcdc); Emerging Infectious Diseases (rcdc); Social Determinants of Health (rcdc); 3 Good Health and Well Being (sdg); 16 Peace; Justice and Strong Institutions (sdg); Drug Overdose (mesh); Drug Users (mesh); Humans (mesh); Naloxone (mesh); Opioid-Related Disorders (mesh); Physical Distancing (mesh); United States; Opioid overdose; Social groups; Integrated threat theory; Drug use; Qualitative research; 11 Medical and Health Sciences (for); 14 Economics (for); 16 Studies in Human Society (for); Public Health (science-metrix); 38 Economics (for-2020) |
| Description: |
While rates of opioid overdose deaths in North American have increased exponentially in recent years, most overdoses are not fatal, especially when witnesses are present and can intervene. Previous research has found that some people who use drugs [PWUDs] trained in overdose response might cut social ties with frequent overdosers, leading to more solitary opioid use and risk of death if someone overdoses alone. To examine the phenomenon of social distancing of people who overdose frequently, we used data from fifty-two in-depth qualitative interviews collected in Southern California with PWUDs who had recently witnessed an opioid overdose. Transcripts were reviewed and coded thematically, using the Integrated Threat Theory (ITT) to conceptualize the observed phenomenon. ITT outlines how realistic and symbolic threats are experienced by a group. We found that while some participants acknowledged the role of adulterated street drugs in overdoses, individualized blame was nonetheless imposed. Accusations of careless drug use practices fostered negative stereotyping towards frequent overdosers. This was attributed to the need to summon 911 for rescue, which often resulted in police dispatch. The intergroup relationship between police and PWUDs is precarious as police pose realistic threats onto PWUDs - such as incarceration, eviction, and manslaughter charges - leading to intragroup anxiety among PWUDs about future overdose events, and labelled frequent overdosers as liabilities. These threats, and inter/intra-group conflict, explained one reason how and why non-fatal overdoses led to social distancing events. People who overdose frequently were also accused of breaking the norm of drug user surreptitiousness; a symbolic threat that endangered the group due to police exposure. Social distancing might dampen exposure to the protective effect of peer-led interventions such as take-home naloxone programs, increasing risk of overdose death. This phenomenon highlights how intergroup dynamics are driving intragroup ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt4qq4t5g4; https://escholarship.org/uc/item/4qq4t5g4; https://escholarship.org/content/qt4qq4t5g4/qt4qq4t5g4.pdf |
| DOI: |
10.1016/j.socscimed.2020.113190 |
| Availability: |
https://escholarship.org/uc/item/4qq4t5g4; https://escholarship.org/content/qt4qq4t5g4/qt4qq4t5g4.pdf; https://doi.org/10.1016/j.socscimed.2020.113190 |
| Rights: |
public |
| Accession Number: |
edsbas.304439BC |
| Database: |
BASE |