Using Women: Gender, Drug Policy, and Social Justice; Discovering Addiction: The Science and Politics of Substance Abuse Research; and coauthor of The Narcotic Farm: The Rise and Fall of America's First Prison for Drug Addicts and Gendering Addiction: The Politics of Drug Treatment in a Neurochemical World.Campbell applied the “Page 99 Test” to her new book, OD: Naloxone and the Politics of Overdose, and reported the following:
Appearing on page 99 is a hand-drawn figure used by Milton Helpern, Chief Medical Examiner in New York City, for a 1972 paper titled “Fatalities from Narcotic Addiction in New York City: Pathologic Circumstance and Pathologic Findings.” That page recounts Helpern’s talk before the British Society for the Study of Addiction in London. Helpern drew attention to the social and economic changes that catalyzed the increase of heroin-related deaths among youth from urban communities of color in New York City. This graph starkly illustrates the increase in such deaths from the early 1950s to the early 1970s, a time when New York Center was the epicenter of overdose in the United States.Learn more about OD: Naloxone and the Politics of Overdose at the MIT Press website.
OD is a history of the present. Page 99 is crucial to the historical tale, as these deaths became “endemic,” the grounds from which the late 20th and early 21st century overdose epidemic grew. Readers are advised to keep calm, carry on, and carry naloxone. Naloxone or NarcanTM itself emerges as a central character on page 100. In 1972, when the page 99 chart was made, naloxone had just been FDA approved and was in the process of being phased into ORs and ERs for reversing overdose.
Naloxone gradually displaced its predecessor, nalorphine or NallineTM, which the book recounts was used by police to detect if someone had recently used heroin by measuring pupil response. Let’s extend the page 99 test to pages 199 and 299. Don’t be intimidated—the book tells a big story but is punctuated by 40 illustrations ranging from ad campaigns by the Scottish Drugs Forum and NYC Health to ‘zine collages from the early overdose prevention that grew out of AIDS activism and needle exchange.
“Resuscitating Society: Overdose in Post-Thatcherite Britain” begins on page 199. This chapter recounts a very different history of overdose in a nation that maintained a cadre of “therapeutic addicts” via the so-called British System, and thus did not experience the influx of “nontherapeutic addicts” until later than the United States. Plus the UK infused harm reduction throughout the National Health Service. Scotland and Wales implemented the world’s first National Naloxone Programmes in “Trainspotting” country.
Page 299 occurs in the last chapter, “Overdose and the Politics of Redemption,” which argues that the life-and-death politics of naloxone have rendered it a “technology of solidarity.” After decades of proven effectiveness in emergency medicine, harm reduction activists wrenched naloxone out of medical hands and distributed it to drug users themselves and people likely to witness an overdose.
Getting naloxone into the hands of those who need it most took decades of dedication to harm reduction—to change law and policy, produce “proof of concept” and evidence, and build organizational infrastructure. The book captures the spirit of harm reduction because its author became a partisan. As argued in conclusion, “Harm reduction is a broad approach that may be adapted to prevent many kinds of social suffering through close attention to people, places, and things that matter. Starting from what matters most, change the world to reduce harms that we know well.”
--Marshal Zeringue
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