Framing Kin Resistance to Opioid Overdose in Philadelphia

ABSTRACT

Interviews with close kin of those who died from opioid overdose in Philadelphia in 2017 reveal myriad strategies that families employ to minimize overdose risk, secure treatment options, and mitigate everyday precarity that can result from heroin addiction. Their efforts to keep kin alive – at times contradictory, conflicted, desperate and, in the end, ineffectual – reveal deeply situated structural vulnerabilities. When understood as “resistance” to death, however, kin strategies return us to a vital tenet of harm reduction – the imperative to develop programs in collaboration with those most impacted, in this case families at risk of overdose fatality.

KEYWORDS:

• United States
• opioid overdose
• kinship
• resistance
• harm reduction
• structural vulnerability

Acknowledgments

I would like to thank the study participants, the interdisciplinary research team, the Division of Substance Use and Harm Reduction at Philadelphia Department of Public Health, and the anonymous peer reviewers. This article contains the opinions of the author alone, and is not a reflection of those of the research team or any other persons or entities associated with the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. All names used in this article are pseudonyms to protect participant identity and because of the sensitive nature of topics discussed.

Additional information

Funding

Research was supported in part by the Council of State and Territorial Epidemiologists (CSTE) and by Centers for Disease Control and Prevention, Cooperative Agreement Number 5U38OT000143-05.

Notes on contributors

Beth A. Uzwiak

Beth A. Uzwiak, PhD is Director of Story Research, a Philadelphia-based consulting firm, and research consultant with the Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania.