The Washington PostDemocracy Dies in Darkness

Science historian examines how an anti-overdose medication helped revolutionize America’s view of drug addiction

A health official displays a naloxone nasal spray at a House committee hearing on federal efforts to combat the opioid crisis in 2017.
A health official displays a naloxone nasal spray at a House committee hearing on federal efforts to combat the opioid crisis in 2017. (Drew Angerer/Getty Images)

Drug overdoses were once spoken about in whispers. Social stigma cast a dark shadow over them because they were seen as the natural, even deserved, consequence of illicit drug use.

So why are they spoken about so openly today?

Science historian Nancy D. Campbell has an answer: naloxone. The miraculous-seeming drug, which reverses opioid overdoses, was first approved in 1971. In “OD: Naloxone and the Politics of Overdose,” Campbell tracks how it helped turn overdose from an unmentionable affliction to an experience that is now seen as both common and preventable.

In the days before overdose reversal, ODs were understudied and barely reported. Drug users faced harsh punishments. Heroin and other opioid overdoses were cast as a problem that mostly affected people of color, even though the majority of opioid users were white, Campbell says, and “overdose deaths occurred at or beyond the margins of respectability.”

But armed with naloxone and a vision of a world without overdoses, scientists, health-care workers and community advocates began to push for more data, treatment and prevention.

Campbell’s deeply researched book is driven by her desire to understand why it took so long for naloxone, and overdose prevention, to hit the mainstream. She discovered a group of varied protagonists — drug users, advocates, scientists and others — whose stories illustrate how naloxone, scientific progress and advocacy slowly shifted social attitudes.

Over time, naloxone helped change society’s focus from preventing drug use to helping people reduce its negative consequences. This harm-reduction model has empowered the people most affected by opioids, Campbell writes.

“When people learn that they might have saved someone’s life if they’d had naloxone, many become ready to take harm reduction into their own hands,” she writes

For Campbell, ODs are an “unnatural disaster” that can be tackled only in the open. Her book offers a riveting and complex look into the history of the phenomenon — and a sense of what a future without ODs could look like.

U.S. drug overdoses rise in West as they drop in East

How the opioid epidemic evolved

Naloxone can save lives. You should learn how to use it.

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