Studying the Opioid Epidemic at Ground Level

Opioid overdose is now the leading cause of accidental injury death in the United States, surpassing both motor vehicle accidents and death by firearms. Specifically in the District of Columbia, Maryland and Virginia, the opioid overdose death rate nearly tripled between 1999 and 2015, claiming a cumulative 2,449 lives during that period. Figures like these led a White House commission to urge President Donald Trump to declare the U.S. opioid epidemic a national state of emergency in a report issued in late July.

If you ask Andrea López, an assistant professor in the UMD Department of Anthropology, it’s a call to action that’s long overdue.

“Opioid overdose as a crisis has existed for a long time, but particular communities have been historically differentially impacted by those issues—mainly poor communities of color in urban areas,” López said. “Now we see a sort of expansion of opioid overdose death into white middle class communities so we have a lot of new attention and different resources coming into play.”

López, who joined the Department of Anthropology in the fall of 2016, has been working with populations who use drugs for more than 17 years, in both a direct-service capacity and as a researcher. Growing up on the U.S.-Mexico border in El Paso, Texas, she saw first-hand the way communities as a whole are impacted by drug economies and the long-reaching effects of strict government policies aimed at cracking down on drug crimes. Since arriving at UMD, López has turned her attention to the nation’s capital and the surrounding metro region.

“As an anthropologist, what I do different methodologically is focus qualitatively on the local context,” Lopez said. “So for me, part of my analysis is what does the portrait of opioid overdose death look like in Washington, D.C. and the DMV for those who are most impacted on the ground? And what expertise should we be rallying as we design policy and programs that work?”

With funding from the BSOS Dean’s Research Initiative, López will spend the next year recruiting participants for a study on opioid overdose from the perspective of people who use drugs. She’ll interview people about their experience with overdose prevention and access to naloxone—the controversial medication used to reverse opioid overdoses. Lopez is also working with local and national policy experts dealing with the opioid crisis to explore any disjuncture between actions at the policy level and the ability to adequately respond in community contexts.

“We have this heightened national attention on the overdose epidemic and the overdose crisis, but there are still barriers in terms of people accessing what they need and issues with stigma and the criminalization of addiction,” López explained. “The central question for me really is, if there are going to be new policies adopted to address this epidemic, how do we ensure people are able to get what they need on the ground and address issues of historical exclusion? Ethnographic methods are particularly suited to watch how this scenario plays out and what the barriers and facilitators may be in the context of increased attention and resources.”

August 31 marks International Overdose Awareness Day, which aims to educate people around the world about overdoses and reduce the stigma surrounding drug-related deaths.

López is working with a D.C.-based group called The Chosen Few to host an event at Marvin Gaye Park in the city’s northeast quadrant from 4 to 8 p.m. on Thursday, August 31. The free event will include a community-wide memorial and vigil, as well as a community dinner during which people will be invited to share stories of loved ones they’ve lost or experiences related to opioid overdose. The Chosen Few is a drug-user organizing group that seeks to represent communities impacted by the war on drugs by combating criminalization, stigma and oppression, and by promoting the health, rights and dignity of people who use drugs.

“There’s so much stigma associated with (overdose) so a lot of times family members really don’t have a space in which to memorialize their loved one in a truly open way,” López said. “This will be a place, hopefully, where people will be able to grieve in ways they haven’t been able to in other contexts. We also hope to bring attention to the fact that overdose death is a crisis in our own communities. It becomes a social justice issue to memorialize these deaths as preventable though access to naloxone and other evidenced-based prevention practices.”

Throughout the fall semester, López plans to incorporate her wealth of knowledge about the opioid epidemic into the courses she teaches on urban health and social marginality in an effort to increase awareness of overdose within the campus community.

“If you did a poll out on the mall on a busy day, the number of students who might have heard of naloxone or Narcan, which is the brand name, would probably be very slim,” López said. “But probably a number of students would know of other students who are taking pills during the semester.”

López will continue her work on this research through the next two semesters and plans to further collaborate with the Chosen Few on events and initiatives around D.C. She is also initiating a research collaboration with an epidemiologist to look at overdose in D.C. from a mixed-methods perspective.

Andrea Lopez, Assistant Professor, UMD Department of Anthropology