Open Marginality: Heroin Epidemics in Different Groups

Abstract

As part of a project to explain heroin use trends, a concept of “open marginality” is created to highlight how different groups impacted by heroin epidemics have a common historical experience. A reading of the history of epidemics in the U. S., together with the authors' work on two epidemics in the Baltimore region, demonstrate the diversity of groups who have been “at risk‘ over the years. The concept is integrated with related work in the drug field, especially the ideas of Winick, Singer, and Grund. An analysis of cases shows that such groups experience a rapid and unexpected change, such that a gap between expectations and reality opens up, a gap that is taken up in national public discourse.