Dear All,
I am delighted to be involved in this discussion around opioid use and opioid misuse disorder.
My name is Nick, I am a research fellow at the university of Exeter. I have been familiar with the work of HIFA for many years, having worked as a volunteer with the organisation prior to going to medical school around 15 years ago. While my direction shifted towards the social sciences and humanities, I have maintained a focus on health and medicine.
My PhD work in anthropology focussed on understanding the relative lack of use of the opioid morphine across north Indian cancer care, particularly thinking about palliation.
I bring this concern to our discussion here. While I have begun to research opioid use disorder and "addiction", I am always wondering how the desire to regulate opioid access intersects with the availability of legitimate opioids for pain relief, particularly given the experience of the United States and the commercialisation of these drugs by pharmaceutical companies there. How can the conversation move forwards from the binaries presented by two extremes - the overprescription witnessed in the US and the absence of use elsewhere - without either foreclosing the possibilities offered by balanced access and restriction?
From the perspective of a social scientist, I am also intrigued by the varied meanings carried by opioid drugs, and how these change and influence their use/misuse. The shift induced via aggressive marketing strategies in the US for oxycontin dramatically raising its prescription rates for example. But also recognising that the US experience is only one component of a global problem, how histories of drug/pharmaceutical use elsewhere can render these drugs more or less desirable, more or less restricted or promoted.
All of which is to say I am very much looking forward to the discussion as it develops!
All the best,
Nick
HIFA profile: Nick Surawy Stepney is a Wellcome Trust research fellow at the University of Exeter. A medical anthropologist, his current research project 'Drug Addiction and De-addiction in India: Genealogies, Politics and Practices' utilises ethnographic and archival methods to examine how ‘addiction’ is imagined and intervened upon in medical settings in north India. He completed his PhD in anthropology at the department of Global Health and Social Medicine at King’s College London in September 2022, with a project analysing the material and symbolic circulations of morphine in Indian cancer care. Subsequent to this, he was a postdoctoral research associate at King's, on the project ‘Grid oncology: remaking cancer care in India’. He is a member of the HIFA working group on opioids. https://www.hifa.org/support/members/nick-surawy https://www.hifa.org/projects/mental-health-meeting-information-needs-su... nick.s.s AT hotmail.com