Abstract
'Take-home naloxone' refers to a life-saving intervention in which a drug (naloxone) is made available to nonmedically trained people for administration to other people experiencing an opioid overdose. In Australia, it has not been taken up as widely as would be expected, given its life-saving potential. We consider the actions of take-home naloxone, focusing on how care relations shape its uses and effects. Mobilising Science and Technology Studies insights, we suggest that the uses and effects of naloxone are co-produced within social relations and, therefore, this initiative 'affords' multiple outcomes. We argue that these affordances are shaped by a politics of care, and that these politics relate to uptake. We analyse two complementary case studies, drawn from an interview-based project, in which opioid consumers discussed take-home naloxone and its uses. Our analysis maps the ways take-home naloxone can afford (i) a regime of care within an intimate partnership (allowing a terminally ill man to more safely consume opioids) and (ii) a political process of care (in which a consumer takes care of others treated with the medication by administering it 'gently'). We conclude by exploring the political affordances of a politics of care approach for the uptake of take-home naloxone.
Highlights
In recent years, opioid overdose deaths have escalated in Australia and around the world (Roxburgh et al 2017)
In this article we ask, do the social dimensions of take-home naloxone bear on its diffusion and uptake, and if so how? Drawing on an interview-based project that explores the reasons for the inertia around take-home naloxone, we identify what, following Martin, Myers and Viseu (2015), we call a complex politics of care
Given the marginalisation and sitgmatisation of many people who consume opioids, we argue that these affordances and the politics of care in which they are immersed need to be understood within the power relations that co-produce both overdose and notions of care themselves
Summary
Opioid overdose deaths have escalated in Australia and around the world (Roxburgh et al 2017). While research indicating the effectiveness of take-home naloxone to save lives continues to build, uptake and diffusion of these programs remains limited Reasons for this are currently being researched (Black et al 2017) and one area needing further examination is how it shapes and is shaped by social relations. The second case study explores an account in which the administration of take-home naloxone entails a politically inflected process of care In this process the participant adopts an especially cautious or ‘gentle’ dosing approach with which he hopes to avoid producing unnecessary painful withdrawal symptoms. Together, these case studies highlight an emergent politics of care that takes shape through take-home naloxone practices. The approach can provide a more ethically considered basis for encouraging uptake, in that it ensures that opioid overdose and related deaths, to which people who consume opioids are enjoined to respond, are not abstracted from the broader social and political arrangements that co-produce them
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